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

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Stat: 150. That’s how many health systems use AI to help draft replies on MyChart, sometimes without disclosing this to patients. (the New York Times)

Contained in a roughly 200-page quarterly filing from JPMorgan Chase last month were eight words that underscore how contentious the bank’s relationship with the government has become. The lender disclosed that the Consumer Financial Protection Bureau could punish JPMorgan for its role in Zelle, the giant peer-to-peer digital payments network. The bank is accused of failing to kick criminal accounts off its platform and failing to compensate some scam victims.

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Stocks Up

Bristol-Myers Squibb rose 1.56% after the FDA approved its new drug for schizophrenia, the first new treatment of its kind in decades. Some analysts expect the drug, Cobenfy, to bring in $6 billion in peak annual revenue.

  • Trump Media gained 5.58% despite a co-founder of its Truth Social platform cashing out nearly all of his shares—worth about $100 million at current prices.
  • Chinese EV maker Nio added another 12.80% to bring its weekly gains to nearly 25%. It’s benefiting from the overall euphoria around Chinese stocks and anticipation over its quarterly delivery numbers due next week.
  • Speaking of the Chinese government’s stimulus measures, investors are wagering that the Macau locations of Las Vegas Sands Corp. (up 5.59%) and Wynn Resorts (up 7.24%) will see more visitors.
  • IonQ, a quantum computing company based in College Park, MD (go Terps), shot up 20.47% after inking a contract with the US Air Force Research Lab.

Stocks down

  • Nvidia dropped 2.17%. Bloomberg reported that the Chinese government is ramping up the pressure on local tech companies to move away from using Nvidia AI chips and lean more on domestic suppliers.
  • WeightWatchers, whose shares are down more than 90% this year, booted its CEO Sima Sistani, who pivoted the company to weight-loss drugs. Investors aren’t betting a change at the top will lead to a turnaround, sending shares 2.11% lower on the day.
  • Globe Life sank 4.74% after the US Equal Employment Opportunity Commission found that the life insurance company tolerated a “pervasive pattern of harassing conduct” at one of its top sales agencies, per Business Insider.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) lost 7.20 points (–0.13%) to 5,738.17 to end the week up 0.62%; the Dow Jones Industrial Average® ($DJI) added 137.89 points (0.33%) to 42,313.00 to end the week up 0.59%; the NASDAQ Composite® ($COMP) fell 70.70 points (–0.39%) to 18,119.59 to end the week up 0.95%.
  • The 10-year Treasury note yield (TNX) fell four basis points to 3.75%, up two basis points for the week.
  • The CBOE Volatility Index® (VIX) jumped to 16.64.

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Meta is facing a fine of $102 million for storing some users’ passwords in “plaintext”. The social media giant has admitted to poor password management.

Acadia and the Department of Justice just reached a ~$20M agreement to settle accusations that the company billed Medicare, Medicaid, and TRICARE for medically unnecessary inpatient mental health services. Acadia found itself under pressure after a New York Times investigation published earlier in September allegedly found that the company kept patients in facilities against their will to maximize insurance payments.

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DAILY UPDATE: Medicaid and Government Employee Health Insurance Changes as Stocks Tank

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

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

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

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Texas Governor Greg Abbott has issued a sharp warning about proposed changes to Medicaid, claiming they could “strip millions of Americans” from access to healthcare. In February 2023, the Centers for Medicare & Medicaid Services (CMS) issued a new proposed rule that would change long-standing practices for how states fund the non-federal share of Medicaid payments. In particular, the CMS is pushing for greater oversight of how states use of healthcare provider taxes to help fund their programs.

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Democratic lawmakers Sen. Richard Blumenthal and Rep. Andy Kim have partnered up with Republican Rep. Jen Kiggans to introduce legislation aiming to give army reservists and members of the National Guard that also work for the federal government options on the type of health care plans they can receive. The bill, which could impact thousands of federal employees that are also in the U.S. Army, plans to give this group of Americans the ability to decide whether they want military or civilian health care. The lawmakers said in a shared statement that their proposal will fix current regulations that limit service members who also work for the government to enroll in the cheaper Tricare Reserve Select (TRS) health plan when they also qualify for federal health plans.

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Stocks tanked last Friday after the big banks reported underwhelming earnings and the sheen from the Magnificent Seven’s AI-driven surge earlier this week wore off. Meanwhile, oil prices continue to rise near six-month highs as concern grows over geopolitical tensions in the Middle East. The tech sector was highlighted in this market, particularly due to the exceptional performance of a group of mega-cap tech giants last year nicknamed the “Magnificent Seven.” This elite group includes Apple (AAPL), Amazon (AMZN), Alphabet (GOOGL), Meta Platforms (META), Microsoft (MSFT), Nvidia (NVDA) and Tesla (TSLA).

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FEDERAL HEALTH PROGRAMS: Defined

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Theranos founder and ex-CEO Elizabeth Holmes was just banned from US federal health care programs for nine decades, according to the US the health department. Holmes was sentenced in November 2022 to 11 years in prison following a trial that determined she knew her blood-testing startup, which was founded in 2003 and which claimed to be able to test for a range of diseases and risks with one finger prick, produced inaccurate and faulty results. Before government probes, Theranos raised hundreds of millions of dollars, named prominent former U.S. officials to its board, and explored a partnership with the U.S. military to use its tests on the battlefield.

So, just what is a Federal Health Care Program?

Federal Health Care Program means any plan or program that provides health benefits, whether directly, through insurance, or otherwise, which is funded directly, in whole or in part, by the United States Government, including, but not limited to, Medicare, Medicaid/MediCal, managed Medicare/Medicaid/MediCal, TriCare/VA/CHAMPUS, SCHIP, Federal Employees Health Benefit Plan, Indian Health Services, Health Services for Peace Corp Volunteers, Railroad Retirement Benefits Black Lung Program, Services Provided to Federal Prisoners, and Pre- Existing Condition Insurance Plans (PCIPs).

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Understanding Modern Healthcare Market Competition

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Updating Competitive Strategy Theory in Healthcare

By Robert James Cimasi; MHA ASA FRICs MCBA AVA CM&AA
By Todd A. Zigrang; MBA MHA ASA FACHE
By Anne P. Sharamitaro; Esq.

www.HealthCapital.com

Michael Porter[i] is considered by many to be one of the world’s leading authorities on competitive strategy and international competitiveness.  In 1980, he published Competitive Strategy: Techniques for Analyzing Industries and Competitors,[ii] in which he argues that all businesses must respond to five competitive forces.

(1) The Threat of New Market Entrants

This force may be defined as the risk of a similar company entering the marketplace and winning business.  There are many barriers to entry of new market entrants in healthcare including: the high cost of equipment, licensure, requirement for physicians and other highly trained technicians, development of physician referral networks and provider contracts, and other significant regulatory requirements.

Certificate of Need (CON) laws, which require governmental approval for new healthcare facilities, equipment, and services have been in place since they were federally mandated in 1974.  State CON laws create a regulatory barrier to entry.  New medical provider entrants commonly face substantial political opposition by established interests, which is manifested in the CON review process.

(2) The Bargaining Power of Suppliers

A supplier can be defined as any business relationship upon which a business relies to deliver a product, service, or outcome.  Healthcare equipment is a highly technical product produced by a limited number of manufacturers. This reduces the range of choices for providers and can increase costs.

(3) Threats from Substitute Products or Services

Substitute products or services are those that are sufficiently equivalent in function or utility to offer consumers an alternate choice of product or service.  An illustration of this in healthcare would be diagnostic imaging as a substitute for surgery, which is often a more costly and risky option for patients. The threat of less invasive or less expensive diagnostic tests other than diagnostic imaging is relatively small for the near term future.

(4) The Bargaining Power of Buyers

This force is the degree of negotiating leverage of an industry’s buyers or customers.  The buyers of healthcare services are ultimately the patients. However, the competitive force of buyers is manifested through healthcare insurers including the U.S. and state governments through the Medicare, Medicaid, TRICARE, and other programs; managed care payors (e.g., Blue Cross/Blue Shield affiliates); workers’ compensation insurers; and, others.  In addition to the government, many of these healthcare insurers are large, national companies, often publicly traded, commanding significant bargaining power over healthcare provider reimbursement.

(5) Rivalry Amongst Existing Firms

This is ongoing competition between existing firms without consideration of the other competitive forces which define industries. Healthcare providers face pressure from other existing providers to obtain favorable provider contracts; maintain the latest technology; increase efficiencies; and, lower prices.

References:

[i]  A professor of Business Administration at the Harvard Business School, Michael Porter serves as an advisor to heads of state, governors, mayors, and CEOs throughout the world.  The recipient of the Wells Prize in Economics, the Adam Smith Award, three McKinsey Awards, and honorary doctorates from the Stockholm School of Economics and six other universities, Porter is the author of fourteen books, among them Competitive Advantage, The Competitive Advantage of Nations, and Cases in Competitive Strategy.

[ii]  Porter, M.E. Competitive Strategy: Techniques for Analyzing Industries and Competitors. The Free Press, 1980.

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