ENTREPRENEURS: Physicians and Medical Professionals

By Dr. David Edward Marcinko MBA

SPONSOR: http://www.MARCINKOASSOCIATES.com

***

***

SERVING ALL PHYSICIANS AND HEALTHCARE PROVIDERS

At D.E. Marcinko & Associates our clients traditionally are medical entrepreneurs that include physicians [MD, MBBS, DPM and DO], dentists [DDS and DMD], Registered Nurses [RNs], Certified Registered Nurse Anesthetists [CRNA], Physician Assistants [PA] and Nurse Practitioners [NP]. A growing cohort of clients include medical technologists, physical, speech and occupational therapists, etc.

The above healthcare providers are naturally segregated into three career tranches: 1. New practitioners, 2] Mid-Career practitioners and 3] Mature practitioners. We serve them all and are fully prepared for any special needs situation that may arise in any tranche [death, divorce, adverse risk event and/or bankruptcy, reorganization, etc].

At D. E. Marcinko & Associates, our colleagues are located throughout the United States. They are considering the sale, purchase, strategic or operational improvement, merger, acquisition and/or other business or personal financial planning transaction. Our guidance helps doctors, nurses, practices, clinics, ambulatory surgery centers, outpatient wound care facilities realize their ultimate goals.

We can do it all for you, or educate and guide do it yourself colleagues to reach the best possible outcomes.

READ MORE: https://marcinkoassociates.com/welcome-medical-colleagues/

COMMENTS APPRECIATED

Thank You

***

***

PHYSICIAN: Executive Leadership Thoughts

By Dr. David Edward Marcinko MBA

SPONSOR: http://www.MARCINKOASSOCIATES.com

***

***

[Human Nature, Medical and Financial Ethics and Modern Principles]

In any medical blog or investing treatise of gravitas, thoughts on human nature are usually placed at the end of the work, or an afterthought if included at all. However, we elected to prominently place this material as a stand alone feature. Why?

In the end, the success of any financial advisor or physician endeavor ultimately comes down to changing human behavior – helping a doctor/nurse/technician alter whatever s/he was doing toward something that will better allow them to avoid errors and pursue quality care and investing or practice management goals.

Yet, there is still remarkably little education or training for financial planners or medical professionals focused directly on motivation or change theory, in any related area except psychiatry/psychology or perhaps professional liability. Instead, doctors and advisors/planners are increasingly turning to professional consultants to learn best practices on how to help them actually make the behavioral changes necessary to achieve their medical quality improvement and client acquisition goals; as we attempt to answer these questions:

  • Are you and your medical practice, or financial advisory practice, ready for change?
  • How to transition from [traditional] solo practitioner B-models to modern forms?
  • What are leadership, management and governance?
  • In group practices, how is leadership shared?
  • What issues need be considered when hiring a financial planner or practice administrator or clinic CEO?
  • What is medical ethics and financial munificence? Why is it needed? How does it work?
  • What are the types of risk?
  • How are risks managed in the medical practice space or financial advisory eco-system?

In addition, medical and financial planning practitioners need to strive to avoid what Zenger and Folkman describe as the 10 most common leadership shortcomings based on a survey of 11,000 leaders. They include:

  1. Lacks energy and enthusiasm
  2. Accepts mediocre self performance
  3. Lacks clear vision and direction
  4. Poor judgment
  5. Not collaboration
  6. Not following standards
  7. Resistant to new ideas
  8. Doesn’t learn from mistakes
  9. Lacks interpersonal skills
  10. Fails to develop others.
  •  Source: Zenger and Folkman: The Daily Stat: The 10 Most Common Failures of Business Leaders, Harvard Business Publishing, June 4, 2009.

Leadership V. Management: https://medicalexecutivepost.com/2023/04/14/healthcare-leadership-vs-management/

COMMENTS APPRECIATED

Thank You

***

***

Can this Doctor RETIRE?

AFFORDABILITY IN 2024

By Staff Reporters

SPONSOR: http://www.MARCINKOASSOCIATES.com

***

***

CAN THIS DOCTOR RETIRE – HE ASKS?

I’m a late career entry and 55 year old burned out doctor who wants out. Can I retire in 2 years with a pension of $6,100 a month (net). I have $825,000 in my 401(k) and 457 plan and a mortgage of $95,000 at 5.30%. I am not planning to move and will retire in place.

SOME THOUGHTS AND ANSWERS?

Congratulations on you solid retirement fund on top of a pending pension. 

The first step you should take is to create a detailed budget for your retirement years. Consider expected living costs, healthcare expenses, travel and any other major expenses. Many folks make the mistake of setting up a monthly budget, but keep out significant milestones that are often costly, such as paying for a child’s college education or wedding.

Next, you should figure out your plan for housing. Mortgage payments, upkeep and taxes are important considerations. There was no mention of mortgage equity. 

Another factor to take into account is state and Federal tax projections. If the 401(k) funds are all pre-tax dollars, any distributions will be taxable and there may be penalties if funds are withdrawn prior to 59 ½ years old. That will impact your retirement plan if you’re preparing to retire at 57-58.

It also sounds like you haven’t taken into account your Social Security allowance. It’s possible that your pension is one that comes with a government pension offset which would explain why you didn’t include it. On the other hand, maybe you’re thinking it’s far out enough that it doesn’t factor into your calculations?

Finally, you may want to look for a fee-only financial advisor that is paid directly by the client and doesn’t receive commissions for recommending financial products. So, advice is less biased. And get a fiduciary advisor which means they are required to put your best interests ahead of their own. 

Also, someone with medical niche specificity. Good Luck!

***

NOTE: This is not an offer to buy or sell any security or interest. All investing involves risk, including loss of principal. Working with an adviser may come with potential downsides such as payment of fees (which will reduce returns). There are no guarantees that working with an adviser will yield positive returns. The existence of a fiduciary duty does not prevent the rise of potential conflicts of interest.

Refer a Colleague: MarcinkoAdvisors@msn.com

***

COMMENTS APPRECIATED

Thank You

***

***

Disruptive Behavior and Bullies in Medicine

“Micro-Aggressors” in Healthcare

[By staff reporters] http://www.CertifiedMedicalPlanner.org

Every workplace has “micro-aggressors” or/or bullies that exhibit disruptive behavior.

But, when the workplace is a hospital, it’s not just an employee problem.

Definition

Microaggression is a term coined by psychiatrist and Harvard University  professor Chester M. Pierce in 1970 to describe insults and dismissals he said he had regularly witnessed non-black Americans inflict on African Americans.

In 1973, MIT economist Mary Rowe extended the term to include similar aggression directed at women; eventually, the term came to encompass the casual degradation of any socially marginalized group, such as the poor and the disabled.

***

vicious-dogs-module-5ee95aa0e5064756

***

Case Report

In one reported case, the worker, felt threatened: His superior came at him “with clenched fists, piercing eyes, beet-red face, popping veins, and screaming and swearing.” He thought he was about to be hit. Instead, his angry co-worker stormed out of the room.

But, it wasn’t just any room: It was in a hospital, adjacent to a surgical area. The screamer was a cardiac surgeon, and the threatened employee was a perfusionist, a person who operates a heart/lung machine during open heart surgery. In 2008, the Indiana Supreme Court ruling in Raess v. Doescherupheld a $325,000 settlement for the perfusionist, who said he was traumatized.

PHYSICIAN COACH: https://marcinkoassociates.com/process-what-we-do/

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

 Harvard Medical School

Boston Children’s Hospital – Psychiatrist

Yale University

Crafting a Medical Practice Strategic Marketing Plan

Necessary Today – Not So In the Past

http://www.MarcinkoAssociates.com

dem

[By Dr. David Edward Marcinko; MBA, CMP™]

Invite Dr. Marcinko

Marketing plays a vital role in successful practice ventures. How well you market your practice, along with a few other considerations, will ultimately determine your degree of success or failure. 

The key element of a successful marketing plan is to know your patients – their likes, dislikes and expectations. By identifying these factors, you can develop a strategy that will allow you to arouse and fulfill their wants and needs. 

The Beginning

Identify your patients by their age, sex, income/educational level and residence. At first, target only those patients who are more likely to want or need your medical services. As your patient base expands, you may need to consider modifying the marketing plan to include other patient types or medical services. 

Your marketing plan should be included in your medical business plan and contain answers to the questions asked below:

·Who are your patients; define your target market(s)?

·Are your markets growing; steady; or declining?

·How is the practice unique?

·What is its market position?

·Where will we implement the marketing strategy?

·How much revenue, expense and profit will the practice achieve?

·Are your markets large enough to expand?

·How will you attract, hold, increase your market share?

·If a franchise, how is your market segmented?

·How will you promote your practice and services?

Practice Competition

Competition is a way of life. We compete for jobs, promotions, scholarships to institutions of higher learning, medical school, residency and fellowship programs, and in almost every aspect of our lives. 

When considering these and other factors, we can conclude that medical practice is a highly competitive, volatile arena. Because of this volatility and competitiveness, it is important to know your medical competitors. Questions like these can help you determine:

·Who are your five nearest direct physician competitors?

·Who are your indirect physician competitors?

·How are their practices: steady; increasing; or decreasing?

·What have you learned from their operations or advertising?

·What are their strengths and weaknesses?

·How do their services differ from yours?

***

Chief-Marketing-Officer

***

Patient Targeting

Patient targeting generally describes the strategic competitive advantage and/or professional synergy that is specific and unique to the practice. Intuitively, it answers such questions as:

·Who is the target market?

·How is the practice unique?

·What is its market position?

·Where will we implement the marketing strategy?

· How much revenue, expense and profit will the practice achieve?  

The science of modern marketing however, is based on intense competition largely derived from the interplay of five forces, codified in the early 1980s, by Professor Michael F. Porter of Harvard Business School. They are placed in this section of the business plan and include the following:

Power of suppliers: The bargaining power of physicians has weakened markedly in the last managed care decade.  Reasons include demographics, technology, over/under supply and a lack of business acumen. 

Power of buyers: Corporate buyers of employee healthcare are demanding increased quality and decreased premium costs within the entire healthcare industry. The extents to which these conduits succeed in their bargaining efforts depend on several factors:

·Switching Costs: Notable emotional switching costs include the turmoil caused by uprooting a trusted medical provider relationship.

·Integration Level: The practitioner must decide early on whether or not he will horizontally integrate as a solo practitioner, or vertically integrate into a bigger medical healthcare complex.

·Product Importance: Increasingly, HMOs do not often strive to delight their clients and may be responsible for the beginning backlash these entities are starting to experience. Additionally, some medical specialties have more perceived value than others (i.e., neurosurgery v. dermatology)

· Concentration:  Insurance companies, not patients, represent buyers that can account for a large portion of practice revenue, thereby bringing about certain concessions.  A danger sign is noted when any particular entity encompasses more than 15-25% of a practice’s revenues.

Threat of new entrants: Some authorities argue that medical schools produce more graduates than needed, inducing a supply side shock. Others suggest that there too many patients? Regardless, this often can be mitigated by practicing in rural or remote locations, away from managed care entities, or in areas with under-served populations.

Current or existing competition: Heightened inter-professional competition has increased the intensity and volume of certain medical services and referrals may be correspondingly with-held.  Rivalry occurs because a competitor acts to improve his standing within the marketplace or to protect its position by reacting to moves made by other specialists.

Substitutions: Examples include: PAs for DOs, nurse practitioners for MDs, technicians for physical therapists, hygienists for dentists, cast technicians for orthopedists, nurse midwives for obstetricians, foot care extenders for podiatrists and even, hospital sanitation workers for medical and surgical care technicians.  Any strategy to ameliorate these conditions will augment the successful business practice plan. 

MORE: Healthcare Market.Tensions 2,0 MARCINKO

MORE: Strategic Management Improvement

Enter the Chief Marketing Officer [CMO]

A Chief Marketing Officer or marketing director is a corporate executive responsible for marketing activities in an organization.  The CMO leads brand management, marketing communications, market research, product management, distribution channel management, pricing, often times sales, and customer service, etc.

***

DEM at Drexel

Invite Dr. Marcinko

Academic Metaphor?

Now, with all the competition today at the college and university level; notwithstanding the recent Hollywood Elite University acceptance debacle, can you see how these basic ideas might also be helpful in the academic and educational strategic marketing ecosystem?



The Emerging Role of University CHIEF STRATEGY OFFICER

***

 The changing role of a college / university Chief Marketing Office [narrow focus] –versus–  Chief Strategy Officer [broader entity focus].

Assessment

A good way to accomplish and codify the above marketing plan concept is through a SWOT analysis. Mention the Strengths, Weaknesses, Opportunities and Threats of your specialty specific practice and what you plan do to maximize the positive, and minimize the negative aspects of the analysis.

Conclusion

Only after the above forces have been considered, should you begin the process that many physicians mistake for crafting their marketing efforts; executing the actual marketing plan. 

If you are not going to the right audience, making the correct statements or delivering your message through the proper advertising channels, you might as well put your medical practice marketing plan into the trash can because it will not secure you funds, or benefit your practice. 

Do you have a marketing plan, and more importantly, how well do you execute it? 

More info: http://www.springerpub.com/prod.aspx?prod_id=23759

Speaker: If you need a moderator or a speaker for an upcoming event, Dr. David Edward Marcinko; MBA is available for speaking engagements. Contact him at: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product DetailsProduct Details

***

DAILY UPDATE: Canadian Drugs, ACA and the Mixed Stock Markets

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

***

States that have long pushed the FDA to allow drug importation from Canada touted the move as a major step forward in their efforts to lower prescription drug spending and rein in healthcare costs. But while the idea of importing drugs from Canada is new for states, some businesses have been using existing drug import pathways to help consumers save money on certain high-cost medications.

***

More than 20 million US residents—a record number, according to the Biden administration—have signed up for health insurance through the Affordable Care Act’s marketplaces. (the New York Times)

***

Here’s where the major benchmarks ended:

Stocks were a mixed bag yesterday as investors pored over the first big earnings reports and new data showing that wholesale prices surprisingly went down in December. Airlines took a hit after Delta beat earning expectations but lowered its profit forecast.

  • The S&P 500 index rose 3.59 points (0.1%) to 4,783.83, up 1.8% for the week; the Dow Jones Industrial Average® (DJI) fell 118.04 points (0.3%) to 37,592.98, up 0.3% for the week; the NASDAQ Composite rose 2.57 points to 14,972.76, up 3.1% for the week.
  • The 10-year Treasury note yield (TNX) fell about 3 basis points to 3.943%.
  • The CBOE® Volatility Index (VIX) rose 0.26 to 12.70.

Retailers and consumer discretionary shares were among the market’s weakest performers Friday, and regional banks were also under pressure. The KBW Regional Banking Index (KRX) fell 2% for the week and ended at a one-month low. Energy shares led gainers behind strength in crude oil futures. The small-cap-focused Russell 2000® Index (RUT) ended little-changed for the week but is still down 3.8% so far this year.

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

COMMENTS APPRECIATED

Thank You

***

***

BANKS: JPMorgan Chase, BoA, Wells Fargo and CitiGroup Report

By Staff Reporters

***

***

JPMorgan Chase’s profit fell in the fourth quarter as the lender set aside nearly $3 billion to help refill a government deposit insurance fund. JPMorgan and several major banks are required to pay a bulk of the $16 billion to replenish the Federal Deposit Insurance Corporation’s deposit insurance fund (DIF), which was drained after Silicon Valley Bank and Signature Bank failed last year.

***

Bank of America’s fourth-quarter profit shrank as the lender took $3.7 billion in combined charges to refill a government deposit insurance fund and phase out a loan index. Its net interest income (NII) – the difference between what banks earn from loans and pay to depositors – fell 5% to $13.9 billion as the company spent more to keep customer deposits and demand for loans stayed subdued amid high interest rates.

***

Wells Fargo press release (NYSE:WFC): Q4 Non-GAAP EPS of $1.29 beats by $0.20. Revenue of $20.48B (+2.2% Y/Y) beats by $100M. Shares -1% PM. Fourth quarter 2023 results included: ◦ $(1.9) billion, or ($0.40) per share, of expense from an FDIC special assessment ◦ $(969) million, or ($0.20) per share, of severance expense for planned actions ◦ $621 million or $0.17 per share, of discrete tax benefits related to the resolution of prior period tax matters ◦ Provision for credit losses in fourth quarter 2023 included an increase in the allowance for credit losses driven by credit card and commercial real estate loans, partially offset by a lower allowance for auto loans. The change in allowance for credit losses also included higher net loan charge-offs for commercial real estate office and credit card loans

***

Citigroup (C) is in the middle of a complicated restructuring. It made it clear Wednesday that its fourth quarter earnings report Friday will be complicated, too.

The giant New York-based bank said in a regulatory document it will take more than $3 billion in one-time reserves and expenses as part of those fourth quarter results. They include everything from a $1.3 billion reserve build for currency exposure in Argentina and Russia to $780 million in charges related to severance costs and other aspects of a wide-ranging restructuring of the bank led by CEO Jane Fraser.

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

***

***

COMMENTS APPRECIATED

Thank You
***

***

DAILY UPDATE: Stock Markets Rocket Upward

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

***

Investors are a day away from an inflation report that may offer some direction in a young year that has seen markets meander, with a brief sell-off and a partial rally back. More action may come as Wall Street banks kick off earnings season on Friday.

Here is where the major benchmarks ended:

  • The S&P 500 index rose 26.95 points (0.6%) to 4,783.45, a two-year closing high; the Dow Jones Industrial Average® (DJI) increased 170.57 points (0.5%) to 37,695.73; the NASDAQ Composite gained 111.94 points (0.8%) to 14,969.65.
  • The 10-year Treasury note yield (TNX) added about 2 basis points to 4.04%.
  • The CBOE® Volatility Index (VIX) fell 0.06 to 12.70.

Among market sectors, the S&P 500 Communication Services Index (SP500#50), which includes “mega-cap” tech companies like Google parent Alphabet (GOOGL) and Facebook parent Meta Platforms (META), gained 1.2% and ended near a two-year high. Consumer discretionary shares were also firm. Energy stocks were one of the weakest performers behind a 1.3% drop in crude oil futures.

Peterson noted strength in tech shares may in part reflect news from this week’s Consumer Electronics Show in Las Vegas, with escalating bullishness surrounding artificial intelligence (AI) driving further gains in Nvidia (NVDA) and other chip companies capable of serving the most advanced forms of AI. Nvidia has jumped more than 10% so far this week and posted a record high for the third straight day.

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

COMMENTS APPRECIATED

Thank You

***

***

DOWN: Digital Health Care Funding

By Dr. David Edward Marciniko MBA CMP

SPONSOR: http://www.MarcinkoAssociates.com

***

***

DEFINITION: According to the Food and Drug Administration [FDA], the broad scope of digital health includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, tele-health and tele-medicine, and personalized medicine. From mobile medical apps and software that support the clinical decisions doctors make every day to artificial intelligence and machine learning, digital technology has been driving a revolution in health care. Digital health tools have the vast potential to improve our ability to accurately diagnose and treat disease and to enhance the delivery of health care for the individual. Digital health technologies use computing platforms, connectivity, software, and sensors for health care and related uses. These technologies span a wide range of uses, from applications in general wellness to applications as a medical device. They include technologies intended for use as a medical product, in a medical product, as companion diagnostics, or as an adjunct to other medical products (devices, drugs, and biologics). They may also be used to develop or study medical products.

Cite: http://tinyurl.com/2jbafuc7

***

As many investors predicted, digital health funding took a dive in 2023, according to Rock Health’s year-end funding report. Startups got creative to stay afloat but many digital health founders will have to “face the music” in 2024, the VC firm’s analysts say.

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

Editor’s Note: I am on the Advisory Board of Medblob™a start-up based in Boston, MA. The digital mission of Medblob™ is to improve community and national health by allowing patients to better manage their health, providers to better treat their patients, and researchers to have the best information to discover cures to the most prevalent and pernicious diseases.

COMMENTS APPRECIATED

Thank You

***

***

DAILY UPDATE: Stocks Rocket Back for Highest 2024 Close as Key Inflation Updates Loom

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

***

Here is where the major benchmarks ended:

Bond yields and stock prices often move inversely to each other, in part because higher interest rates on virtually risk-free bonds lower the premium investors can expect from riskier assets like stocks, making it less appealing to buy equities. Last week, the 10-year Treasury yield briefly increased to 4.10%, near a three-week high, before dropping back near 4% Monday.

  • The S&P 500 index was up 66.30 points (1.4%) at 4,763.54; the Dow Jones Industrial Average was up 216.90 points (0.6%) at 37,683.01; the NASDAQ Composite was up 319.70 points (2.2%) at 14,843.77.
  • The 10-year Treasury note yield (TNX) was down about 3 basis points at 4.015%.
  • The CBOE® Volatility Index (VIX) was down 0.28 at 13.07.

Semiconductors shares were among the strongest performers, helped by a surge of 6.4% in Nvdia Corp. (NVDA), the top 2023 performer in the S&P 500 with a gain of 239%. Small-cap stocks were also firm as were consumer discretionary and communication services. The Russell 2000® Index (RUT) gained 1.9% to partly climb back from last week’s 3.7% drop.

Energy shares were soft because crude oil futures sank nearly 4% following reports Saudi Arabia lowered its prices.

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

COMMENTS APPRECIATED

Thank You

***

***

DAILY UPDATE: Crypto-Currency, ETFs and the Stock Markets

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

The Markets as of 10:00am ET. Here’s what these numbers mean.
Markets: One week into 2024, stocks and bonds are off to their worst start in 21 years as investors maybe got a bit ahead of their skis in anticipating Fed rate cuts.

This week, Wall Street will be focused on fresh inflation data and the beginning of Q4 earnings season.

                        

Bitcoin ETF cleared for launch? The first spot bitcoin ETF—could be approved by regulators this week in what would be a watershed moment for Wall Street’s embrace of digital tokens. The hype around these proposed funds, which would allow regular investors to gain exposure to bitcoin without buying it directly, drove bitcoin’s price up 162% over the past year.

Here is where the major benchmarks ended:

  • The S&P 500 Index was up 84.15 points (1.9%) at 4,495.70; the Dow Jones Industrial Average (DJI) was up 489.83 points (1.4%) at 34,827.70; the NASDAQ Composite (COMP) was up 326.64 points (2.4%) at 14,094.38.
  • The 10-year Treasury note yield (TNX) was down about 18 basis points at 4.453%.
  • CBOE’s Volatility Index (VIX) was down 0.60 at 14.16.

The small-cap focused Russell 2000 Index (RUT), which has lagged large-cap benchmarks for most of the year, jumped more than 5% Tuesday. Small-caps are often seen as being more exposed to the economic cycle and had suffered because of concerns that high interest rates could push the economy into recession.

Other interest rate-sensitive sectors, such as real estate, materials, and utilities, also saw outsize gains.

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

COMMENTS APPRECIATED

Thank You

***

***

DAILY UPDATE: “Medical Properties Trust” Tanks, FDA Approves Canadian Drugs and Medicare Advantage Health Plan [Part C] Patient Traps

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Markets: Stocks climbed a bit on Friday as investors took in the news that the US added more jobs than expected in December, capping off an epic 2023 for the labor market. But it wasn’t a bright start to the year, as all three major averages broke a nine-week winning streak. Stock spotlight: The country’s largest hospital landlord, Medical Properties Trust, tanked after revealing that its biggest tenant was $50 million behind on rent.

***

Yesterday, the Food and Drug Administration (FDA) approved Florida’s request to import bargain medications from the country. It’s the first state to get permission from the agency to bring in medications from Canada under a law Congress passed 20 years ago to help Americans pay less for drugs. Florida officials say ordering cheaper drugs for conditions like HIV and diabetes from Canadian wholesalers will save Medicaid and other state programs $150 million over the first year.

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

***

Older Americans say they feel trapped in Medicare Advantage plans.

READ HERE: http://tinyurl.com/yck2yb8z

COMMENTS APPRECIATED

Thank You

***

***

IMPLICATION OF WITHDRAWALS IN A MODERATE INTEREST RATE ENVIRONMENT

  A SPECIAL ME-P REPORT

A Retrospective Review … and Implications for Modernity

[Copyright Manning & Napier Advisors, Inc.]

Dr. Jeff Coons

By Jeff Coons PhD CFA

By Dr. David Edward Marcinko MBA CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

The general trend of declining interest rates experienced over the last several decades, part of a long-term trend Manning & Napier Advisors, Inc. and others have focused on since the early 1980’s, created new challenges for managing investment portfolios with regular and significant cash withdrawals.

Historical Review

This continuing report, first prepared 25 years ago, will provide an analysis of the investment implications of withdrawals in light of the secular shift in the economic and market conditions today. This analysis and historical review aims to guide decisions as to the appropriate level of withdrawals from an account in the more current moderate interest rate environment of 2014; and estimated thru to 2023.

The Questions

Declining interest rates restrict the ability to generate income from high quality investments, so a greater proportion of a given withdrawal requirement must come from the potential price appreciation of the securities.  Of course, the inherently volatile nature of the financial markets makes price appreciation the less predictable of the sources of total return available to fund withdrawal needs.

The natural questions that arise from this observation include:

  • What withdrawal rate inhibits the ability to pursue long-term capital growth as a primary investment objective?
  • What withdrawal rate may create a significant risk of a sustained deterioration of capital?
  • What is a reasonable range of withdrawal rates given the relatively low interest rate environment that we face? 

The answer to the first question can be derived from interest rates and dividend yields.  With a dividend yield of 1.0%-2.0% on stocks (e.g., the yield on the S&P 500 Index as of December 2000 was 1.2%) and yields on intermediate-term and long-term fixed income securities between 5.0% and 6.0% (e.g., as of December 2000, a one-year Treasury Bill had a yield of 5.4% and a thirty-year Treasury bond had a yield of 5.5%), growth-oriented portfolios should generally produce a level of income adequate to allow 2.5%-3.5% withdrawals on an annual basis.

Thus, rates of withdrawal of less than 3.5% generally should not inhibit the pursuit of long-term capital growth as a primary investment objective.

***

Portfolio analysis

***

Management Approach

To establish the high end of the achievable withdrawals under a management approach pursuing long-term capital growth, consider some historical evidence.

Assume that withdrawals are taken from each of three portfolios (i.e., 100% stocks, 80% stocks/20% bonds, and 50% stocks/50% bonds using data from Ibbotson Associates, Inc.) starting at the beginning of 1973.  How many years did it take to regain the original capital of the portfolio?

As can be seen in the following table, it took between 4-8 years for these portfolios to recover from the 1973-74 bear market with a 5.0% withdrawal rate.  If withdrawals are at a 7.5% rate per year, over ten years elapsed before the original capital was restored.

Finally, with a 10.0% withdrawal rate, it took between 13-15 years to restore the capital.  While the 1973-74 bear market was severe, it is not the worst bear market that can be used to illustrate the risk of significant withdrawals taken when the portfolio’s market value is depressed.

The clear conclusion is that withdrawals of greater than 5.0% are a potential impediment to pursuing long-term capital growth, given the long periods required to restore capital for the various growth-oriented asset mixes offered in this analysis.

***

When Was Original (12/72) Capital Restored?
  1. 0% W/D
 

  1. 5% W/D
 

  1. 0% W/D
 100% Stock  9/80(7.75 years) 6/83(10.5 years) 6/86(14.5 years)
80% Stock/ 20% Bond  9/80(7.75 years) 3/83(10.25 years) 6/86(14.5 years)
50% Stock/ 50% Bond  12/76(4.0 years) 3/83(10.25 years) 3/87(15.25 years)

***

Another key issue to remember is that the withdrawal rates above are a percentage of current market value, so the dollar value of the cash withdrawn from the account is assumed to decline in a bear market.  However, most of us think of our withdrawal needs in terms of dollars instead of percentages (e.g., $50,000 from a $1,000,000 account, which translates to 5%).

If we attempt to maintain the dollar value of withdrawals in bear market periods, the percentage of current market value being withdrawn actually increases, and the impact on the portfolio far exceeds the example provided above.

SAMPLE:

To demonstrate, consider maintaining withdrawals of $50,000, $75,000 and $100,000 on an account with a $1,000,000 market value as of 12/72 (see table below).

In the case of a $50,000 annual withdrawal, approximately 8-10 years elapse before the original $1,000,000 market value is restored.  If the withdrawals are $75,000 per year, 13 years elapse for the 50/50 asset mix and almost 19 years pass for the 80/20 asset mix before the $1,000,000 is restored.  For the 100% stock portfolio, nearly 25 years elapse before the original $1,000,000 is restored.

Finally, for $100,000 withdrawals off of a $1,000,000 market value in 1972, all capital in the account is depleted within 10-15 years given these withdrawals.  Thus, the risk of significant cash withdrawals having a detrimental impact on the ability to preserve and grow capital is much more pronounced when withdrawals remain high in dollar terms.

***

When Was Original Capital ($1,000,000 in 12/72) Restored?
$50,000 W/D  $75,000 W/D  $100,000 W/D
 100% Stock  3/83(10.25 years) 9/97(24.75 years) Capital Depleted9/83
80% Stock/ 20% Bond  12/80(8.0 years) 9/91(18.75 years) Capital Depleted3/85
50% Stock/ 50% Bond  9/80(7.75 years) 3/86(13.25 years) Capital Depleted9/87

***

So far, the major point we have established is that a withdrawal rate of 2.5%-3.5% may be achievable without hampering the pursuit of long-term capital growth, but withdrawals of 5% or greater may have a significant impact on the ability to manage for growth.  Therefore, accounts expected to experience withdrawals of 4%-5% (or greater) should be managed with a goal of satisfying these withdrawal needs on a regular basis first, with the pursuit of capital growth taking secondary importance.

However, the analysis provided above also implies that there is a rate of withdrawals that forces us to focus on capital preservation, because depletion of capital is a likely outcome.  For withdrawals in the range of 10.0%, the example above shows that the risk of depletion of capital is significant at these high annual levels, especially if the withdrawals are on a dollar basis and not adjusted by the decline of current market value in a bear market.

In fact, with long-term U.S. government bond yields at approximately 5.0%-6.0%, annual withdrawals greater than 7.5% are likely to be too high to allow a manager to effectively pursue long-term capital growth without a high degree of risk to the capital of the account.  That is, since attempts to provide returns above the current Treasury yields imply risk of volatility, and volatility can lead to the examples provided above, withdrawals at 7.5% or more and maintained on a dollar basis imply a high likelihood that original capital will be depleted over a 15-20 year period.

In general, the current level of yields in the market imply that management of a portfolio requiring over 7.5% per year in withdrawals faces a strong possibility of depleting capital under any scenario, and so portfolio management should focus on dampening market volatility so as to extend the life of the capital for as long as possible as it is drawn down.

Final Questions

The final question[s] (i.e., the appropriate level of withdrawals) is driven by both the client’s need for the assets and the parameters outlined above:

  1. Withdrawals less than 3.5% of current market value should not inhibit the pursuit of long-term capital growth as a primary objective.
  2. Withdrawal rates between 3.6% and 7.4% require a primary focus on satisfying withdrawal needs over the market cycle, possibly with a secondary goal of long-term capital growth to protect future withdrawal needs.
  3. Withdrawal rates greater than 7.5% are likely to result in a depletion of capital, so the goal should be to manage the drawdown of capital by dampening year-to-year volatility of the portfolio.

While we all would like to achieve capital growth, the ability to pursue growth-oriented strategies depends on the flexibility to moderate withdrawals, if required by market conditions, and on the overall reliance on these assets.

As another example, an endowment can control its withdrawals to some extent, but there is a level beyond which the belt cannot be tightened without harming the services being funded.

Yet another example comes from a physician-executive or someone living primarily on an IRA account, especially after becoming accustomed to the high (and falling) interest rate/high asset return environment of the last fifteen years.  Aggressively pursuing capital growth in the face of large withdrawals may result in exposure to significant risk of depletion of the IRA assets when other sources of income are unavailable.

If, on the other hand, the IRA was a small part of the wealth available in retirement, then there is some flexibility to work towards long-term capital growth.

Financial Planning MDs 2015

Implications for defined benefit retirement plans

A defined benefit retirement plan may have an outside source of funding to help restore capital (i.e., contributions from the employer), but defined contribution and Taft-Hartley plans have much less of a safety net.  As a result, the risk taken to pursue growth in the face of significant withdrawals must take into account the nature of the assets and the problems associated with a deterioration of capital in the account.

Assessment

And so, withdrawals can have a significant impact on the ability of a manager to preserve capital and pursue long-term capital growth.  However, while lessening the level of withdrawals will help provide flexibility for the manager to pursue these goals, the need for the assets may require that withdrawals are maintained at a certain level.  Once withdrawals are minimized, the manager should focus on investment goals that correspond with this minimum level.

If withdrawals are below 3% of current market value, pursuit of long-term capital growth can be a primary objective.  Withdrawals between 4% and 7.5% of market value on an annual basis require a focus on working towards satisfying these annual needs.  Long-term capital growth, in this case, should be a secondary goal.

Finally, if withdrawals are above a 7.5% annual rate, then the investment management approach should focus on preserving capital and dampening market volatility so as to work towards allowing the assets to last as long as possible as they are drawn down.

NOTE: The 10-year Treasury rate’s just fell below 3.91% after Fed, ECB nominees; today.

Conclusion

This historical review paper provides a retrospective review of IRs and implications for modernity.

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

Product DetailsProduct DetailsProduct Details

Product Details

Product Details

***

Invite Dr. Marcinko

***

DAILY UPDATE: Walgreens’s Dividend Dives as Stocks Post Down Week

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

DEFINITION: A stock dividend is a payment to shareholders that consists of additional shares rather than cash. The distributions are paid in fractions per existing share. For example, if a company issues a stock dividend of 5%, it will pay 0.05 shares for every share owned by a shareholder. The owner of 100 shares would get five additional shares.

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

Stat: 3.9%. That’s Walgreens’s new dividend yield after the pharmacy chain cut its quarterly dividend of 7.0%. The company said that it was using the money to “strengthen [its] long-term balance sheet and cash position.” Walgreens stock fell 11% the day after the announcement. (CNBC)

Here is where the major benchmarks ended:

  • The S&P 500 index was up 8.56 points (0.2%) at 4,697.24, down 1.6% for the week; the Dow Jones Industrial Average® (DJI) was up 25.77 points (0.1%) at 37,466.11, down 0.6% for the week; the NASDAQ Composite® (COMP) was up 13.77 points (0.1%) at 14,524.07, down 3.2% for the week.
  • The 10-year Treasury note yield (TNX) was up about 6 basis points at 4.051%.
  • The CBOE® Volatility Index (VIX) was down 0.77 at 13.36.

Consumer staples and real estate ranked among the market’s weakest performers Friday, and technology shares remained under pressure with tech bellwether Apple (AAPL) extending this week’s nearly-6% slide and ending near a two-month low. Financial shares were one of the stronger sectors with the Philadelphia KBW Bank Index (BKX) rising 1.6% to a 10-month high. Small-cap stocks remained in the red with the Russell 2000® Index (RUT) ending the week down 3.7%. 

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: Second Apple Downgrade with Mixed Markets as Investors Await Payroll Data and Lilly Sells Medications Directly to Patients

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) was down 16.13 points (0.3%) at 4,688.68; the Dow Jones Industrial Average® (DJI) was up 10.15 points at 37,440.34; the NASDAQ Composite was down 81.91 points (0.6%) at 14,510.30.
  • The 10-year Treasury note yield (TNX) was up about 9 basis points at 3.997%.
  • The CBOE® Volatility Index (VIX) was up 0.08 at 14.12.

Oilfield services and consumer discretionary shares were also among the market’s weakest performers Thursday. Banking and health care were among the strongest sectors, illustrating renewed investor interest in stocks that lagged the broader market last year.

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

And, Eli Lilly is poised to sell medicine directly to consumers — with an emphasis on newly popular weight-loss drugs — in a move toward cutting out the controversial middle players in drug distribution.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: Technology Stocks Tank on Perihelion Day

By Staff Reporters

***

Today the Earth is the closest it can get to the sun, a point in orbit known as perihelion, which happens every year two weeks after the December solstice.

***

SPONSOR: http://www.MarcinkoAssociates.com

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) was down 38.02 points (0.8%) at 4,704.81; the Dow Jones Industrial Average® (DJI) was down 284.85 points (0.8%) at 37,430.19; the NASDAQ Composite was down 173.73 points (1.2%) at 14,592.21.
  • The 10-year Treasury note yield (TNX) was down about 3 basis points at 3.91%.
  • The CBOE® Volatility Index (VIX) was up 0.84 at 14.04.

In addition to tech shares, retailers and banks were also among the market’s weakest performers Wednesday. Small-cap stocks were also under pressure with the Russell 2000® Index (RUT) down about 2.7% to a three-week low. Energy shares strengthened behind a jump of nearly 4% in crude oil futures.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Thank You

***

***

DAILY UPDATE: Apple and the “Magnificent 7” Stocks Drop with the Markets

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Driving much of the tech slump was a 4% drop by Apple’s stock, a dive precipitated by an analyst downgrade questioning why the $2.9 trillion (market capitalization) company is trading at such an expensive valuation considering its negative earnings and profit growth.

Other members of the “magnificent seven” tech stocks, which gained a collective $5.1 trillion in market cap last year, also flailed Tuesday. Alphabet, Amazon, Meta, Microsoft, Nvidia and Meta each fell 1.6% or more, while Tesla was the sole magnificent seven member in the green, as its shares slipped less than 1% after reporting more fourth-quarter electric vehicle deliveries than fore-casted.

Here is where the major benchmarks ended:

  • The S&P 500 index was down 27.00 points (0.6%) at 4,742.83; the Dow Jones Industrial Average® (DJI) was up 25.50 points (0.1%) at 37,715.04; the NASDAQ Composite was down 245.41 points (1.6%) at 14,765.94.
  • The 10-year Treasury note yield (TNX) was up about 7 basis points at 3.931%.
  • The CBOE® Volatility Index (VIX) was up 0.73 at 13.18.

Semiconductor companies led the way lower Tuesday after Bloomberg reported Netherlands-based ASML Holding NV (ASML) canceled shipments of some of its machines to China at the request of U.S. President Biden’s administration weeks before export bans on the high-end chipmaking equipment came into effect. The Philadelphia Semiconductor Index (SOX) tumbled 3.7%. Health care and energy sectors were among the few areas of strength, the latter gaining despite a 1.6% drop in crude oil futures.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: ChristianaCare Settles FCA Lawsuit as Stock Markets Celebrate 2023 but Start Off Rocky in 2024

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

ChristianaCare agreed to pay $47.1 million to resolve illegal kickback allegations flagged by its former chief compliance officer.

***

Markets: The stock market was closed yesterday to give investors time to celebrate New Year’s Day 2024. As the just passed old year, 2023, provided plenty of reasons to pop bottles and celebrate:

For example, global stock markets had their best year since 2019, and all three major US indexes finished the year higher than they started it, with tech company gains pushing the NASDAQ up the most. Even among tech giants, Nvidia was a standout, boosted by A.I. suddenly being everywhere.

But, all major markets are down as of this posting time, today.

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

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Thank You

***

***

HELPING DOCTORS ACHIEVE: New Year Resolutions

COACHING AND MENTORING

Physician Goal Setting [Business V. Personal Approach] in 2024

By Marcinko Associates, Inc.

SPONSOR: http://www.MarcinkoAssociates.com
***

CORPORATE APPROACH

The year-end physician, nurse and/or medical employee reviews in general aren’t very effective at motivating employees in ACOs, and VBC organizations, etc.

And, according to a Gallup [non-medical worker] poll, only 14% of employees “strongly agreed” that a performance review inspired them to improve. But in recent years, some workplaces have changed how they conduct performance reviews—or abandoned them altogether especially in technology.

  • A decade ago, Microsoft disbanded its version of stack ranking, the practice pioneered by General Electric CEO Jack Welch in the 1980s in which the company would rank every employee. Experts say it hurts morale and can create a toxic work culture.
  • Netflix has around 10,000 employees but has eschewed the year-end review for informal conversations during the year.
  • Google revamped its system last May by reducing performance reviews from twice to once a year.
  • Apple dropped performance reviews completely.

Healthcare business and corporate employees want feedback, even physicians, but it has to be useful.

PERSONAL APPROACH

Now that you’ve set your personal goals on your landmark date (New Year 2024), how you pursue it will go a long way toward whether you achieve it. There are generally two ways to tackle the goals you’ve set for yourself—and one yields more success than the other.

  • Avoidance goals: While this works well when it comes to your ex-medical partner or spouse, it’s not how you want to attack resolutions. Avoidance goals include “stop eating sweets” or “watch less TV.”
  • Approach goals: Instead of avoiding a behavior, you create a new one. Your goals would be “eating more vegetables” or “reading more books” to replace the habits you want to shake.

And, a recent study found that approach goals are more likely to be accomplished (59%) than avoidance goals (47%) across a wide range of potential resolutions. Good luck with that!

WE CAN HELP.

COMMENTS APPRECIATED

Thank You

PHYSICIAN COACHING: https://marcinkoassociates.com/process-what-we-do/

***

***

HAPPY NEW YEAR: From All of Us at the ME-P

***

www.CERTIFIEDMEDICALPLANNER.org

www.MARCINKOASSOCIATES.com

***

***

EDUCATION: https://marcinkoassociates.com/textbooks-academic-catalog/

***

 From us all to you and yours.
Here’s to making a difference and paying it forward today, in 2024, and beyond. 

THANK YOU

***

DAILY UPDATE: S&P 500 is High as McKinsey Settles Opioid Claims

***

The S&P 500 has climbed about 24% in 2023, hovering right around its all-time high. And, the NASDAQ Composite is up 44%, although the tech-heavy index still has some ground to cover before it starts carving out new all-time highs of its own.

***

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Consulting firm McKinsey and Co. has agreed to pay $78 million to settle claims from insurers and health care funds that its work with drug companies helped fuel an opioid addiction crisis. The agreement was revealed late Friday in documents filed in federal court in San Francisco. The settlement must still be approved by a judge.

Under the agreement, McKinsey would establish a fund to reimburse insurers, private benefit plans and others for some or all of their prescription opioid costs. The insurers argued that McKinsey worked with Purdue Pharma – the maker of OxyContin – to create and employ aggressive marketing and sales tactics to overcome doctors’ reservations about the highly addictive drugs. Insurers said that forced them to pay for prescription opioids rather than safer, non-addictive and lower-cost drugs, including over-the-counter pain medication. They also had to pay for the opioid addiction treatment that followed.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Thank You

***

***

DAILY UPDATE: Stocks Fall on Last Day of a Strong 2023 Year

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Here’s where the major benchmarks ended:

  • The S&P 500 index fell 13.52 points (0.28%) to 4,769.83; the Dow Jones Industrial Average® was down 20.56 points (0.05%) at 37,689.54; the NASDAQ Composite® (COMP) was down 83.78 points (-0.56%) at 15,011.35.
  • The 10-year Treasury note yield (TNX) rose nearly 2 basis points to 3.86%. 
  • The CBOE® Volatility Index (VIX) finished nearly unchanged at 12.51, still near recent four-year lows.

The S&P 500 and Dow Jones Industrial Average posted their ninth consecutive weekly advances, but the NASDAQ Composite finished slightly lower for the week, hurt in part by a soft performance from Apple (AAPL). The Russell 2000® Index (RUT) fell 1.18% on Friday but climbed 15% for the year.

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

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: Another Health System Data Breach as the “Magnificent Seven” Stocks End Mixed

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

A health system in Michigan has experienced its second cybersecurity breach this year, affecting more than 1 million patients, according to state officials. Michigan Attorney General Dana Nessel announced Tuesday there was a breach at HealthEC, a vendor that provides services to Corewell Health’s southeast Michigan properties. The breach exposed patients’ personal and medical information.

***

***

With Nvidia and Tesla on the rise, acronyms like FAANG and MAMAA no longer cut it: The top tech giants (Amazon, Alphabet, Apple, Meta, Google, plus Nvidia and Tesla) have now been dubbed the “Magnificent Seven.” Buoyed by the generative AI gold rush, they were responsible for 29% of the S&P 500’s total value.

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 1.77 points at 4,783.35; the Dow Jones Industrial Average was up 53.58 points (0.1%) at 37,710.10; the NASDAQ Composite® (COMP) was down 4.04 points at 15,095.14.
  • The 10-year Treasury note yield (TNX) was up nearly 6 basis points at 3.844%.
  • The CBOE® Volatility Index (VIX) was up 0.03 at 12.46.

The S&P 500, Dow Jones Industrial Average, and NASDAQ Composite are all on track for a ninth consecutive weekly advance. Other parts of the market Thursday turned in mixed performances. The Russell 2000® Index (RUT) fell 0.4% but is still on track for a seventh consecutive weekly gain and has climbed 17% for the year.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: 2023 Business Start-Up Failure Review with Stock Market Gains

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

***

3,200 business startups failed in 2023, according to PitchBook data. Those startups raised more than $27 billion combined, or roughly the 2022 GDP of Cambodia. (Business Insider).

***

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 6.83 points (0.1%) at 4,781.58; the Dow Jones Industrial Average was up 111.19 points (0.3%) at 37,656.52; the NASDAQ Composite® (COMP) was up 24.60 points (0.2%) at 15,099.18.
  • The 10-year Treasury note yield was down over 9 basis points at 3.791%.
  • The CBOE® Volatility Index (VIX) was down 0.49 at 12.50.

Small-cap stocks continued a strong finish to the year as the Russell 2000® Index (RUT) gained 0.3% to settle at its highest level since April 2022. Retailer shares were among the market’s strongest performers amid reports of strong holiday sales. The S&P Retail Select Industry Index (SPSIRE) rose 0.6% and ended near an 11-month high.

In other markets, the U.S. dollar traded around $1.11 versus the euro (EUR/USD), its weakest level since late July and a reflection of expectations that lower rates in the United States will prompt investors to seek higher returns elsewhere.

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

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: Holiday Spending Solid as Stock Market Rally Continues

By Staff Reporters

***

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Consumer spending grew solidly this holiday season, rebuking concerns of a slowdown and reinforcing positive signals about the U.S. economy as it approaches the end of a tumultuous year.

Buying among shoppers rose 3.1% over the holidays compared to the same period last year, according to data released on Tuesday by Mastercard SpendingPulse, which measures in-store and online purchases from November 1st to December 24th across all forms of payment. The data is not adjusted for inflation.

***

Here’s where the major benchmarks ended: 

  • The S&P 500 index was up 20.12 points to 4,774.75 up 0.42%; the Dow Jones Industrial Average was up 159.36 points at 37,54533, up 0.2% ; the NASDAQ Composite® (COMP) was up 81.6 points to 15,074.57 up 0.54% to start the week.  
  • The 10-year Treasury note yield (TNX) was down 1 basis point to 3.895%.
  • The CBOE® Volatility Index (VIX) was down 0.38% to 12.98.

Small-cap stocks continued to outpace their larger cousins, a common theme lately. The Russell 2000® Index rose Tuesday following six weeks of gains. Financials and real estate sectors were among strongest S&P 500 performers during the session, and the Russell 2000 has a heavy exposure to financials. In other markets, the U.S. Dollar Index (DXY) extended its recent slide and now trades at five-month lows, reflecting ideas that potentially lower interest rates may prompt investors to seek higher returns elsewhere.

With just three trading days left in 2023, the S&P 500 and other major equity benchmarks are poised to turn in a strong year that may more than make up for 2022’s losses. With Tuesday’s gains factored in, the SPX is closing in on its all-time high close just below 4,800 posted in early 2022. Through Tuesday, the S&P 500 was up more than 24% for the year, after tumbling 19.4% in 2022. The Dow Jones Industrial Average and the NASDAQ Composite were up 13% and 44%, respectively, after losing 8.8% and 33% in 2022.

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

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: Happy “Festivus” with Drug Delays as the Stock Market Win Streak Continues

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Festivus is a secular holiday on December 23rd as an alternative to the pressures and commercialism of the Christmas Season. Originally created by author Daniel O’Keefe, Festivus entered popular culture after it was made the focus of the 1997 Seinfeld episode which O’Keefe’s son, Dan,co-wrote.

The non-commercial holiday’s celebration includes a Festivus dinner, an unadorned aluminum Festivus pole, practices such as the “airing of grievances” and “feats of strength”, and the labeling of easily explainable events as “Festivus miracles”. The TV episode refers to it as “a Festivus for the rest of us”.

It has been described both as a parody holiday festival and as a form of playful consumer resistance. Journalist Allen Salkin describes it as “the perfect secular theme for an all-inclusive December gathering”.

***

***

(Bloomberg) — Drug-makers are slow-walking products to market to get around President Joe Biden’s plan to lower medication prices.

Companies from Roche Holding AG to biotech Alnylam Pharmaceuticals Inc. are among those delaying or evaluating therapies in light of the government’s new ability to negotiate for lower prices. Firms that normally try to sell drugs as soon as possible are suspending clinical trials and shifting timelines, while patient groups are demanding change. 

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 7.88 points (0.2%) at 4,754.63, up 0.8% for the week; the Dow Jones Industrial Average was down 18.38 points at 37,385.97, up 0.2% for the week; the NASDAQ Composite® (COMP) was up 29.11 points (0.2%) at 14,992.97, up 1.2% for the week.
  • The 10-year Treasury note yield (TNX) was up about 1 basis point at 3.901%.
  • The CBOEe® Volatility Index (VIX) was down 0.62 at 13.03.

Small-cap stocks continued a strong finish to the year. The Russell 2000® Index (RUT) rose 0.8% Friday to end at its highest level since April 2022 and rose 2.5% for the week, the small-cap benchmark’s sixth consecutive weekly gain. Regional banks and utilities were also among the strongest performers. In other markets, the U.S. Dollar Index (DXY) extended its recent slide and dropped to its weakest level since late July, reflecting ideas an outlook for lower interest rates may prompt investors to seek higher returns elsewhere.

Finally, with just four trading days left in 2023, the S&P 500 and other major equity benchmarks are poised to turn in a strong year that may more than make up for 2022’s losses. Through Friday, the S&P 500 was up nearly 24% for the year, after tumbling 19.4% in 2022. The Dow Jones Industrial Average and the NASDAQ Composite were up 13% and 43%, respectively, after losing 8.8% and 33% in 2022.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: Three Arrows Capital is Down as Stock Markets Rebound

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

***

Almost $1 billion in assets belonging to the founders of cryptocurrency hedge fund Three Arrows Capital have been frozen by a British Virgin Islands court, according to the firm’s liquidator. The court issued an order preventing co-founders Su Zhu and Kyle Davies, as well as Davies’ wife Kelly Chen, from transferring or selling assets worth up to $1.14 billion, the liquidator Teneo said in an emailed statement, adding that it estimates creditors are owed roughly $3.3 billion. 

***

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) was up 48.40 points (1.0%) at 4,746.75; the Dow Jones Industrial Average was up 322.35 points (0.9%) at 37,404.35; the NASDAQ Composite®(COMP) was up 185.92 points (1.3%) at 14,963.87.
  • The 10-year Treasury note yield (TNX) was up about 1 basis point at 3.89%.
  • The CBOE® Volatility Index (VIX) was down 0.02 at 13.65, after earlier rising to 14.49.

Among market sectors, Micron Technology’s gain helped send the Philadelphia Semiconductor Index (SOX) up 2.8%. Retail and transportation shares were also among the strongest performers.

The Russell 2000® Index (RUT), which is largely small cap focused, rose 1.7% and is on track for a sixth consecutive weekly gain.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: First Day of Winter as FedEx and the Stock Markets Crash!

HAPPY WINTER SOLSTICE

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

***

Astronomical winter begins at the winter solstice, which is the shortest day of the year. This means days get longer during winter—very slowly at first, but at ever-larger daily intervals as the March Equinox approaches, heralding the start of spring.

Locations closer to the poles experience larger differences in day length throughout the year, so winter days are shorter there. In Toronto, the shortest day is just under 8 hours and 56 minutes long; in Miami, roughly 2000 kilometers or 1200 miles farther south, it lasts about 10 hours and 32 minutes.

Places within the polar circles experience polar night during all or part of the winter season when the Sun does not rise at all.

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index (SPX) was down 70.02 points (1.5%) at 4,698.35; the Dow Jones Industrial Average (DJI) was down 475.92 points (1.3%) at 37,082.00; the NASDAQ Composite® (COMP) was down 225.28 points (1.5%) at 14,777.94.
  • The 10-year Treasury note yield (TNX) was down about 6 basis points at 3.858%.
  • The CBOE® Volatility Index (VIX) was up 1.14 at 13.67.

Shares of semiconductors and banks were among the weakest performers Wednesday, giving back some recent gains after ranking among upside leaders during the recent rally.

Transportation shares also slumped behind weakness in FedEx. The Dow Jones Transportation Index (DJT) fell 1.5% and ended at its lowest level in a week. 

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DOL: Proposes “Best Interest” Retirement Investment Advice

SPONSOR: http://www.MARCINKOASSOCIATES.com

***

***

The Department of Labor’s proposal aims to close governance loopholes and require financial advisers to give retirement advice in the best interests of savers rather than chase the highest payday.

“Bad financial advice by unscrupulous financial advisers driven by their own self-interest can cost a retiree up to 1.2% per year in lost investment,” President Biden said. “That doesn’t sound like much but if you’re living long, it’s a lot of money.

MORE: https://medicalexecutivepost.com/2023/03/11/recast-an-interview-with-fiduciary-bennett-aikin-aif-2/

“Over a lifetime, it can add up to 20% less money when they retire. For a middle-class household, that can amount to tens of thousands of dollars over time.”

MORE: https://marcinkoassociates.com/financial-planning/

FIDUCIARY OATH: https://medicalexecutivepost.com/2023/02/19/the-fiduciary-oath/

***
COMMENTS APPRECIATED

Thank You

***

***

DAILY UPDATE: IRS Zaps Debt as Stock Markets Ascend!

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Americans who owe back taxes will be given an incentive to pay up after the Internal Revenue Service it would waive nearly $1 billion in late-payment penalties. Roughly 4.6 million individual taxpayers who owe for tax years 2020 and 2021 will be eligible for the penalty relief. The IRS is extending the olive branch because it stopped sending out many collection letters during the pandemic. It hoped the letter halt would help struggling taxpayers and reduce its backlog. The long absence of these computer-generated letters had big consequences for taxpayers. Americans’ debt on unpaid back taxes had been growing with interest and penalties, and many were likely in the dark about just how much they owed.

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 27.81 points (0.6%) at 4,768.37; the Dow Jones Industrial Average was up 251.90 points (0.7%) at 37,557.92; the NASDAQ Composite® (COMP) was up 98.03 points (0.7%) at 15,003.22.
  • The 10-year Treasury note yield (TNX) was down about 3 basis points at 3.924%.
  • The CBOE® Volatility Index (VIX) was down 0.03 at 12.53.

Energy shares extended an early week rally behind a continued rebound in WTI Crude Oil futures (/CL), which rose for a fifth straight day and ended near a three-week high above $74 per barrel.

Banks and retailers were also particularly firm. The S&P 500 Retail Select Industry Index (SPSIRE) surged over 2% and ended at its highest level in over 10 months.

And, Tuesday’s big winner was Affirm, whose shares skyrocketed 15% after the buy now, pay later company announced it’s expanding its Walmart partnership to include the retailer’s self-checkout kiosks.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: Goldman Sachs Speaks as the Stock Markets Rise

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

The Federal Reserve’s pivot last week to an easier monetary policy made many investors more bullish toward stocks. You can count Goldman Sachs among them. It has raised its year-end 2024 target for the S&P to 5,100 from 4,700. The new forecast represents an 8% increase from 4,740 on Dec. 18. Goldman has a three-month target of 4,800 and a six-month target of 4,900.

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 21.37 points (0.5%) at 4,740.56; the Dow Jones Industrial Average was up 0.86 points at 37,306.02; the NASDAQ Composite was up 90.89 points (0.6%) at 14,904.81.
  • The 10-year Treasury note yield (TNX) was up about 2 basis points at 3.946%.
  • The CBOE® Volatility Index (VIX) was up 0.25 at 12.53.

Energy shares were among Monday’s strongest performers behind a rally in WTI Crude Oil futures (/CL), which jumped 1.7% to end at a two-week high amid concern over supply disruptions following attacks on ships in the Red Sea.

Communication services and consumer staples were also firm. Financials gave back some of last week’s sharp gains, with the KBW Bank Index (BKX) down nearly 1%.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

IRS Inheritance Rule Change and the “Delta Dental” Data Breach

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

***

The IRS is demanding billions from small business who took this credit ...

***

The IRS Quietly Changed the Rules on Children’s Inheritance

The IRS just issued Revenue Ruling 2023-2, which had a substantial impact on estate planning, particularly where an irrevocable trust is involved.

In the last decade or so, more families have begun utilizing irrevocable trusts to protect their assets from spend-down in order to qualify for government benefits, such as Medicaid and VA Aid and Attendance. Prior to the issuance of this ruling, it was unclear whether assets passing to beneficiaries through an irrevocable trust would receive a step-up in basis, thereby eliminating any capital gains taxes that would otherwise be owed.

Historically, assets that are disposed of during an individual’s lifetime are subject to capital gains taxes on the increase in value of that asset over time. The amount of capital gains owed is determined largely by the difference between the value at the time of purchase and the value at the time of transfer.

***

Delta Dental of California data breach exposed info of 7 million people

“Delta Dental of California and its affiliates are warning almost seven million patients that they suffered a data breach after personal data was exposed in a MOVEit Transfer software breach.Delta Dental of California provides 24 months of free credit monitoring and identity theft protection services to impacted patients to mitigate the risk of their exposed data.”

LINK: https://tinyurl.com/bp4u2chv

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: The “Magnificent Seven” Technology Stocks PLUS Uber

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

  • Markets: The Magnificent Seven technology mega-cap stocks—Microsoft, Apple, Alphabet, Nvidia, Tesla, Meta, and Amazon—have surged 75% this year, while the other 493 companies in the S&P 500 have gained 12%. The Magnificent Seven now account for nearly 30% of the entire index’s value, per the WSJ.
  • Stock spotlight: Speaking of the S&P 500, it’s getting a prominent new member—Uber will join the index today. With a market cap of $127 billion, Uber is the most valuable company that hadn’t yet been included in the S&P 500, and it celebrated by notching a 52-week high last week.
  • CITE: https://www.r2library.com/Resource

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

MICRO-CERTIFICATIONS: Physician Insider Knowledge for Financial Advisor Success?

Micro-Credentials on the Rise

KNOWLEDGE RICHES IN NICHES

DR. DAVID EDWARD MARCINKO MBA CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

***

***

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

Micro-Certification Basics

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

Micro-Certification Requirements

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

Uses of Micro-Certifications

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

Examples of iMBA, Inc., Micro-Certifications

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

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

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

How to Start Learning and Earning Recognition for Your Knowledge

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

Mini-Certification Tuition, Books and Related Fees

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

***

Contact: For more information, or to speak with an academic representative, please contact Ann Miller RN MHA CMP™ at: MarcinkoAdvisors@msn.com [24/7] -OR- 770-448-0769[9:00 – 5:00 EST].

***

DAILY UPDATE: Mental Health and NASDAQ Technology Stocks

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

“We kept hearing nightmare stories about Americans not getting the treatment that they needed because insurance companies were denying them care. But we didn’t have enough data to show just how extensive and deep the problem was.”—

Bill Smith, founder of mental health advocacy coalition Inseparable, on patients with mental health diagnoses not receiving care (NPR)

***

***

The NASDAQ closed at an all-time high yesterday, breaking the record it set in November 2021, as technology stocks continued to rally on the news that the Fed may cut interest rates next year.

DocuSign shot up following reports that the $11 billion company whose tech lets you use your signature without a pen could be up for sale.

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

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: Healthcare Artificial Intelligence Safety as the DJIA Sets Record

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Twenty-eight healthcare companies, including CVS Health , are signing U.S. President Joe Biden’s voluntary commitments aimed at ensuring the safe development of artificial intelligence (AI), a White House official said yesterday. The commitments by healthcare providers and payers follow those of 15 leading AI companies, including Google, OpenAI and OpenAI partner Microsoft to develop AI healthcare models responsibly.

***

***

Health insurance company Humana is being accused of allegedly wrongfully denying care to elderly patients, who are enrolled in Medicare Advantage Plans, using an augmented intelligence model “to override” physicians’ orders on “necessary care patients require,” according to a new lawsuit.

The lawsuit, filed by two Humana Medicare Advantage Plan customers on December th 12 in Kentucky, claims that Humana uses an AI model called nH Predict, and it allegedly has a high error rate. And allegedly, despite knowing that it’s inaccurate, the company still uses it.

Related: CVS, Kroger and Rite Aid face unsettling medical privacy concerns

***

***

Here is where the major benchmarks ended:

The S&P 500 index was up 12.46 points (0.3%) at 4,719.55; the Dow Jones Industrial Average was up 158.11 points (0.4%) at 37,248.35; the NASDAQ Composite® (COMP) was up 27.59 points (0.2%) at 14,761.56.

  • The 10-year Treasury note yield (TNX) was down about 11 basis points at 3.923%, falling under 4% for the first time since early August.
  • The CBOE® Volatility Index (VIX) was up 0.25 at 12.44.

Financial shares remained among the market’s strongest post-FOMC gainers, reflecting ideas that lower interest rates will boost profit margins for banks. Goldman Sachs (GS) rallied nearly 6%, the second-best gain among Dow companies, and hit a 23-month high. The KBW Bank Index (BKX), which includes major companies like Bank of America (BAC) and Citigroup (C) as well as several regional lenders, surged 5% to a nine-month high.

Also, the small-cap Russell 2000® Index (RUT) continued to outgain large-cap counterparts, rising 2.7% to a 4 ½-month high.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: DJIA Records a High as Treasury Yields Drop

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

***

MANY THANKS E.R. HEROES

The holidays can be a stressful time for many, especially emergency healthcare workers, as Emergency Departments and ERs tend to get crowded. Holiday-related injuries spike in December, from slipping in the snow or falling while decorating to overindulging in holiday cocktails. So, to all the emergency healthcare providers working on holidays this year, the ME-P thanks you very much.

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 63.39 points (1.4%) at 4,707.09; the Dow Jones Industrial Average was up 512.30 points (1.4%) at 37,090.24; the NASDAQ Composite was up 200.57 points (1.4%) at 14,733.96.
  • The 10-year Treasury note yield (TNX) was down about 18 basis points at 4.024%.
  • The CBOE® Volatility Index (VIX) was up 0.14 at 12.21.

Financial shares led Wednesday’s gainers, reflecting ideas that lower interest rates will boost profit margins for banks. The KBW Regional Banking Index (KRX) surged nearly 6% and ended at its highest level in over four months. The Fed’s outlook for slower growth in 2024, but no recession, also appeared to drive optimism among smaller companies, which are considered to have greater exposure to economic downturns. The small-cap Russell 2000® Index (RUT) outpaced its bigger counterparts, gaining 3.5% and ending at a four-month high.

Treasury yields fell sharply, with the 10-year note dropping to a four-month low just above 4%.

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

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: Norton Healthcare Hacked – Pharma Chains Give Health Data to Police and the Stock Markets Climb

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Kentucky-based healthcare provider Norton Healthcare has confirmed that it has suffered a significant ransomware attack that may have put the data of millions of its patients at risk. In a filing to the Maine Attorney General on December 8th, the healthcare giant said that 2.5 million individuals had been affected by the breach.

***

***

Meanwhile, the nation’s largest pharmacy chains have handed over Americans’ prescription records to police and government investigators without a warrant, a congressional investigation found, raising concerns about threats to medical privacy. Though some of the chains require their lawyers to review law enforcement requests, three of the largest — CVS Health, Kroger and Rite Aid, with a combined 60,000 locations nationwide — said they allow pharmacy staff members to hand over customers’ medical records in the store.

The policy was revealed in a letter sent to Xavier Becerra, the secretary of the Department of Health and Human Services, by Sen. Ron Wyden (D-Ore.) and Reps. Pramila Jayapal (D-Wash.) and Sara Jacobs (D-Calif.).

HIPAA anyone?

***

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 21.26 points (0.5%) at 4,643.70; the Dow Jones Industrial Average®(DJI) was up 173.01 points (0.5%) at 36,577.94; the NASDAQ Composite® (COMP) was up 100.91 points (0.7%) at 14,533.40.
  • The 10-year Treasury note yield (TNX) was down about 3 basis points at 4.206%.
  • The CBOE® Volatility Index (VIX) was down 0.56 at 12.07.

Technology shares were among Tuesday’s strongest performers despite a 12% drop in Oracle (ORCL), which plunged after reporting lighter-than-expected quarterly revenue late Monday. The Philadelphia Semiconductor Index (SOX) posted its highest close since January 2022.

Financial shares were also firm. Energy shares were under pressure because WTI Crude Oil futures (/CL) extended a slump below $70 per barrel and settled at its lowest price since late June.

Here is where the major benchmarks ended:

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: Health Care, FOMC and the Tepid Markets

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

In healthcare, legislators could vote next week on a major health reform package that includes a ban on spread pricing in Medicaid and a push toward site-neutral payments.


In more news from the Hill, a bipartisan bill was introduced that seeks to cancel a 3.4% Medicare pay cut to docs, which has drawn plenty of ire from the industry.

***

The final FOMC meeting of the year will take place this week, and like most work meetings in mid-December, not a whole lot is going to happen. Chair Jerome Powell is widely expected to leave interest rates unchanged as inflation continues its descent to a 2% target. But 2024 planning is in full swing, and investors are desperate to learn when the Federal Reserve thinks it will need to cut rates next year.

***

Here is where the major stock index benchmarks ended:

  • The S&P 500 index was up 18.07 points (0.4%) at 4,622.44; the Dow Jones Industrial Average® (DJI) was up 157.06 points (0.4%) at 36,404.93; the NASDAQ Composite was up 28.51 points (0.2%) at 14,432.49.
  • The 10-year Treasury note yield (TNX) was little-changed at 4.239%.
  • The CBOE® Volatility Index (VIX) was up 0.28 at 12.63.

In addition to retailers, semiconductor company shares also posted outsized gains Monday, boosted in part by a jump of nearly 10% in Broadcom (AVGO). The Philadelphia Semiconductor Index (SOX) gained more than 3% and ended near a two-year high. Transportation companies were also strong.

In other markets, Natural Gas futures (/NG) plunged more than 6% to a six-month low, reflecting warmer-than-normal U.S. temperatures and excess supplies.

Finally, the so-called Magnificent Seven stocks of Apple, Microsoft, Alphabet, Amazon.com, Nvidia, Tesla and Meta Platforms each fell at least 0.8%. Meta led the declines, dropping 2.2%. But only one out of 11 S&P 500 sectors fell. Even the information technology sub-index ticked higher, reflecting gains outside of the largest companies in the sector.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

The UK Questions Microsoft & OpenAI as Aetna Medicaid Aids Hungry Homeless

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

United Kingdom Regulators Looking into Microsoft’s Partnership with OpenAI

A British watchdog is asking for feedback on whether Microsoft’s $13 billion, 49% stake in the ChatGPT-maker’s for-profit division constitutes a merger, the WSJ just eported. So, if the agency decides to launch a formal investigation into whether the partnership creates an unfair advantage in the artificial intelligence industry, it could eventually force the companies to change how they operate.

And, following OpenAI’s dramatic firing and rehiring of CEO Sam Altman last month, Microsoft was given a “nonvoting observer” seat on the OpenAI board.

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

***

Aetna Better Health of Georgia has invested $510,000 in 17 local organizations that offer services for individuals experiencing food insecurity and homelessness across the state of Georgia.

“A holistic approach to health care starts with ensuring each individual has stable and consistent access to healthy, nutritious foods, as well as a safe place to live,” said Sonya Nelson, division president at Aetna Medicaid. “By partnering with local organizations committed to improving the quality of life for all Georgians, we can help ensure people’s most basic needs are fulfilled and they’re able to prioritize care for themselves and their families.”

***

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: “Soft Economic Landing” and Paramount Pictures Corporation

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

The S&P 500 heads into the week at its highest level of the year after Friday’s solid jobs report suggested that the Fed could be all clear for a “soft landing”—bringing inflation back to normal without sending the economy into a recession. The S&P and Dow have posted gains for six straight weeks, their longest streak since 2019.

***

But, the week’s big winner was Paramount, which spiked on reports that Shari Redstone might sell the entertainment giant.

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

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

The Perfect Holiday Gift [The “Business of Medical Practice”]

Third Edition of Classic Text Now Available

[Transformational Health 2.0 Skills for Savvy Doctors]

By Ann Miller RN MHA [Executive-Director]

Product Details

For the first time anywhere, we offer our loyal ME-P readers and subscribers an exclusive first look at the new book: The “Business of Medical Practice” from the Institute of Medical Business Advisors Inc, in Atlanta, GA www.MedicalBusinessAdvisors.com

Synopsis

Now in its 3rd edition, the book explores a variety of issues and seeks to answer these questions:

  • Does Health 2.0 enhance or detract from traditional medical care delivery, and can private practice business models survive?
  • How does transparent business information and reimbursement data impact the modern competitive healthcare scene?
  • How are medical practices, clinics, and physicians evolving as a result of rapid health- and non-health-related technology change?
  • Does transparent quality information affect the private practice ecosystem?

A Tool for all Stakeholders

Answering these questions and more, this newly updated and revised edition is an essential tool for doctors, nurses, and healthcare administrators; management and business consultants; accountants; and medical, dental, business, and healthcare administration graduate, doctoral students and virtually all stakeholders of the healthcare industrial complex.

Management and Operational Strategies for Private Practice

Written in plain language using nontechnical jargon, the text presents a progressive discussion of management and operation strategies. It incorporates prose, news reports, and regulatory and academic perspectives with Health 2.0 examples, and blog and internet links, as well as charts, tables, diagrams, and Web site references, resulting in an all-encompassing resource. It integrates various medical practice business disciplines-from finance and economics to marketing to the strategic management sciences-to improve patient outcomes and achieve best practices in the healthcare administration field. With contributions by a world-class team of expert authors, the third edition covers brand-new information, including:

  • The impact of Web 2.0 technologies on the healthcare industry
  • Internal office controls for preventing fraud and abuse
  • Physician compensation with pay-for-performance trend analysis
  • Healthcare marketing, advertising, CRM, and public relations
  • eMRs, mobile IT systems, medical devices, and cloud computing
  • and much more!

Front Matter: Front Matter BoMP – 3

Assessment

Please send any question/and or comments directly to us at: MarcinkoAdvisors@msn.com

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Product DetailsProduct DetailsProduct Details

WHY: Your Medical Internet Marketing Campaign Still Isn’t Effective?

THE THREE VITAL ELEMENTS

SPONSOR: http://www.MarcinkoAssociates.com

***

***

A strong online presence is crucial for any medical or healthcare businesses, but many are struggling to figure out where to invest their marketing dollars. It is important to diversify marketing efforts and not rely solely on one channel, as changes in the industry are inevitable. Search marketing, direct marketing, and social media are three key components that healthcare organizations should incorporate in their marketing campaigns.

  1. Search marketing has evolved over the years with changes in Google’s algorithms and the saturation of the market, requiring a focus on quality content and the expertise of an expert.
  2. Direct marketing is becoming more popular, with lead generation companies and email marketing being effective and budget-friendly tactics. Social media is constantly evolving and increasing in price, with networks like Facebook and Twitter pushing paid advertisements.
  3. While social media should not be the focal point of a healthcare organization’s marketing campaign, it is an integral component that can contribute to search engine rankings.

***

***

Overall, a well-rounded marketing strategy that incorporates these three elements is crucial for success. A strong online presence is crucial for healthcare businesses, and diversifying marketing efforts across search marketing, direct marketing, and social media is important for success. Search marketing has changed with Google’s algorithms and increased ad costs, while direct marketing and social media have become more popular. Social media also affects search engine rankings.

COMMENTS APPRECIATED

Thank You

***

***

DAILY UPDATE: Economy Modest, Sickle Cell CRISPR Therapy Approved and Stock Markets Rise

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

According to the Organization for Economic Cooperation and Development’s November economic outlook report, global growth is on track to stay modest this year and into 2024. And, while gross domestic product growth has been stronger than anticipated in 2023 so far, it’s now “moderating on the back of tighter financial conditions, weak trade growth and lower business and consumer confidence,” the report’s authors noted. The OECD anticipates global GDP growth of 2.9% in 2023, and a dip to 2.7% in 2024. 2025 looks better, with predicted global growth of 3%.

***

The Food and Drug Administration on Friday approved a powerful treatment for sickle cell disease, a devastating illness that affects more than 100,000 Americans, the majority of whom are Black. The therapy, called Casgevy, from Vertex Pharmaceuticals and CRISPR Therapeutics, is the first medicine to be approved in the United States.

CRISPR: https://medicalexecutivepost.com/2022/08/06/crispr-play-by-play-of-an-experiment/

Here is where the major benchmarks ended:

The S&P 500® Index (SPX) was up 0.41% at 4,604.46, up marginally for the week; the Dow Jones Industrial Average (DJI) was up 130 points (0.36%) at 36,247.87, up marginally for the week; the NASDAQ Composite® (COMP) was up 63.98 points (0.45%) at 14,403.97, up 0.7% for the week.The 10-year Treasury note yield (TNX) was up 10 basis points at 4.235%. The CBOE Volatility Index (VIX) was down 5.44% at 12.35.

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

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

CAREER: Physician Coaching and Development in 2024

MARCINKO ASSOCIATES, Inc.

SPONSOR: http://www.MarcinkoAssociates.com

***

***

Did you Know?

Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.

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

Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.

CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].

NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686971/

THANK YOU

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

CONTACT US: https://marcinkoassociates.com/process-what-we-do/

***

DAILY UPDATE: Deflation Pending as Stock Markets Gain

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

After grappling with high inflation for more than two years, American consumers are now seeing an economic trend that many might only dimly remember: falling prices — but only on certain types of products. 

Deflation is impacting so-called durable goods, or products that are meant to last more than three years, Wall Street Journal reporter David Harrison told CBS News. As Harrison noted in his reporting, durable goods have dropped on a year-over-year basis for five straight months and dropped 2.6% in October from their September 2022 peak.

These items are products such as used cars, furniture and appliances, which saw big run-ups in prices during the pandemic. Used cars in particular were a pain point for U.S. households, with pre-owned cars seeing their prices jump more than fifty percent in the first two years of the pandemic.

Here is where the major benchmarks ended:

  • The S&P 500 Index was up 36.25 points (0.8%) at 4,585.59; the Dow Jones Industrial Average was up 62.95 points (0.2%) at 36,117.38; the NASDAQ Composite was up 193.28 points (1.4%) at 14,339.99.
  • The 10-year Treasury note yield (TNX) was up about 2 basis points at 4.144%.
  • The CBOE® Volatility Index (VIX) was up 0.09 at 13.06.

Tech sector strength was highlighted by the Philadelphia Semiconductor Index (SOX), which gained nearly 3%. Financial shares were also among the strongest performers, as the KBW Regional Banking Index (KRX) rose 2% and ended at a four-month high. In other markets, WTI crude oil futures (/CL) posted the market’s first gain in six days after earlier dropping to its lowest level since late June.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: Apple Market Cap Up as Major Stock Indexes Ease

By Staff Reporters

MEDICARE ANNUAL ENROLLMENT ENDS

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Apple regains a $3 trillion market cap and is on track to end the year as the world’s most valuable company for the 5th time in a row.

Today marks the 82nd anniversary of the attack on Pearl Harbor that drew the US into WWII.

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) was down 17.84 points (0.4%) at 4,549.34; the Dow Jones Industrial Average® (DJI) was down 70.13 points (0.2%) at 36,054.43; the NASDAQ Composite® (COMP) was down 83.20 points (0.6%) at 14,146.71.
  • The 10-year Treasury note yield (TNX) was down about 5 basis points at 4.117%.
  • The CBOE® Volatility Index (VIX) was up 0.10 at 12.95.

Energy shares were again among the market’s weakest performers as crude oil futures extended a slump, closing below $70 per barrel for the first time since late June on concerns over slowing global demand. And, Liz Ann Sonders of Schwab said a “somewhat stealthy” rotation continued under the market’s surface, with the S&P 500® Equal Weight (SPXEW) and Russell 2000®(RUT) indexes outperforming both the S&P 500 and NASDAQ over the past month or so. She also noted a defensive tone to Wednesday’ trading, illustrated by strength in utilities and weakness in technology.

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

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***

DAILY UPDATE: Non-Physician Practice Ownership Quality Down as Stock Markets Slip

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Nearly 60% of doctors who practice as employees of hospitals and other corporate entities say that non-physician practice ownership results in lower quality patient care, per a new survey commissioned by the Physicians Advocacy Institute. Loss of face time with patients and greater focus on finances negatively impact quality, they say.

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index was down 2.60 points (0.1%) at 4,567.18; the Dow Jones Industrial Average was down 79.88 points (0.2%) at 36,124.56; the NASDAQ Composite® (COMP) was up 44.42 points (0.3%) at 14,229.91.
  • The 10-year Treasury note yield was down about 11 basis points at 4.18%.
  • The CBOE® Volatility Index (VIX) was down 0.23 at 12.85.

Energy shares were among Tuesday’s weakest performers on pressure from slumping crude oil futures, which dropped for a fourth consecutive day and hit a five-month low amid concern over global demand. Retail and transportation sectors were also soft. Technology and consumer discretionary shares were among the few gainers.

COMMENTS APPRECIATED

Refer a Colleague: MarcinkoAdvisors@msn.com

Your referral Count: 0

Thank You

***

***