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Daniel Andres Jacome

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  • Amedisys Positioning to Become the 800-Pound Gorilla of Home Healthcare [View article]
    hospice is lower margin but I beleive thier is more visibility there and earnings are less "at risk"
    Apr 12 08:40 AM | Likes Like |Link to Comment
  • Forbes Speculates on Winners From Healthcare Reform Bill [View article]
    the real question on this increased volume should be what is their margin profile versus BEFORE reform. In general, the volumes will come in at lower profits. Some company will pass along fees, others will not. Some will get healthy customers, some will not. Some companies will not see enough of a boost in volumes (maybe the mandate and penalties to small business are not enough) to offset the degradation in margins. As for pharma, the narrowing of the Part D gap also has mixed ramifications, given more adherence, more brand uptake presumably, but at the cost of providing rebates of ~50%....
    Apr 12 08:32 AM | 1 Like Like |Link to Comment
  • Healthcare Reform Hikes Corporate Medical Costs [View article]
    captain jack, the subsidy is still there, the tax advantage is wiped out
    Apr 3 05:12 PM | Likes Like |Link to Comment
  • Healthcare Reform Hikes Corporate Medical Costs [View article]
    so what? this was expected and has been known since last summer...what is more interesting: what will happen to the PBMs that service these employers. Presumably, some clients will drop the retirees and kick them into a PDP.......then what??
    Apr 1 02:25 PM | Likes Like |Link to Comment
  • Amedisys Positioning to Become the 800-Pound Gorilla of Home Healthcare [View article]
    Did you tax effect that +$0.31 EPS? Can you walk me through that EPS calculation again. 3% is the price add on? And there is a margin AMED gets off that, what is it? Just confused by your math
    Apr 1 08:59 AM | Likes Like |Link to Comment
  • U.S. Healthcare Reform: Likely a Big Boon for Majority of Healthcare Companies [View article]
    minimum MLR for some med advatange plans not good...the grp will have to play some reclassifying games b/t SG&A and med costs in order to please govt...oh well
    Mar 29 06:32 PM | Likes Like |Link to Comment
  • Tenet Healthcare: Potential Breakout Coming [View article]
    ** PE isnt really the best way to look at these guys since they are so cap intensive - EV/EBITDA much better...THC should be FCF positive sometime this year - thats a notable break from recent trends last few yrs

    ** agree that they will benefit from medicaid pool expnading - lots of exposure THC and HMA have to crowded ERs and un/underinsureds.....

    ** hard to see multiple expansion without their commerical volumes improving. Last q's trend wasnt what I was looking for on a sequential basis but as the economy improves, THC should see improvement.

    ** they have done an awesome job de-levering and people may not be giving them enough credit - thats has long been an overhang on the name. Last time I checked, CYH was most geared up name

    Thanks for article Zach!
    Mar 28 12:10 PM | Likes Like |Link to Comment
  • Psychiatric Solutions: Time to Take Some Profits? [View article]
    Real good article – thank you. I guess the argument against your thesis would be that the PSYS price right now doesn’t take into account that PSYS is the prime beneficiary of a regulatory ruling that passed in 2008.

    The legislation, THE MENTAL HEALTH PARITY ACT, outlaws health insurance practices that set lower limits on treatment or higher co-payments for mental health services than for other medical care. Typical annual limits in the past have included 30 visits to a doctor or 30 days of hospital care for treatment of a mental disorder. Otherwise stated, the new playing field mandates that plans require equivalence, or parity, in coverage of mental and physical ailments. This means managed care plans have to redesign benefits to better accommodate mentally ill people. I believe this should lead to an uptick in PSYS admissions over the long-term.

    If PE is looking at this, you are right, they’ll probably do the deal in the low 30s even though I think the stock is worth more that – its just that as you know, PE doesn’t want to give all the upside to current stockholders and rather keep more for itself when it refloats this in 2 years or sells it to an HCA or larger hospital system.
    Mar 26 08:03 AM | Likes Like |Link to Comment
  • LHC Group: Home-Based Healthcare Is Good Business [View article]
    nice thoughts. agree -- either way, bigger players will benefit from shift in reimbursment cycle and mom/pops will get rolled up. Industry should get more concentrated, you are right.
    Mar 24 10:53 AM | 1 Like Like |Link to Comment
  • How Much Does Healthcare Reform Cost? [View article]
    you are right - and as someone mentioned, the CBO score assumes the -21% cut to docs persists - back that out and you get a +$1T costing bill. The cost is higher than purported, the savings will likely be lower than purported. hocus pocus
    Mar 19 02:57 PM | 3 Likes Like |Link to Comment
  • Dark Clouds Hang Over WellPoint [View article]
    the jump in MLR guidance for 2010, 100 bps was due to reclassification of G&A stuff migrating to the MLR line...normalized, its +70 bps y/y
    Mar 18 05:52 PM | Likes Like |Link to Comment
  • Athenahealth's Q4 Results Come as Good News to Shareholders [View article]
    the blowup a few wks ago was silly - the segment they were going to restate was single digit % of sales - and yet 1/4th of the analysts who cover it downgraded it - rash reaction if you ask me.
    Mar 16 07:15 PM | Likes Like |Link to Comment
  • Why I Sold Walgreen and Bought Abbott [View article]
    ** the big question is what happens to RAD. There is still too much saturation in NYC - getting RAD out of the picture thru their demise, or selling off assets to WAG, would be terrific.

    ** Duane Reade was a .3x sales on a cash basis and they [WAG] got a solid sales/sq foot generator so Im optimistic about that deal longer-term.
    Mar 14 07:41 PM | Likes Like |Link to Comment
  • Why I Sold Walgreen and Bought Abbott [View article]
    WAG front end sales will be weird until the CCR initiatives is rolled through 3000+ stores – that’s roughly 43% of their store base. You made a good profit, so no hurt taking some $ off the table. Thinking more LT, however, its interesting how WAG is building a vast health services empire – the recent “rumored” deal with Delta may insinuate that they are trying to beef up their alternative PBM “eliminate the middleman” model….time will tell. Valuation on WAG is one of the highlights, but I don’t expect the PE to widen anytime near-term
    Mar 12 08:27 AM | Likes Like |Link to Comment
  • The Truth About the Health Insurance Industry [View article]
    "
    A major problem for group health care insurers during a declining payroll economy is that younger workers in excellent health choose to self-insure ( take their chances) and not to buy insurance, while those already in bad health or currently collecting more in benefits than they'll every pay in premiums stay insured through COBRA. "

    EXCELLENT POINT...adverse selection and member attrition are behind the rate hikes
    Mar 8 10:44 AM | 1 Like Like |Link to Comment
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