A monthly list of interesting facts and figures from the world of healthcare, finance, and public markets. 2/3: The estimated number of Medicare quality metrics deemed uncertain or invalid by a NEJM study. 25%: the percentage of healthcare costs attributable to the top 1%. 10%: the likelihood of being in the top 10% of healthcare … Continue reading February’s Index
Putting a Price on Benefits
With the US close to full employment, for employees, health benefits could matter more. Many prospective hires are rightly fixated on salary, bonus, growth, and purpose but draw blanks on benefits. "The company offers a few plans and I pay around $1,000 year in premiums" is the usual type of analysis, if at all. Some … Continue reading Putting a Price on Benefits
January’s Healthcare Index
Inspired by the monthly Harper's Index, this is 2019's first index on healthcare and finance. The average ratio of Medicaid-to-Medicare payments spending across the US across all services: .72; In CA: .52. The factor by which commercial insurance payments exceed the reimbursements from Medicare: 1.88x The net assets of HCA, the largest publicly-traded hospital in the … Continue reading January’s Healthcare Index
What Bartleby Says
It's a fine day for the people who care about this sort of stuff when the topic of corporate wellness makes the year's first edition of The Economist. New resolutions for a new year surely had something to do with the timing. The Bartleby column is out with The spy who hired me. More heat … Continue reading What Bartleby Says
Stats on High Deductibles
November has past and healthcare open enrollment is behind us. It's the time when spreadsheets are pulled together, employees and spouses (even actuaries) run front and back of the envelope calculations to decide where to enroll. Stock photos of happy couples in the 30-page guides beckon workers toward a tortuous process. It's usually a choice … Continue reading Stats on High Deductibles
On Hidden Risks and Volatility
Volatility in investing can be a great thing. The attraction to Bernie Madoff's scam can be better understood by its lack of volatility. His funds showed annual returns of an eerily consistent 10-12% and at one point reported 72 consecutive months of positive returns. His strategy used a split-strike or collar options strategy (not related … Continue reading On Hidden Risks and Volatility
Costco: Lessons from Member Obsession.
Some call them clients, others guests or customers. Costco (Ticker: COST, revenue $141B) calls them members, a term that makes you feel like you're part of a special club. It's a club that will not sell you junk*. They do not exaggerate. Theirs is not fake-Enron-style-ethics-bragging, and they actually list shareholders' interests last. Focus on the … Continue reading Costco: Lessons from Member Obsession.
Medical Bankruptcies in America
Financial valuation uses multiple approaches to estimate the value of a company, whether a shoe factory, a chain of Tex-Mex restaurants, a software company, a bank, or a law firm. The questions are framed around what a firm is worth relative to cash flow, book value, relative to similar assets, recent industry transactions, or others. … Continue reading Medical Bankruptcies in America
On RVs and Write-Offs
Businesses love metrics. One form or novel way (a 5 on the hack prowess scale) is to find the perfect metric that makes the future a little more predictable. The eager student tells the elderly person, "Teach me to be wealthy, only quicker" to paraphrase C.T. Munger. A year after the financial crisis of 2007-2008, … Continue reading On RVs and Write-Offs
The $4,500 Deductible
$4,537 can buy a lot of Skittles*. Or it can buy you the average single deductible for an unsubsidized enrollee with healthcare coverage on the Affordable Care Act (ACA) exchanges. At 3.4x less, the $1,350 average deductible for the 152 million who get their insurance through an employer looks benevolent. In spite of having the word "affordable" … Continue reading The $4,500 Deductible
