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The Survey Says…

by Industry TrendsThought Leadership

Headlines latch on to 5% and $20k, leadings numbers from the 200+ page annual Kaiser Employer Health Benefits Survey. Forbes, NYT, Bloomberg, Health Affairs, and the WSJ all take this angle. The press is warranted. Healthcare costs continue to grow at 2x inflation and annual premiums for family coverage crossed $20,000, more than a mortgage in the midwest. The survey carriers weight. Employers are the largest purchasers of healthcare in the US, commanding budgets that approach $1T, larger th ...

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My Lehman Brothers Experience

by InvestingThought Leadership

In September, 2008 I sat alone sipping a juice in the open town hall area of a Goldman Sachs office. My eyes were fixed on a freshly printed 4-page report from CEO Dick Fuld on the status and future of Lehman Brothers, capital positions, $600B+ in assets, tangible book value per share, value-at-risk, etc. The $4.00 share price, many multiples lower than the 52-week high, tempted me into a modest 400 shares. People were scared: "Be greedy when others are fearful and fearful when others are greed ...

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September’s Index

by IndexIndustry Trends

This month's index, inspired by the Harpers index, touches on charity care, gross margins, stock valuation metrics for three healthcare firms, sample UK health costs, algorithms, machine learning, and big data (just kidding on the last 3). The cost of charity and other uncompensated care as a percentage of total revenue at HCA hospitals in 2018: 7%. In 2010: 6%. Income as a multiple of federal poverty limits required to access charity care at HCA hospitals prior to 2018: 2x. In 2018 ...

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Healthcare Alpha

by Benefits ToolsIndustry TrendsInvestingThought Leadership

Discerning luck from skill can be hard. Baseball has 162 games per season. Boring for some but more than enough games for randomness to average out. How telling is one game? How telling is one case study? It could be random or just cherry picked. It's the consistent rate attributable to skill that we're after, whether in money management, baseball managers, healthcare, or other domains. It's the alpha. Investopedia describes alpha as "a term used in investing to describe a strategy's ability t ...

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Will Software Eat Healthcare?

by Industry TrendsInvesting

In 2011, the legendary venture capitalist Mark Andreessen wrote why software is eating the world. Efficiency and scale could cut the costs of servers and development by 100x+. Entertainment (Netflix, Disney), cars (all), retail (Amazon), job hunting (LinkedIn), and more, all have software as integral parts of the product and value. This view has held. Software has devoured Sears, Borders, Blockbuster and others. It's added layers of analytics, cheaper travel, better communication, higher click r ...