Doctors denounced the accuracy and value of data listing $77 billion in Medicare payments to 880,000 medical providers, while consumer and industry groups said it could make the health-care system more cost-effective.
The divergent views of Medicare’s first-ever release of U.S. payments to physicians suggested the impact may take years to play out. U.S. officials, meanwhile, said they may follow yesterday’s report on 2012 data by providing the same information from earlier years, a move that would help regulators and consumers trace changes in health care over time.
“Geeks, nerds and data freaks will have a good time with this,” said Arthur Caplan, director of medical ethics at NYU Langone Medical Center in New York. “But tomorrow morning, in terms of selecting your doctor it won’t make one iota of difference. I’m not saying it’s valueless, but its value is in trends and patterns” over the long haul.
Release of the information may help get private researchers and the public involved in ferreting out misuse of services and fraud in Medicare, the government health program for the elderly and disabled, said Jonathan Blum, principal deputy administrator at the U.S. Centers for Medicare and Medicaid, in a call yesterday.
“We know there’s waste in the system,” Blum said. “We know there’s fraud in the system. While we’ve made tremendous investments to reduce that fraud, we want the public’s help to identify spending that doesn’t make sense, that appears to be wasteful, that appears to be fraudulent.”
Given the choice between investing in their businesses or paying off shareholders, European chief executive officers are choosing the latter.
Companies of the benchmark Stoxx Europe 600 Index will pay 11.54 euros a share in dividends this year, the most since data going back to 2002, according analysts’ estimates compiled by Bloomberg. At the same time, cash flow from operations is poised to be the highest since 2011, at 37.45 euros a share. Stocks have more than doubled since 2009 after European Central Bank President Mario Draghi pledged to preserve the single currency.
European companies have pushed cash balances to 2 trillion euros ($2.8 trillion), close to the most since at least 2003, following the 2008 financial crisis, according to data compiled by Bloomberg. While the region emerged from its worst recession ever last year, CEOs remain skeptical about the euro area’s economic recovery and want to see results of monetary policy, according to RMG Wealth Management LLP’s Stewart Richardson.
“There is money, but companies don’t want to invest in big capex programs,” Richardson, who helps manage about $100 million as RMG’s chief investment officer, said in a phone interview. “They are uncertain where growth will come from, and there is a huge focus from corporate management to shore up balance sheets and share prices.”
European Stocks erased their advance as carmakers and utilities fell, offsetting gains by personal and household goods companies after LVMH Moet Hennessy Louis Vuitton SA reported its results. U.S. index futures were also little changed, while Asian shares climbed.
LVMH added 3.6 percent as the world’s largest luxury-goods company posted the fastest growth in fashion and leather-goods sales in two years. Tryg A/S lost 3.9 percent after reporting first-quarter net income that missed analysts’ estimates.
The Stoxx Europe 600 Index dropped 0.1 percent to 334.87 at 10:04 a.m. in London, erasing a gain of as much as 0.6 percent. The benchmark has fallen 1.3 percent from a six-year high on April 4 as investors sold technology stocks and the shares with the highest valuations. Standard & Poor’s 500 Index futures also slipped 0.1 percent today. The MSCI Asia Pacific Index climbed 0.6 percent.
The Federal Reserve played down predictions by some of its policy makers that interest rates might rise faster than they previously forecast, according to minutes of the central bank’s March 18-19 policy meeting released after European markets closed yesterday.
Fed Chair Janet Yellen said in a press conference following last month’s meeting that rates might start to rise about six months after the central bank halts its monthly asset purchases.
A disease that damaged banana crops in Southeast Asia has spread to the Middle East and Africa, posing a risk to world supplies of the most-traded fruit, according to the United Nations Food & Agriculture Organization.
The TR4 strain of Panama disease, a soil-born fungus that attacks plant roots, is deadly for the Cavendish banana that makes up about 95 percent of supplies to importers, including North Americaand Europe, Fazil Dusunceli, an agriculture officer at the FAO, said by phone yesterday from Rome. While the disease hasn’t reached top Latin America exporters such as Ecuador, Costa Rica or Colombia, TR4 was discovered in Jordan and Mozambique, indicating it moved beyond Asia, he said.
“The export market is dominated by the Cavendish, and it is unfortunately susceptible to this particular race of the disease,” Dusunceli said. “This is serious for the medium term, but at the same time we should avoid panicking too.”
World banana exports were worth a record $8.946 billion in 2011, according to the most recent FAO figures. The U.S. is the biggest importer, followed by Belgium, the data show. Belgium’s Port of Antwerp is the world’s largest banana port, it says.
Tens of thousands of hectares of banana crops in Indonesia, China, Malaysia, the Philippines and Australia have been destroyed since the TR4 strain of Panama disease, a type of Fusarium wilt, first appeared in Asia in the 1990s, according to Wageningen University in the Netherlands.
Alcoa advanced 3 percent in early New York trading after saying that premiums for aluminum surged during the quarter. Intuitive Surgical Inc. slumped 9.1 percent after predicting that first-quarter revenue will decline by more than a fifth.
Futures on the Standard & Poor’s 500 Index expiring in June gained 0.1 percent to 1,847.7 at 10:39 a.m. in London. Dow Jones Industrial Average contracts added 38 points, or 0.2 percent, to 16,218 today.
“Alcoa has kicked off the reporting season with its first quarter numbers,” Richard Hunter, head of equities at Hargreaves Lansdown Plc in London, wrote in an e-mail. “Dow futures are pointing slightly higher, and the market’s recent lackluster performance offers the potential of something of a recovery. This will largely depend on improving U.S. economic data and, in particular, the strength of the corporate updates in the next few weeks.”
The S&P 500 rose 0.4 percent yesterday as technology shares dragged the index higher. The benchmark had retreated 2.4 percent in the previous three-day period.
The Federal Reserve releases the minutes of its March 18-19 meeting at 2 p.m. today. Officials dropped the link between interest rates and a specific level of employment at that gathering. TheFederal Open Market Committee said it would look at indicators including labor-market conditions, inflation expectations and financial markets.
A doctor who treats a degenerative eye disease in seniors was paid $21 million by Medicare in 2012, twice the amount received by the next ophthalmologist on a list of 880,000 medical providers released by the government. The data on the payments was given to the public for the first time today by the Centers for Medicare and Medicaid Services. The list, a detailed account of how $77 billion in federal health-care funds were spent in 2012, showed a wide range in which some top earners were paid as much as 100 times the average for their respective fields. Consumer groups have long urged the release of data showing Medicare’s true cost to taxpayers, saying it could help highlight fraud, while doctors’ groups argued against the release of raw payment data, saying it may lead patients to jump to the wrong conclusions. “When I was prosecuting Medicare fraud cases years ago, it was often difficult even for us as prosecutors to get Medicare data in a timely fashion,” said Jay Darden, a partner at Patton Boggs LLP in Washington who left the Department of Justice in 2010. “So the notion that now it’s not only being released, but released to the public, that could very well signal a recognition from CMS that it’s had a problem in the past and it needs to do something about it.” Two doctors listed, who together were paid about $30 million, spent time in court in 2013 on claims they defrauded the government. While Medicare fraud cases aren’t unusual, the data released will provide a new level of transparency into the agency practices that may force doctors to become more careful in how they bill for Medicare patients.
When Mario Draghi flies to the U.S. this week, he’ll leave a 1 trillion-euro ($1.4 trillion) question mark hanging over Europe.
While the European Central Bank president can show his new quantitative-easing plan to officials at the International Monetary Fund meetings in Washington, he has yet to reveal his full hand to investors on its design. That suspense risks setting them up for disappointment, according to economists at UniCredit SpA and Deutsche Bank AG.
With the revelation last week that the ECB has simulated an anti-deflation QE program deploying as much 1 trillion euros in bond purchases, Draghi and his colleagues can expect intensifying scrutiny of the measure he divulged on April 3. Governing Council member Ewald Nowotny signaled today that action isn’t likely any time soon and asset purchases may focus on private securities rather than public debt.
“All this talk about QE has gotten markets rather excited,” Erik Nielsen of UniCredit wrote in a note yesterday. “I am sure the ECB -– like most of us -– is happy about this, but action is not imminent. What happens when markets realize that this was all just a semi-public discussion of the toolbox – – and not what will happen, unless we get an emergency?”
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