They can sure try! I used to work somewhat closely with these negotiations - I was on the provider side, fwiw.
The big, big factor comes down to leverage, imo. If a payer has >50% market share, and there are a lot of physician groups, the payer will hit them over the head, take these crappy rates or I’ll take half your panel to a competitor. This is a big part of why payers and providers have consolidated.
As an anecdotal story, when I did this we had a physician group in Oregon (don’t want to get too specific here) that was getting paid about 230% of Medicare rates because they were the only game in town. But my physicians in Florida… there were WAY too many docs there for the population, so payers had leverage, and commercial rates were 20% BELOW Medicare. And Medicare rates aren’t exactly generous.
But I think this may be the case where it’s a shit sandwich, and everyone has to take a bite.
Still need to start selling some of my physical silver. A lot of this is about rotating into better stuff (e.g. switching from obscure sterling silver numismatic collectible coins to more popular collectible bullion e.g. Kookaburras).
So… gold down 12% plus or minus a bit. Time to buy more? Yes, the pick for Treasury is better than expected, but Trump’s still out there destabilizing the world and blowing out the budget.
Dollar strengthened for a bit…and now its back down.
Consensus is that USD will keep devaluing relative to the usual weighted basket of currencies (minus possibly JPY which is a mess still)
I don’t think buying gold at 5k makes much sense. Its already super volatile at that price, so the upside is potentially much smaller (vs your previous trades).
Capital flows (that used to go into the US) are now going to emerging markets because of the potential of better returns (due to starting from a lower base plus their goods are in global demand)
I personally do not invest in China because their governance is still very poor for external investors, but if this type of thing doesnt bother you as much it is worth considering.
Dipped my toes back in; 8% gold and 3% silver (as a % of my total investments) purchased today, up +1.8% from there and considerably more after hours. I still believe the stuff is headed higher, but didn’t want to stick around for the shakeout because I am a TERRIBLE INVESTOR.
Klayman, You’re buying volatile assets, and these have a way of embarrassing almost all investors at times. It’s clear to me that the longer term trends support metals pricing but if you’re watching returns over periods of days, weeks or months you are liable to get some rude surprises.
Agree, 11% is a pretty big concentration in something that is a day trade at this point.
Unrelated note: my SPHD (+6%) and LVHI (+7.5%) ETFs seem to have become a bit disconnected from the rest of the market (+1%) so far this year. My hot take is that they are starting to price in future inflation into dividends. 2021 showed that US companies could just reprice their products to remain profitable, and overall inflation did not hurt these companies, their profits just went u with inflation. Historically, they have had a .5 beta based on my experience watching my portfolio and surviving Liberation day volatility.
I’m not looking to “day trade” previous metals, I did manage to hold most of it for a year. But it did go crazy high and I wasnt comfortable with what going on. I guess if I believed the trend I could have just held on. I saw the crazy amount of selling at the local dealer along with reports that other dealers were having difficult selling what they were buying and I was sure some amount of bubble was ready to pop…
You got out and bought back in a week later after a dip, hoping to catch another rally.
It’s your money. If you have done your research and think its a good buy at 5k an ounce, do it. I think the rest of us are just making an observation based on what you have told us here.
If the 11% you have in metals is your target allocation, party on. If you started at 5%, maybe just rebalance back to 5%. You did something right to get to where you are, just take a step back and make sure you aren’t getting caught in a frenzy. It’s a good way to lose money.
We had a crypto thread going several years back. We all got into the frenzy, but with small amounts, DNGAF money. We all watched it double, and now its worth 35% of what we put in.
