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10 Fundamental Things to Note About 1031 Exchanges

If you want to expand your investment portfolio through real estate, you should definitely pay attention to the 1031 exchange. The same knowledge could also come in handy if you are thinking about selling one of your properties and buying another for investment purposes. 

The 1031 exchange is probably one of the least known forms of investment strategy that allow you to defer capital gains tax after selling and buying a like-kind investment property.

1031 exchanges can be one of the most lucrative ways of developing your real estate portfolio if done correctly. Here are the ten essential things you should know about 1031 exchanges.

Understanding Section 1031 Provision

A 1031 exchange is a barter or swap of one’s business or investments assets for another of like-kind. The US Internal Revenue Code section 1031 defines what type of trade will be recognized. 

Although the exchange can be for various assets, its primary use is real estate investments. Most property exchanges are taxable as sales, but if yours qualifies for a 1031 exchange, you can have your capital gains tax deferred. 

Thankfully, there’s no limit on the number of times an investor can capitalize on a 1031 exchange. In short, you can buy investment properties and swap them as many times as you wish, as long as they meet the requirements.

Finally, you can pay tax at the long-term capital gain rate when you sell for a profit. Here are the fundamental points you should familiarize yourself with 1031 exchanges:

1. Exchange Property Should be for Business or Held for Investment Purposes Only

This provision for exchange is only for trade, business, and investment properties and not for personal use. Properties used as primary residences or vacation homes do not qualify.

However, a former primary residence may be applicable under certain conditions. 

2. Exchange Property Should be of Equal or Greater Value

It is important to note that the replacement property has to be of equal or greater value than the property you have sold. There is a provision to re-invest your proceeds into one or more properties of equal or more value.

Properties cannot qualify if they are in different countries. Both properties must be in the United States to be eligible for the 1031 provision.

3. Properties Must be ‘Like-Kind.’

The terminology ‘like-kind’ can cause some confusion as even though the like-kind phrase is broad, you should be careful how you use it.  

Replacement properties should not necessarily be the same type, but similar; both assets should be income-generating or held for investments.

For example, you may swap land with a building, or a multi-family home with a commercial property, so long as they are suitable for exchange.

Video: The 1031 Exchange Explained | A Faster Way to Build Wealth

4. Only Specific Types of Properties Qualify for the Exchange

Changes to the tax bill applicable after January 2018 indicated that tax-deferred exchanges are now only valid for the buying and selling of real estate, referred to as real property. 

All investment real estate property qualifies for an exchange, such as:

  • Land
  • Commercial properties
  • Single-family homes
  • Multi-family homes

Other assets such as vehicles, machinery, and other intangible business assets do not qualify for like-kind exchanges. 

5. Properties Held for Sale do not Qualify

If you buy a property intending to sell, you will not qualify for this provision. That’s because properties held primarily for sale cannot apply this exchange provision. If you sell this type of property, the taxman will treat it as ordinary income and charge you accordingly.

If, however, you maintain the property for investment purposes for several years, and the property attracts market-based gains, then you could qualify for the 1031 provision.

6. There are Time Constraints When Choosing Replacement Property and Closing the Deal

There is a stipulated timeline for the exchange and two fundamental rules to be observed. You have 180 days to complete the transaction after the transfer of the exchanged property.

Basically, from the day you sell your property to the final closing of the replacement property, you would have six months to complete the transaction. You have 45 days from the sale date to identify one or more potential properties for exchange formally. 

7. The Role of a Qualified Intermediary

Any proceeds that you receive from the sale of your property should be taxable. However, you should not touch the sale proceeds for the transaction to be eligible for the 1031 exchange. This is one critical factor that most investors are unaware of and often make mistakes.

It would be best if you transferred all sales proceeds to a third party, a qualified intermediary, who holds the proceeds and transfers them to the seller of the next property for you. Be careful not to use your own agent or fiduciary such as attorney, realtor, or Certified Public Accountant.

8. Three Property Identification Rules Apply

Identification rules will apply differently to multiple properties. In the first instance, you may identify up to three properties that are like-kind to be your replacement properties, irrespective of their value in the market.

The other rule allows you to identify an unlimited number of properties as long as their cumulative market value does not exceed 200% of the fair market value of your property.

The last possibility is known as the 95% rule, where you may identify several properties, but you must close on 95% of the value of all the properties you specified. 

Three Property Identification Rules Apply

9. Consider Depreciation Recapture

Since depreciation allows for lower property tax throughout its useful life, YOU should target this and capture some of these deductions and consider them into the total taxable income. 

10. File Your Reports to IRS

When filing your tax returns for the year, you also need to report the exchange. Use Form 8824 to indicate the exchange details, including the transfer dates, description of the properties, and their value.

If you assumed some liabilities after the transfer of properties, you should also indicate that correctly. Be careful when filling in the form to shield from adverse effects such as penalties or a high tax bill. 

Final Word

The 1031 provision allows many investors to defer their capital gains tax until later. That means many investors can grow and diversify their portfolios in an easy legal way.

However, you must engage with a qualified intermediary who will walk you through all the transaction steps and take advantage of this option to grow your portfolio.

Prepare the exchange properties well in advance and arm yourself with the correct information as you only have six months to complete the transaction after the initial sale. 

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A Beginner’s Guide to Real Estate Investing for Physicians

If you’ve decided to take the leap and start investing in real estate, congratulations! You’ve embarked on a journey that could potentially supplement your earnings. However, it can be a stressful experience if you don’t know your way around.

But worry not! This comprehensive guide will help you learn the ropes since it provides tips on the best real estate investments, spells out investing strategies with proven track records, and lists the best states for investing.

Why Invest in Real Estate

The US real estate industry is a robust and lucrative market, with a value of $113.58 trillion as of 2023. Residential real estate takes the lion’s share of the market, accounting for $88.91 trillion, while commercial real estate has a value of $24.67 trillion.

According to Redfin, the value of the housing market experienced a 5.3% annual increase ($2 trillion increase for a total of $47.5 trillion) in 2023, which is more than the total national debt ($34.8 trillion as of Q3 2024).

Value-of-US-homes-vs-national-debt

Value of US homes vs national debt

Source: https://www.investopedia.com/us-homes-got-a-usd2-trillion-value-boost-in-2023-8603202#:~:text=U.S.%20homes%20were%20worth%20more,lack%20of%20houses%20for%20sale.

Besides it being an enticing investment vehicle, here are other reasons to invest in real estate:

  • An additional source of income: Investing in rental property can help earn some passive income to cover the cost of the mortgage repayment and even supplement your earnings. The current market is especially lucrative as rents are rising faster than wages, with rents increasing by 4% between 2019 and 2023 compared to 20.2% for wages during the same period.
  • Potentially reduce your tax bill: There is a possibility of minimizing your tax burden by investing in real estate, such as deferring profits in a 1031 like-kind exchange or a Topic No. 701 personal-residence exemption for selling your home.
  • Diversify investment portfolio: You should consider investing in real estate as a hedge against losses when the stock market performs poorly. Diversifying your portfolio spreads your risk, improving your chances of navigating downturns unscathed.

Best Real Estate Investments in 2024

After extensive research, we found that these are the best real estate investments:

1. Rental properties

Becoming a landlord is a great way to earn some income. At the moment, the typical home is 37% more costly to buy than rent on a monthly basis, so naturally, more people are flocking to rentals.

As a result, rents for 2-bedroom apartments reached an all-time high of $1,716 in May 2023. Further, rental prices kept rising steadily, hitting $1,847 in March 2024.

However, remember that unless you hire a property manager, owning a rental property comes with extra responsibilities like maintaining the property, running adverts to find tenants, filing taxes, securing insurance, and paying the mortgage. On the other hand, hiring a property manager will mean a cut on your take-home.

2. REITS

Real estate investment trusts (REITs) are corporations or trusts formed to consolidate investors’ cash to buy, manage, and sell income-generating real estate properties.

They are bought and sold on major exchanges as you would stocks. A REIT pays 90% of its taxable profits to shareholders as dividends, so it does not have to pay corporate income tax.

Unknown to many, REITs outperform stocks over the long term. Data from the FTSE NAREIT shows it performed better than the S&P 500 over the past 20, 25, and 50-year periods.

REITS-outperforms-the-S_P-500-in-the-long-term.

REITS outperforms the S&P 500 in the long term.

Source: https://www.fool.com/research/reits-vs-stocks/

Although all equity REITs made a loss of 5.8% in April 2024, they bounced back in May 2024, chalking up 3.1%. Mortgage REITs offered 12.5% in dividends, while Equity REITs chipped in with 4.2%.

All-REITs-performance

All REITs performance

Source: https://www.reit.com/data-research/data/quarterly-reit-performance-data

3. Real estate investment groups (REIGs)

These operate like mutual funds for rental properties. They are appropriate for the investor who does not have the time to manage real estate but wants to enjoy the benefits of a landlord.

A REIG is a company that buys properties and allows investors to join the group. You can own as many units as you wish. The company will then take charge of maintaining, advertising, and running the properties in exchange for a cut of the monthly rent.

There are different types of REIGs:

  • Equity REIG: The most common, where investors earn income generated from rent, capital gains, and appreciation. A REIG can invest in multiple types of properties, like commercial, residential, or industrial real estate. Aimed at cash flow and long-term growth and investors who don’t mind real estate’s volatility and illiquidity.
  • Debt REIG: Invest in debt instruments (such as mortgages and loans) secured by real estate. They generate income from fees, interest payments, and principal repayments. Are not as lucrative as Equity REIGs, but are less risky. Suited to investors looking for predictable and steady income geared toward capital preservation rather than maximizing returns.
  • Hybrid: Refers to a REIG that invests in both debt and equity instruments. Enjoys the features of both types of REIGs, providing a balanced result of income and growth while diversifying exposure to varied market conditions. Moderate risk for the returns.

4. Real estate limited partnerships (RELP)

Similar to REIGs, only RELPs are set up for a finite number of years. The general partner (an expert in real estate investments) will set up a plan to acquire a viable real estate project and seek investors to finance the property’s purchase in exchange for shares.

The partners might receive some income from the unit as they wait for an opportune time, as the end goal is the sizable profit they will hopefully receive from selling the property.

5. Mutual funds

Real estate mutual funds usually invest in real estate operating companies and REITs, allowing for diversified portfolio and exposure. Several investors pool their cash to purchase securities in REITs or companies investing in real estate.

A real estate mutual fund refers to pooled investment consisting of real estate and other diverse investment vehicles, such as stocks and bonds, placed under professional portfolio management.

Investors receive returns from real estate mutual funds in two main ways:

  • Capital appreciation: An increase in the net asset value could mean greater profits if the underlying property is sold at this higher value.
  • Dividends: Mutual funds announce dividends. Taxes are paid before distributing the dividends, so the proceeds are tax-free.

6. Multifamily homes

The multifamily segment is worth $3.8 trillion and is renowned for its stability, adaptability to market dynamics, and consistent cash flow. Investing in multifamily homes presents opportunities for multiple revenue streams with an annual cash-on-cash return rate of about 5-10%.

This figure reflects the rental income only but does not account for the returns you will receive if you decide to sell or refinance the property. Taking into account the sale of the profit bumps up the returns to 18-22% on average yearly.

A study by the National Multifamily Housing Council (NMHC) shows the multifamily sector offers the highest returns and lowest volatility of all commercial real estate (CRE) sectors.

Multifamily-units-outperforming-other-CRE-segments-in-the-long-run

Multifamily units outperforming other CRE segments in the long run

Source: https://www.nmhc.org/contentassets/98b98e79c61c48f5ab981ffbc7713a9b/explaining-high-apartment-returns.pdf

7. Farmland

This is an underrated and often ignored sector in real estate, yet it has one of the best ROIs. It is a market that was worth $3.18 trillion in 2022, covering about 52% of all US land base.

Non-operator farmland owners (they own the land but don’t actively participate in farming) accounted for 31% of all farms in 2014. In the past 30 years up to 2024, non-operator owners rented about 40% of all farmland.

Farmland-real-estate-growth-in-value

Farmland real estate growth in value

Source: https://www.ers.usda.gov/topics/farm-economy/land-use-land-value-tenure/farmland-value/#:~:text=The%20value%20of%20U.S.%20farmland,percent%20when%20adjusted%20for%20inflation.

The value of farmland increased by 7.4% in 2023, with a compound annualized growth rate of 4.6% for the period between 2017 and 2022. Average annual returns is 12.8%, and the sector has recorded positive returns yearly since 1990.

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Strategies for Investing in Real Estate

These are the most popular real estate investing strategies:

1. Buy and hold

This refers to the practice where an investor buys a property, holds on to it long-term, and sells it when prices rise. With median home prices rising more than 200% over the past 20 years, it’s easy to see the appeal of this strategy.

You can also force appreciation by making improvements to the property, such as remodeling and raising the rent. Holding property for the long haul has several other benefits, such as tax shelter occasioned by depreciation and steady amortization of loans.

2. Fix and flip

This strategy involves targeting rundown homes, improving them, and selling them for a profit. Fix-and-flip investors enjoyed an average ROI of about 27.5% (gross profit of $66,000) in 2023.

Returns-on-house-flipping

Returns on house flipping

Source: https://www.attomdata.com/news/most-recent/home-flipping-plummets-across-u-s-in-2023-as-profits-slump-again/

However, you must possess knowledge of spotting structural issues in buildings to have any success using this strategy. If you don’t have the skills to gauge the structural integrity of properties, you could always engage experienced contractors or real estate agents.

Finding finances for the project might also be tricky because traditional lenders won’t advance you a standard mortgage for a fix-and-flip home. You can only rely on your savings or business partners.

3. Wholesaling

Find a property with great potential for high profits and link a buyer to the seller at a higher price than the selling price. Collect the difference in selling price and the amount the buyer pays.

It is heavily reliant on the “driving for dollars” technique, as most users of this strategy drive around neighborhoods looking for promising properties. You need a vast network of potential buyers and strong sales and marketing skills to pull this off.

4. BRRRR

It is short for “Buy, Rehabilitate, Rent, Refinance, Repeat.” It follows the same principles as fixing and flipping homes, but in BRRRR, you rent the unit instead of selling. After buying a distressed property, fix it, lease it, and once it has gained a history of cash flow, refinance and get cash to fund the next project.

It is a time and resource-intensive strategy, as you must have the resources to pull off the repairs without expecting to receive cash in the near future. You will also spend time managing the repairs and sourcing tenants.

Best States to Invest In

One of the best-known phrases in real estate is “location, location, location,” with good reason. Your success in real estate investments will have a strong relation to where you buy the property. Therefore, it is essential that you buy a property in the best real estate markets.

Each state has its own pros and cons, so it is critical that you familiarize yourself with information pointing to the suitability of investing in a particular state.

After an extensive review of real estate data, we’ve compiled the list below showcasing some of the best states to invest in:

1. Idaho

The 14th largest state’s median home price of $460,955 is reasonably above the US median home price of $363,438 in June 2024. Its GDP has grown by over 15% in the five years to 2023, and annual employment growth is 2.7%.

2. South Carolina

Homes are affordable, as they will set you back $301,130 only, while the value of homes increased by 3.7% between June 2023 and 2024. The state charges a lowly effective property tax rate of 0.50%, minimizing operating expenses.

3. Kentucky

This state is well suited to beginner real estate investors because homes cost just $251,300 as of June 2024, a 3% increase year-over-year (YoY). The typical rent is about $1,259, and there are no rent controls. Population growth is 0.32% YoY in 2023.

4. Indiana

With a median household income of $66,785, low cost of living (91.5), lowly home value of $242,500 (as of November 2023), and annual home appreciation rate of 6.1% between Q2 2022 and Q2 2023, Indiana presents an enticing prospect for real estate investment.

5. Georgia

The typical home has a manageable cost of $316,000. The median household income of $72,837 combined with a low annualized unemployment rate of 3.2% in May 2024 and a 1.3% jobs growth YoY in June 2024 place Georgia on the radar of most savvy real estate investors.

Final Word

Your best chance to stay ahead of the competition is to invest time learning and researching about the real estate business.

This will help you gain insights on making inroads in the industry and how to avoid potential pitfalls. Most of the information is readily available online on helpful sites such as BiggerPockets and Realtor.com.

Further, consult experienced contractors and real estate agents operating in your target area to learn more about the intricacies of the local market. They are a source of expert knowledge and networking opportunities when you start operating in that area.

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Why Doctors Can’t Make Ends Meet

Doctors claim they can’t seem to catch a financial break as inflation puts a squeeze on earnings, which is exacerbated by the widening gap between the rising cost of healthcare delivery and stagnating Medicare reimbursements.

Data points out healthcare prices grew faster than other components of the economy, rising by 3.3% between 2001 and 2021, unlike all goods and services, which only expanded by 2.2% during the same period.

However, the Bureau of Labor Statistics (BLS) data shows health insurance experienced a yearly rise of 28% in September 2022, higher than the inflation rate of 8.2%. Moreover, although health prices traditionally outpace inflation, the consumer price index (CPI) grew by 3.5% in March 2024, while medical prices rose by only 2.2%.

So, does this prove doctors are better off? Not really.

There seems to be a downward spiral of doctors’ earnings, with a study pointing to a 24.9% decrease in inflation-adjusted reimbursements to radiologists per beneficiary between 2005 and 2021. This article provides an in-depth analysis of the effect of inflation on Medicare reimbursements and its contribution to impoverishing doctors.

The Rising Cost of Healthcare Delivery

The government uses the Medicare Economic Index (MEI) as a measure of inflation in medical practice costs. 2024’s adjustments in reimbursements (effective 7/1/2024) raised the MEI percentage to 4.7%, up from 3.8% in 2023. This is the highest MEI percentage this century.

The American Medical Association (AMA) compared the rise in physician payments to inflation and found it declined 29% between 2001 and 2024. This proves payments are not keeping up with practice cost inflation.

Physicians’ payments do not match inflation

Physicians’ payments do not match inflation

Source:  https://www.ama-assn.org/system/files/2024-medicare-updates-inflation-chart.pdf

This is in stark comparison to other health professionals who have their annual increases based on MEI. If that were to apply to physicians, they would have seen their payments increased by 4.6%, not reduced by 4.7%.

John Corker, MD, emergency physician, put it succinctly:

“…over about the last quarter-century, doctors’ offices and physician practices have been dying a slow death by a thousand paper cuts as it pertains to Medicare reimbursements.”

From 2001 to 2021, physicians’ pay dropped by 1.1% per year on average, for a cumulative decline of 20%. The pay diminished a further 4% (adjusted for inflation) between 2021 and 2023.

Medicare payments compared to inflation (2001 to 2021)

Medicare payments compared to inflation (2001 to 2021)

Source: https://www.ama-assn.org/system/files/medicare-pay-chart-2021.pdf

By comparison, the CPI grew by 3.5% in March 2024 year-over-year (YoY) compared to a 2.2% rise in medical care prices. This does not follow the usual trend as medical care prices typically outpace the CPI historically.

CPI vs. medical care prices

Source: https://www.healthsystemtracker.org/brief/how-does-medical-inflation-compare-to-inflation-in-the-rest-of-the-economy/#Annual%20percent%20change%20in%20Consumer%20Price%20Index%20for%20All%20Urban%20Consumers%20(CPI-U),%20January%202001%20-%20March%202024

Increased costs of medical equipment, supplies, and technology

The cost of inpatient and outpatient hospital and related services (7.7%) and nursing homes (3.9%) rose higher than physicians’ services (0.7%) and prescription drugs (0.4%). By 2021, an estimate shows the average pharmaceutical supply costs increase by nearly 12% annually ($10.21 million per hospital in 2014 vs. $18.4 million in 2021).

Medical surgical costs increased by about 6.5% on average between 2017 and 2021. Digging deeper, the costs went up by 3% between 2019 and 2020 compared to a 10% increase between 2020 and 2021.

Rising cost of medical and surgical supply costs

Rising cost of medical and surgical supply costs

Source: https://www.definitivehc.com/resources/healthcare-insights/changes-in-supply-costs-year-to-year

This is impactful since medical and surgical supply costs make up about 35% of all hospital supply expenses. Moreover, the Centers for Medicare and Medicaid Services (CMS) predicted that hospital provider spending will increase by 50% between 2022 and 2030.

The impact of inflation on operational expenses

While supply and labor costs are rising, hospital margins continue to shrink. The AMA notes that the cost of running a medical practice between 2001 and 2021 grew by 39% (1.6% increase yearly increase), while the MEI leaped by 51% during the same period (2.1% annually).

With inflation still some way above ideal levels, hospitals are struggling to maintain staffing levels. Further, healthcare workers’ incomes were at a 4.5% deficit compared to national income levels in 2022. This has contributed to a nursing shortage estimated to run well into the near future.

Nursing shortage projections

Nursing shortage projections

Source: https://kpmg.com/kpmg-us/content/dam/kpmg/pdf/2023/the-impacts-of-inflation.pdf

Healthcare labor costs per adjusted hospital discharge increased by 25% between 2019 and 2022, with services at 16%, supplies at 18%, and pharmaceuticals at 21%. Labor costs still remain high, which could lead to a 10-20% deficit in registered nurses and a 6-10% shortage in doctors by 2025.

The Labor shortages could lead to a decline in health systems and cause access risks because of increased wait times and site-of-care closures. John Corker, MD, observed:

“…Doctors are forced to make difficult decisions about what days they can be open, what staff…they can afford to pay, and…what services they can provide for their patients.”

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The Stagnant Medicare Reimbursement System

The Biden administration slashed 2024 Medicare reimbursements by 1.25% from a year ago. This included a 3.4% decrease in the conversion factor. Keen observers would have noted this follows in the steps of a 2% reduction in physicians’ payments in 2023.

Data shows that health insurance prices in September 2022 had grown by 28% from the previous year, while inflation growth was only 8.2%. It came as no surprise when the shares of health insurers fell by 6% and 12% in April 2024 when announcements for the Medicare Advantage payments by the government signaled a cut in 2025 rates.

The rates were only a 0.2% drop from the previous rates but were enough to trigger suspicions of a margin squeeze from an industry grappling with high medical costs. Insurers are under pressure to lower the number of benefits due to the low rates and high costs.

How did we get here?

The formulas used to determine the prices of healthcare services are not only used to determine the prices in the prevailing year but are also used to update prices over time. In short, each year’s update is determined using projected changes in the “market basket index,” which is usually finalized in Q2 of the preceding year.

This quirk in price planning means projection errors sometimes occur and are often not accounted for when determining the payment updates. Failure to fix the error results in lower payments and creates a domino effect of lower prices in subsequent years.

For instance, the market basket increase projections for 2021 (made before the spiraling inflationary trends experienced at the back end of 2020) were determined at 2.4%, but the actual increase was 3.1%. The following year (2022), the projections of 2.7% were also made in Q2 2021 (during periods of relatively low inflation), yet the actual market basket increase was higher than 4.1%.

Projected vs actual market basket changes

Projected vs actual market basket changes

Source: https://www.brookings.edu/articles/what-does-economy-wide-inflation-mean-for-the-prices-of-health-care-services-and-vice-versa/

Remarkably, the market basket projections between 2009 and 2019 were 0.4% above the real increase on average.

How Medicare reimbursements are determined

Medical reimbursements are typically pegged at 80% of the cost of services provided, although they could drop to 75% for clinical social workers and rise to 85% for clinical nurse specialists.

The establishment rate schedule contains pre-determined base rates calculated using the resource-based relative value scale (RBRVS) grounded on a formula that takes into account several factors:

  • Complexity of service provided
  • Type of equipment used
  • Geographical location of the facility and services
  • Type of medical facility or professional
  • Adjustments for inflation on the services and procedures

It is multiplied by a conversion rate to determine the final disbursement.

Impact of inflation on the purchasing power of Medicare payments

Since healthcare services account for 16% of personal consumption spending on average, any changes in inflation will have some impact on Medicare payments. According to the Medicare Plans Patient Resource Center, nearly 33% of Medicare recipients spend 20-30% of their monthly wages on healthcare.

Most beneficiaries pay the base amount of Medicare Part B, which is adjusted yearly for inflation and is paired with the cost of living adjustment (COLA). The Social Security Administration determines the COLA increases since most premiums are deducted from social security benefits, and the goal is to ensure the stability of the beneficiaries’ buying power.

However, COLA does not always keep up with inflation. For instance, COLA was 5.9% in 2022, but the average inflation rate stood at 8%, which was not enough to cover Part B premiums.

The same trend is seen in Medicare Part D costs, where in 2020, prices of 50% of all prescription medications covered by Part D outstripped the inflation rate. Average prices rose from $31.47 monthly in 2021 to $33 in 2022. This meant Part D participants paid higher premiums for medication coverage and made more out-of-pocket payments.

John Corker, MD, observed:

“…And I think at the end of the day, it all comes back to access. If doctors can’t keep their doors open and they can’t have appropriate staff because of dwindling reimbursement rates for Medicare, patients can’t access services from their doctors.”

The Impact on Patient Care

Inflationary pressures could lead to a reduction in patient volumes, causing medical facilities to cut costs by reducing investments in healthcare. The financial pressures also affect doctors’ ability to provide quality care, and patients postpone or stop treatment to stay within their budgets.

For instance, when inflation breached a 40-year ceiling in 2022, about 38% of adults skipped or delayed treatment. They cut back on essentials like food and utilities or borrowed money to pay medical bills.

This could spell doom for 116 million people living with hypertension, 37 million with diabetes, and others with other chronic diseases who can’t afford to postpone or skip medication as it could be life-threatening.

People are forced to choose between day-to-day necessities, which compete with the need for healthcare. And if they were to decide to take on second jobs, the extra hours spent on working could harm their health. A study shows that for every $1 spent on healthcare benefits, $0.61 of productivity is lost to injury and illness.

A 2024 National Bureau of Economic Research study shows that every $100 (24.4%) decrease in the monthly budget for prescription drugs resulted in a 13.9% rise in deaths, primarily caused by patients cutting back on costly medication for hypertension, asthma, diabetes, and heart disease.

As Dr. Jason Goldman, MD, put it:

“…fix Medicare now, not just because physicians need to be paid fairly, but because the patients need their physicians. And if they do not fix Medicare, we will not have a healthcare system.”

It should also be noted that inflation raises costs in the long term, which can cause changes in behavioral health that may negatively impact overall health.

Potential Solutions

Several proposals have called for physicians’ pay to be tied to inflation. In late March 2024, the Medicare Payment Advisory Commission (MedPAC) recommended the pay be pegged at 50% of MEI, but the AMA proposed an annual inflationary payment update tied to the MEI.

That’s because the practice-expense part of physicians’ pay accounts for more than half of Medicare physicians’ payments. MedPac wrongly asserted that half of MEI covers all physician’s practice costs. However, this assertion omits the costs of running a medical practice, such as the energy, time, and expertise spent treating patients.

The AMA also called on congressional leadership to ensure physicians’ pay keeps up with inflationary growth in health care costs yearly. It is worth noting that physicians are the only providers who are unrepresented in the inflationary payment update.

This is especially important because a payment freeze is in place until 2026 and will resume at a 0.25% yearly increase indefinitely, although projections show clinician’s costs will rise by more than 2% annually from 2025 through 2033.

Final Word

While inflation is inevitable, the foremost issue physicians face is that Medicare reimbursements do not keep up with inflation. Further, the CMS estimates national health expenditure will grow 5.4% yearly from 2019 through 2028.

These will add to the cost of ballooning wages, capital, overhead, and maintenance costs, making it increasingly difficult to remain in practice. Physicians are faced with tough choices in the face of underpayment relative to inflation, forcing them to cut corners that negatively impact the provision of patient care.

Physicians will continue to feel the inflationary pressures for the next 2-3 years until the subsequent renegotiation of contracts to align payment with costs.

What can you do?

  1. Be a voice of change: Reach out to your congressman, association, patients, and state medical society and express your views on the matter.
  2. Optimize operations: Streamline operations to minimize wastage and hire staff appropriately.
  3. Network: Partner with other physicians or medical facilities to pool operational resources.
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Crypto vs Central Bank Digital Currencies: Who Wins?

Central Bank Digital Currencies (CBDCs) are a new entrant in the world of finance, even newer than cryptocurrencies. They are a type of currency promising faster transaction speeds at a lower cost than traditional currency.

At their core, CBDCs are digital currencies that operate on the blockchain, like cryptos. So, are CBDCs a plot by Central Banks to replace crypto, or are they designed to work alongside one another?

This article examines CBDCs and cryptocurrencies and their use cases and investment options for physicians.

The Concept of CBDCs

The most common medium of exchange we are conversant with is fiat currency, typically in the form of banknotes and coins. A CBDC is the digital currency equivalent of fiat currency—it has all the functionality and utility of fiat currency but in a digital form.

97% of the money currently in circulation is in digital format, mostly from checking deposits. However, CBDC differs from normal digital cash because it is a direct liability to the Central Bank, like coins and paper money.

CBDCs operate like cryptocurrency—users utilize digital wallets for transactions, which are recorded in a blockchain database. Unlike cryptos, CBDCs are managed by Central Banks. This is aimed at enabling the government to manage money more effectively.

They eliminate the threat of private entities controlling a country’s economy. For instance, Alipay and WeChat Pay account for 94% of all Chinese online transactions, which could lead to anticompetitive tendencies.

The leading CBDC, e-CNY, digitalizes some of China’s physical coins and notes that are already in circulation. e-CNY allows users to make e-yuan payments even in offline stores or without a charged phone. Like fiat currency, CBDC systems don’t require intermediaries to process payments, boosting efficiency and lowering costs.

CBDCs offer the same convenience as cryptos, and since they are backed by the Central Bank, they are more trusted. Its inherent properties have led to more widespread research and adoption of CBDCs.

Rise of CBDC usage

Rise of CBDC usage

Source: https://www.imf.org/en/Publications/fandd/issues/2022/09/Picture-this-The-ascent-of-CBDCs

Benefits of CBDCs

1. Increased stability

Cryptos are highly volatile since they are subject to market sentiment, and there is no regulatory body monitoring their performance. On the other hand, CBDCs have a central bank monitoring and regulating them, ensuring price stability.

For instance, when the US faced 40-year high inflation rates of 9.1% in June 2022, and the dollar index hit 20-year highs of 112.12 in September 2022, the Federal Reserve (The Fed) raised interest rates by 5.25% points between 2022 and 2023 in a bid to stabilize the dollar.

These measures have seen interest rates cool down to 3.36% in April 2024, although it is still not at the Fed’s target rate of 2%. The dollar index has since lowered to 104.43 in April 2024. A central bank can do the same for a CBDC since it controls it.

Cryptocurrencies have no entity controlling them, so their prices can rise and fall seemingly on a whim. For example, Bitcoin’s price hit $69,000 on November 10. 2021. By December 31, 2021, it was trading at $46,208. In January 2023, its price was $16,530, but it rose to $42,258 by the close of that year.

Bitcoin’s price swings

Bitcoin’s price swings

Source: https://www.investopedia.com/articles/forex/121815/bitcoins-price-history.asp

2. Easier integration with traditional finance

Central Banks have designed CBDCs to operate seamlessly with the available cryptocurrencies and blockchains, which could enhance interoperability between digital and traditional finance systems.

3. Legitimacy

Cryptocurrencies are plagued by legitimacy concerns since no one controls the blockchains in which they operate. CBDCs are a cure for this as central banks regulate them, encouraging more people to invest in them as there is a familiar entity to ensure fairness in dealings.

A poll covering 13 countries found that most respondents prefer digital currencies issued by their central banks rather than private entities (by 13 percentage points). They also inferred that safety and privacy are the most essential features of a digital currency, even more important than convenience. 

4. Regulatory compliance

Since CBDCs are developed by Central Banks, they are more likely to adhere to regulations. The banks give clear guidelines on their usage, eliminating uncertainty.

Regulators are still coming to terms with crypto, so they keep on enacting laws that could be detrimental to their development and operations.

5. No need for a bank account

6% of US adults are still unbanked and often rely on costly alternatives like money orders and payday loans. CBDC eliminates the need for a bank account to transact. All you need is a smartphone and a smart wallet to access your cash and transact at much lower fees.

Drawbacks  

1. Centralized

CBDCs are subject to government control, unlike decentralized cryptocurrencies. The disadvantages of centralization include:

  • Vulnerability to cyberattacks and hacking. The servers are in a centralized platform under the control of a single entity, so the information could be easily accessed once breached. Crypto, on the other hand, is stored in several decentralized ledgers under no one’s control, and the data is immutable. Any unauthorized changes to the data are rejected.
  • Lack of transparency. The Bank decides what information on transactions it will disclose, unlike cryptos.  
  • Manipulation by the Central Bank. Centralized monetary systems can be controlled by a central bank. They can make decisions in their best interests instead of letting market forces dictate pricing, as happens with cryptocurrencies.

2. Privacy concerns

They also come with the baggage of diminished privacy, which is hard-baked into cryptocurrencies. Moreover, CBDCs offer none of the finality or privacy protection of hard cash. The Bank does not know what dollar bill a person has. However, it can access information on the users of each CBDC and use that information as it deems fit.

How Can Physicians Invest in CBDCs?

CBDCs operate like cryptocurrencies, so most of the investment avenues applicable to crypto will likely work on them. Although CBDCs have limited investment opportunities since they are a relatively new concept, they present prospects for direct and indirect investments.

China launched e-CNY in January 2022 in 11 pilot areas, with special emphasis on trials in venues used in the Beijing Winter Olympics in February and March. Following its success. The central Bank has now run test pilots in 23 cities.

As of October 2021, 123 million individual and 9.2 million corporate wallets were operational, with a cumulative transaction value of about $8.8 billion. Although they have not released official figures, Central Bank officials estimate that by March 1, 2022, 261 million wallets were in operation, with transactions hitting approximately $14 billion.

Since then, the central bank governor says transactions grew to $249.33 billion by the end of June 2023, up from about $13.8 billion in August 2022. This growth was spurred by 950 million transactions. Interestingly, this only accounts for 0.16% of all China’s cash in circulation, so there’s still plenty of room for growth.

By buying shares in companies or projects that facilitate payment, growth, or asset management solutions for CBDCs, an investor could see their investment grow with mass adoption. For example, Project Cedar is developing a platform enabling cross-settlement of wholesale cross-border multi-currency payments.

Alternatively, you could invest in an organization that could potentially utilize the CBDCs. These include banks that have expressed an interest in adopting the new tech. FinTechs involved in digital payments are also likely to use it more often once it gains widespread usage.

Like crypto, an emerging investment class for CBDCs is exchange-traded funds (ETFs). These will track the price performance of the CBDCs, allowing investors to speculate on the price movements of foreign exchange and currency markets.

Like FX trading, users can buy and hold on to a CBDC in the hope that it will increase in value. If it does, the investor can sell it for a profit.

Though difficult, the key is to monitor trends, developments, and financial news to find the opportune time to make the investments.

What are Cryptocurrencies?

Cryptos are also digital currencies whose transactions are recorded, verified, stored, and run on a decentralized system of distributed public ledger called the blockchain. Before any transaction is recorded, it must be agreed upon by the nodes that maintain the ledger. Cryptos facilitate secure digital payments and can also be used for investing.

How Physicians Can Use Crypto to Manage Their Finances

Physicians can utilize crypto in several ways:

1. Savings for the practice

One of the underrated uses of crypto or the blockchain is its ability to minimize costs since no intermediaries are used to transfer the funds.

For example, the World Food Program implemented the Building Blocks blockchain pilot program in Jordan in 2017, which enabled the organization to save $2.4 million in reduced administrative and transaction costs.

2. Streamline operations

The healthcare industry faces widespread inefficiencies, with experts estimating it loses 25% in wasteful spending annually. Inefficiencies in the supply chain also add up to 50% in operational costs.

The blockchain can replace and hasten the manual inventory management process, which is error-prone and requires frequent upkeep. Using the blockchain might improve the tracing of supplies, and smart contracts can trigger supply chain operations like ordering supplies, reducing operation time and reliance on third-party verification.

Streamlining operations is such a crucial part of doing business that a survey shows that 70% of retail and manufacturing businesses have started shifting to digital supply chain operations.  

3. Yield farming

If you have some cash lying in a low-interest bank account and have the appetite for a high-risk high-return venture, try yield farming.

It is a form of investing otherwise known as liquidity mining, where you can lend your crypto assets or set a smart contract that automatically moves your crypto holdings to a blockchain network paying the highest interest. Yield farms can offer annual percentage yields (APY) of over 200% compared to Bank APY’s of 1-4%.

Since crypto prices are highly volatile, prone to interest rate fluctuations, and smart contracts can fail, this is a risky venture. Token pools like Venus, Uniswap (V3), Curve Finance, and PancakeSwap (V2) offer reasonable returns.

4. Staking crypto

Another passive way to earn some returns is to lock your crypto assets on a certain blockchain and agree not to sell or trade it (staking). For example, about 27% of all the Ethereum is staked as of May 30, 2024.

Biggest cryptocurrencies based on total staked value as of December 5, 2023

Biggest cryptocurrencies based on total staked value as of December 5, 2023.

Source: https://www.statista.com/statistics/1279011/crypto-staked-value/

You will receive interest or rewards in return. Data from Statista shows rewards can go as high as 19.7%.

Benefits of Cryptocurrencies to Physicians

1. Lower fees

Crypto transaction costs can be lower than traditional bank charges, especially for international transfers. A physician can take advantage of this when processing and paying for supplies from abroad.

2. Faster turnaround

Some payment options, like wire transfers, have long wait times, often lasting 1 to 2 business days. You can complete a transaction on the blockchain in a matter of minutes, even when sending money to offshore suppliers.

3. Immutability of records

Data is recorded on the blockchain, and it cannot be changed. This enables secure storage of sensitive information, like patient records, or data prone to manipulation, like inventory figures.

Drawbacks

1. Limited acceptance

CBDCs are supplied by the country’s Central Bank, so they are legal tender. Some countries may limit the usage of cryptocurrencies, while countries like China, Bolivia, and Saudi Arabia have banned crypto usage entirely.

2. High risk

Compared to most other options, cryptocurrency investing is one of the riskiest. It is subject to extreme volatility and regulatory uncertainties.

Using a Two Sigma Factor Lens, not including the crypto factor, 90.76% of Bitcoin’s risk between January 2015 and March 30, 2021, is inexplicable. By comparison, the S&P 500 showed a less than 1% residual risk over the same period.

Bitcoin’s risk

Bitcoin’s risk

Source: https://www.twosigma.com/articles/risk-analysis-of-crypto-assets/#:~:text=91%25%20of%20Bitcoin’s%20risk%20since,lower%20than%20that%20of%20Bitcoin’s.

Final Word

The best investment vehicle for your particular case will depend on your risk appetite. If you are risk averse, investing in CBDCs could be the right move. The Central Bank is directly liable for it, and its value is usually pegged on the national currency, enhancing price stability.

If you have the stomach for higher risk, cryptocurrency investing is the way to go. Market forces dictate crypto prices, so there’s potential for higher returns. Besides investing, crypto could help cut transaction costs and streamline operations by automating some tasks in supply management.

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Crypto vs Gold vs Stocks vs Real Estate: Which Should You Choose?

Gallup released a report on Americans’ favorite long-term investment options. The findings showed that the top 3 investment assets were real estate, gold, and stocks.

Investing in either one of these could prove a prudent decision, but which is best?

The statistics show at least 65.9% of Americans own their homes, while 61% own stocks. Only 38% of retail investors have ownership of physical gold. Considering a survey asserts that 40% of American adults now own cryptocurrencies, we’ll include it in this analysis.

We’ll provide all the top reasons for investing in each of these assets, possibly helping you determine the best option.

A. Why Invest in Real Estate

In the 2023 Gallup report, 34% of Americans thought real estate was the best long-term investment. And it’s easy to see why.

Real estate is often at the apex of passive income streams, as its value generally increases over time and helps its owners build equity. Further, real estate is a great hedge against inflation since a rise in inflation almost always means an increase in prices, delivering positive returns in the long run. Here’s why you should consider investing in real estate:

1. Appreciation

Fluctuations in interest rates influence the mortgage rate and real estate affordability, consequently impacting demand for real estate. The current 30-year fixed mortgage interest rate average of 7% is partly to blame for the stratospheric rise in housing prices.

Predictably, housing affordability has been on the decline. The National Association of Realtors (NAR) found that a 7.7% increase in monthly mortgage payments in March 2024 year-over-year (YoY) contributed to a 4.7% increase in the median home price.  

Despite all this, home prices continue to rise, reaching all-time highs of $552,600 in Q4 2022 and still persist beyond the half million mark to date. Even with the stubbornly high mortgage rates, home sales remain beyond the 4 million mark, only dropping below this once in 2023.

Real estate performance over time

Real estate performance over time

Source: https://www.redfin.com/news/housing-market-value-hits-record-high-2023/ 

2. Hedge against inflation

Generally, a strong economy fuels housing demand as more people have the money to buy homes, and the opposite is true.

For instance, the US economy faced headwinds in the past four years, with the economy contracting for consecutive quarters in 2022 and 2023, hitting lows of -2% in Q1 2022. The Federal Reserve (Fed) instituted a series of interest rate hikes in a bid to tame runaway inflation.

Despite this, median rent prices hit all-time highs of $2,054 in August 2022. Home median sale prices also reached all-time highs of $432,525 in May 2022 and still lurk beyond the $420k mark to date.

3. Diversified portfolio

You might think the real estate industry is a monolithic investment path limited to buying and selling property, which is a preserve of the rich. However, it is much wider than this, enabling even investors of modest means to dip their toes in the industry:

  • Renting out property: Purchase and let rental property. Use the proceeds of the rent to pay the mortgage fees. Only 65.7% of American adults own their own home as of Q4 2023, so there’s still plenty of market for rental housing.
  • Real Estate Investment Trusts (REITs): Combines the liquidity of a stock with the ease of owning…a stock. Investors earn returns from real estate appreciation and dividends, too. National Association of Real Estate Investment Trusts data shows REITs outperform stocks on 20-50 year horizons, providing 12.7% annual returns vs 10.2% average stock market return from the S&P 500 between 1972 and 2023.

Nareit Performance

Nareit performance.

Source: https://www.fool.com/research/reits-vs-stocks/

  • Real estate platforms: These platforms unite investors with developers seeking capital to finance projects. While some only allow accredited investors, some take advantage of fractional ownership, allowing investors to only purchase a fraction of the property. Fractional ownership has found some usage in the blockchain, enabling the tokenization of real estate properties.

B. The Case for Investing in Crypto

Cryptocurrencies have acquired a bad reputation for volatility, but high risk can come with great rewards. Understanding the characteristics of this emerging market could potentially hold the key to higher returns.

1. Potential for high returns

Most cryptocurrencies, like Bitcoin, have a supply cap. A limited supply creates scarcity, which might increase its value over time.

Bitcoin also has halving events, which slows down its rate of production. These halving events have historically led to increases in Bitcoin prices.

After the first halving event in 2012, Bitcoin’s price rose by 145% in the first 90 days, 982% after 180 days, and 7,851% a year after. On average, its price has increased by 2,908% a year after each halving. Even the most conservative uptick happened during the second halving, where the price appreciated 279% a year later.

Bitcoin has outperformed all other major asset classes in eight of the past ten years (2013-2023). Since its inception, Bitcoin has recorded 116.01% annualized returns compared to its nearest competitor, the S&P 500 index, which managed 13.48%.

Bitcoin vs. other asset classes

Bitcoin vs. other asset classes

Source: https://www.visualcapitalist.com/bitcoin-returns-vs-major-asset-classes/

2. Could be a hedge against inflation

Fiat currency is controlled by Central Banks, which can influence it to achieve a favorable outcome. Cryptocurrencies are different as they operate on the principles of decentralization, free from manipulation by any entity.

Cryptos like Bitcoin also go through halving events, which cut down their supply by 50% at set intervals. These measures ensure cryptos do not face the same inflationary pressures triggered by fiat currency supply growth, which could minimize loss of value due to inflation.

C. Why You Should Try Gold

Gold has held a special place in investors’ portfolios for a long time. It is the go-to investment in times of geopolitical and economic uncertainty for various reasons:

Gold reaches all-time high

Gold reaches all-time high

Source: https://www.xm.com/research/analysis/allNews/xm/technical-analysis-gold-unlocks-fresh-all-time-high-again-195318

1. Hedge against inflation

Gold has a proven track record of holding value, making it the perfect medium to hedge against inflation in times of economic turmoil. It has an inverse relation to other types of investments, usually rising in value when the economy is on shaky ground.

For instance, while the value of the S&P plummeted by 56.8% during the 2007-2009 financial crisis, the value of gold rose by 25.5%. Its value increased by 101.1% between 2008 and 2012.

It’s also a great option when faced with market uncertainty. When the Israel-Palestinian conflict began in early October 2023, gold prices gained 6.8% within a few weeks.

While inflation has failed to dial down to the Fed’s target of 2% since 2021, reaching highs of 9.06% in June 2022, gold rose by 8.57% between February and March 2024, easing past $2,300 an ounce, an all-time high.

2. Store of value

Gold prices are relatively stable compared to other investment assets like stocks. Using the Dow Jones Industrial Average (DJIA) as an example, gold has outperformed it in 43% of the years between 1925 and 2015, despite only a 2.1% average return annually compared to 7.3% for the DJIA.

Even during times of recession, the two-year average return for gold is about 1.65%, while the DJIA dipped to lows of 55% during the Great Depression in the 1930s. Gold even remains stable in the good times, performing 13% better on average in 26 of the 65 years without a recession.

Gold’s performance over the years

Gold’s performance over the years

Source: https://www.economicsobservatory.com/is-gold-a-safe-haven-for-investors#:~:text=Over%20the%20past%20100%20years,%25%20(see%20Figure%203).

D. Reasons to Invest in Stocks

A 2023 Gallup survey found that 61% of Americans own stocks. Stock ownership, on average, was 62% between 2001 and 2008. The top 1% hold 49.4% (worth $19.7 trillion), while the top 10% own 93% of all stocks. What is the allure of stocks?

1. Potential for higher returns

While stocks might be perceived as high-risk investments, they also possess the potential for high returns. They certainly provide higher returns than conventional investment options like gold, treasury bonds, and bank deposits.

For example, stocks returned a 10.4% yearly average between 1989 and 2017, compared to just 6.1% for bonds over the same time. Returns from the stock market can go as high as 40% yearly, but beware—they can also dip by as much as 40%.

2. Beat inflation

While stock prices are volatile, they tend to level off in the long run. Therefore, they are a great option as a hedge against inflation for long-term investors. As studied over the past 35 years, the stock market shows a positive return in nearly every 7 out of 10 years.

The average inflation rate has hovered around the 2 to 3% mark for the past 20 years (2003 to 2023), with the long-term inflation rate at 3.1% since 1913. Large domestic stocks recorded an annualized average return of 7.7% (or 9.8% with the dividends reinvested) over the same 20-year period.

Historical performance of the S&P 500

Historical performance of the S&P 500

Source: https://www.macrotrends.net/2526/sp-500-historical-annual-returns

3. Promising short-term investment

Nevertheless, one of the biggest draws for investing in stocks is the allure of handsome short-term returns. With luck, investing in stocks can yield astronomical returns.

While extremely rare, it is not unheard of to see a stock’s price jump 100% in a single day. For example, Gateway Industries stock rose 18,000% in a single day in February 2011 following a takeover announcement. Currently, meme stock AMC rose by as much as 120% on May 15, 2024, while GameStop finished the day 60% higher.

4. Liquidity

Stocks are generally perceived as highly liquid assets since you can convert them into cash more easily than investments like real estate.

For instance, the Nasdaq witnesses more than 4.4 million shares traded daily, involving more than 31 million trades. This is several magnitudes higher than the real estate industry, which only experiences about 4 million units traded monthly.

Stocks also list on stock exchanges with nationwide coverage, which means investors usually have a sea of buyers willing to take the stocks off their hands, for the right price.

5. Variety

Investors have a wide array of stocks to choose from, each offering different benefits:

  • Common shares: The most common type of equity investment. It offers a chance for capital growth when prices rise, earning dividends, voting for directors who run the company, and advantageous tax treatment.
  • Preferred shares: Reliable income stream and dividends paid before common shareholders. It offers higher income compared to common shares, with some allowing investors to plow the dividends back into the company.

A qualified dividend is a common dividend that meets the qualification requirements set by the IRS. Qualified dividends are usually charged at a capital gains tax rate, which can be lower than the income tax imposed on some taxpayers.

Investor Considerations

There’s no one-size-fits-all approach to investing since every investor has a unique set of circumstances that make them suited to one investment approach over another. These should be your top considerations before choosing any of these investment options:

Risk tolerance

Before investing, ask yourself, “How much risk am I comfortable with”? Understand that every investment carries some level of risk, although some are less risky than others.

From the choices above, crypto and stocks are the riskiest due to their high volatility. Gold and real estate are far less risky, so choose what fits your risk management strategy.

Younger investors have time on their hands, so they can either try the riskier options or settle on safer, longer-term options and reap the rewards of compounding.

Investment horizon

How long do you intend to hold your investments? Some investment assets, like stocks and crypto, are excellent for short-term trading, while others, like real estate, only really work if you hang on to them for the long term.

Liquidity needs

If you have no emergency fund, invest in stocks, gold, or the most popular cryptos since they are more liquid. Real estate is off the table as it is less liquid.

Investment goal

What is your goal? Are you aiming for income, capital appreciation, or a combination of both? The answer to this will determine which investment option is best.

For instance, gold might be great for capital appreciation but not for income generation. Most forms of real estate investment offer both appreciation and income, and the same goes for some stocks and cryptos.

Liquidity needs

What is your goal? Are you aiming for income, capital appreciation, or a combination of both? The answer to this will determine which investment option is best.

For instance, gold might be great for capital appreciation but not for income generation. Most forms of real estate investment offer both appreciation and income, and the same goes for some stocks and cryptos.

 

Conclusion

Stocks, gold, cryptos, and real estate are desirable investment options, each with its own pros and cons. Cryptos and stocks can be great for the short term; gold generally retains its value, while real estate usually appreciates in the long run.

Remember, all investments carry some risk, although some are riskier than others. There’s no universal approach to investing, as the best investment choice depends on your specific goals and financial situation. Exhaustively consider your investment horizon and risk tolerance to make informed choices.

For your own good, consult a financial advisor for personalized advice, especially if you intend to spend huge sums.

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Can Crypto Protect Your Savings Against Inflation?

The prices of goods and services were out of control in 2021 and 2022. Egg prices rose by 59.9% between November 2021 and a year later, with elementary and secondary school meals spiking 305.2% during the same period.

This was all thanks to rampant inflation.

The Consumer Price Index (CPI) hit 9.06% in June 2022 (the highest in 40 years), compared to just 0.12% in May 2020.

Inflation is a consequence of the price of goods and services rising over a sustained period, eroding the purchasing power of earnings and savings.

The inflation rate has since dropped off to a more reasonable 3.36% in April 2024, still some way off the Fed’s target of 2%. But if you think the price of goods and services is still unreasonable, you’re on to something.

Despite the drop in inflation, prices rose by 20.8% from February 2020 to 2024. Even the best high-yield savings accounts don’t provide such yields, so your savings would feel the pinch of the inflationary pressures.

So, could cryptocurrencies guard your savings against the ravages of inflation? Let’s find out.

Inflation Trend

The Threat of Inflation on Your Savings

It is actually desirable for the prices of goods and services to rise over a number of years. But inflation must be moderate for it to benefit a country.

High inflation is triggered by the rapid rise in prices, while deflation, where prices are falling, means the economy is stagnant, experiencing little to no growth. Moderate, stable, and predictable inflation is good as it allows business owners to keep growing and pay their workers higher wages.

When inflation rises, it erodes the dollar’s value, eating into the buying power of your money. If your savings do not grow at the same rate as inflation, you are losing money. You won’t have the capacity to keep up with the cost of living, as inflation curtails your ability to purchase as much as when you began saving.

If you are saving for retirement, you won’t meet your target unless you keep saving more to beat inflation. But that will be a lot harder since commodity prices will rise, making it more difficult to save an extra coin.

The only way to beat inflation is to place your savings in an investment offering a higher interest rate than the inflation rate, and that’s where cryptocurrencies could come in handy.

Characteristics Favoring Cryptocurrencies’ Inflation Protection

Normal/fiat currency is susceptible to inflation because it is subject to manipulation. A country’s Central Bank can print more money in the face of undesirable economic climates.

An example is when the US printed money in 2020 and handed out about $1 trillion collectively to individuals as part of the COVID-19 stimulus package. This partly contributed to the consequent 40-year high inflation rate.

Here are some features that make crypto the go-to solution for fighting inflation:

1. Limited supply

Unlike the case of a Central Bank printing a limitless supply of a fiat currency, most crypto have a predetermined maximum supply in their code. They are finite resources, creating scarcity.

Crypto scarcity is ripe ground for a potential hedge against inflation, as demand for the limited supply could lead to an increase in value.

Bitcoin, with a lifetime supply of 21 million coins to be mined by the year 2140, is a prime example. Research provides evidence that Bitcoin prices usually appreciate against inflation shocks.

2. Decentralization

Cryptos are also free from Central Bank manipulation. They operate on decentralized networks that are not controlled by any entity. This allows cryptos to operate independently. A Central Bank can implement fiscal control by printing more money, leading to inflation.

3. Transparency

The blockchain allows for transparency by displaying all transactions made using a particular crypto. Further, the transaction information is immutable (can’t be changed).

Independent parties can track and ascertain all transactions, making it harder to arbitrarily increase a crypto’s supply without detection. These measures ensure a stable operating environment, reducing the probability of supply inflation.

4. Deflationary tendencies

With time, cryptos are burned while in use. Others are locked in wallets and passwords are forgotten, never to be retrieved. This removes them from circulation, making the crypto deflationary and creating further scarcity.

A WSJ analysis suggests there are about 20% or 1.8 million “lost” Bitcoin worth nearly $20 billion, and it is highly unlikely they’ll be recovered.

How Has Crypto Performed During Inflationary Periods?

Yes, cryptos are volatile, but they have displayed some resilience in the face of high inflation. For instance, in the first half of 2020, Bitcoin rose by 27%, higher than gold, silver, and platinum, which have long been the traditional hedges for inflation.

Bitcoin outperforms gold, silver, and platinum

Despite gaining 16% during the same period and reaching 8-year highs in June, gold still underperformed the crypto by nearly 11%. Platinum and silver registered negative gains during this time.

This was during a recessionary period, with inflation rising from 1.6% in June 2019 to 2.5% in January 2020, then dropping sharply to 0.2% in May 2020 before rising to 40-year highs in 2022.

Gold performance vs CPI

For a while, cryptos did well despite rising inflation in 2020 and 2021, with Bitcoin gaining 60% in returns in 2021. Most cryptos were affected by high inflation rates due to diminished purchasing power and devaluation of the dollar.

But when inflation kept soaring and blew past the 9% mark in 2022, cryptos and even commodities felt the heat and plummeted in value. With investors seemingly scared of the riskier investment, Bitcoin lost 64% of its value in 2022.

However, when the Fed eased off its interest rate hikes in 2023, and the CPI cooled to a more manageable yearly average of 3.4%, the narrative changed. Bitcoin gained 156% of its value YoY in 2023, with prices rising to $43,700 in December 2023, up from lows of $16,529 in December 2022.

Overall, cryptos are too new to provide a definitive answer to their claim as a hedge against inflation. Research shows cryptos have positive real returns correlated to inflation but not nominal returns. This suggests cryptos can stop an investor’s money from losing purchasing power as a result of inflation.

Using Bitcoin as an example, the evidence for or against the assertion that cryptos are a hedge against inflation is erratic. Its price performance over time has not supported either thesis conclusively, as it remains relatively untested in diverse economic scenarios.

How do cryptos compare to traditional assets?

There’s no definite correlation between precious metals price performance and inflation. Sometimes, they lose or gain value, all dependent on market sentiment.

For instance, gold gained by nearly 600% between 2000 and 2011, when the inflation was relatively stable, but lost nearly half its value from 2011 to 2016, when the inflation rate was around the Fed’s long-term desired inflation target of 2%.

In 2021 and 2022, when the CPI was 7.2% and 6.4%, gold sank by -3.5% and -0.1%, respectively, but rose 13.4% when the CPI dropped to 3.3% in 2023. Gold reached an all-time high of $2,449 per ounce in May 2024, with inflation hovering around 3-4%.

An ETF that has been tracking the price of gold reported returns of 5.5% annually compared to 15.3% for the S&P 500 for the past 15 years. Although stocks typically perform poorly with rising inflation, they can act as a hedge against inflation in the long run.

Data tracking the S&P 500 shows the largest 500 capitalization stocks gained 10.7% on average since its introduction in 1957, but the average yearly inflation rate from 1914 to 2023 is 3.3%.

Bonds have also been perceived as a good store for value. They are a source of stable yet small gains. Although bonds yields steadily declined since the 80s, so did inflation, leading to sustained bonds yields over the years.

However, minor gains in bonds usually mean they will underperform in the face of strong inflation. If you invest in bonds with 4-6% yields, your investment will lose value faced with 8-9% inflation rates. As seen in recent years, investors have lost at least 1% of their bonds values annually from 2019 to 2023.

Bonds have lost value since 2019 after a bull market since the 80s

Crypto Portfolio Inflation Protection Strategies for Physicians

Investors must gauge the risk/return tradeoff before deciding which cryptocurrencies to invest in. Fixed income assets offer less risk but provide less returns compared to cryptos.

For example, Bitcoin has annual returns of 50% against 75% volatility, while Ethereum provides annualized returns of close to 80% and annualized volatility of 90%. By contrast, fixed-income investments offer less than 10% in annualized returns and volatility.

Using Monte Carlo methods and holding a 60/40 stocks and bonds portfolio, a simulation shows adding Bitcoin worth 5% of the total portfolio value offers the optimum Sharpe Ratio, a measure for risk-adjusted returns.

The Sharpe Ratio keeps rising until it gets to 5% before leveling off, showing no improvements in risk-adjusted returns after this mark. Although not entirely accurate, the results suggest holding 5% of Bitcoin in your portfolio is the optimal ratio for risk/returns.

Risk returns ratio

1. Diversification across cryptocurrencies

The best way to mitigate cryptocurrency volatility is to spread your investments across several cryptocurrencies and blockchain assets like NFTs.

This should guard against the risks of investing in a single crypto and reap the rewards of emerging trends. For instance, NFTs had a great run in 2021 through 2022, with the top 10 most expensive pieces being sold for over $7 million during this time.

2. Consider Risk Tolerance and Investment Timeframe

What are your investment objectives? Do you wish to gain wealth in the long term, or are you seeking the thrill of short-term gains? Your goals should help determine which investment strategy to settle on based on the volatility prospects of each asset.

Also, conduct an honest review of your risk tolerance to establish your comfort level. It will help you choose a crypto or asset aligned to your investing style and minimize chances of abandoning strategy mid-investing.

3. Investing strategies for managing volatility

  • HODL: This refers to the long-term buying and holding of crypto. The strategy aims to ride out the price volatility, which will iron out to the investor’s advantage over time. A study of Bitcoin’s price since its inception points to an upward trajectory if held over a long stretch.

Bitcoin’s price rise in the long run

  • Dollar-Cost Averaging: A practice where you make small amounts of recurrent purchases following a set schedule. This relieves the pressure of having to time the market or missing out on opportune moments to buy. In the long run, it reduces the impact of volatility. Investors may make extra purchases when there are significant market dips.
  • Active trading: If you have the time, score short-term gains by frequently buying and selling crypto to exploit crypto volatility. This strategy requires extensive market research and is the most high-risk tactic.

Considerations and Risks

The most common risks and considerations include:

  • Volatility: The bane of every investor. Cryptocurrencies are notoriously volatile, so prepare a strategy to mitigate this risk and avoid being swayed by emotions.
  • Security: There were 283 crypto theft incidents in 2023, with $24.2 billion received by illicit addresses. As of 15 January 2024, $8.37 million worth of crypto had already been reported stolen. Ensure you install sufficient security measures to prevent incidents of hacking and fraud.
  • Regulatory: It is still a relatively new market, so new regulations keep cropping up in different states as legislators come to grips with cryptocurrencies. These new laws may introduce unforeseen risks.

Can Crypto Be Your Inflation Shield?

Most cryptocurrencies have a fixed supply that promotes scarcity. Additionally, they are based on decentralization, suggesting they are prime candidates for inflation protection.

However, being new entrants in the market, they have not yet faced wide-ranging economic scenarios. The data on their performance amidst rising inflation is limited, so it is impossible to draw conclusions on their efficacy as solutions against inflation.

Like any other investment class, cryptocurrencies come with some level of risk. If you intend to spend large sums on purchasing some in an effort to beat inflation, it is in your best interest to seek the services of a financial advisor with crypto experience.

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Health Spending Trends and What It Means for Physicians

Researchers from the Commonwealth Fund found that Americans visit physicians less often than citizens in other high-income countries and have one of the lowest ratios of practicing physicians and hospital beds per 1,000 people. Yet, the US spends 3-4 times more on healthcare than Japan, New Zealand, and South Korea.

Further, the US spends almost 18% of its GDP covering healthcare costs, yet its citizens are less healthy than those in peer countries. Strangely, the US spent 17.8% of its GDP on healthcare in 2021, nearly double the average spend of OECD countries, yet does not guarantee health coverage as other high-income countries.

health-expenditures-per-capita-u.s.-dollars-2022-current-prices-and-ppp-adjustedWhat does this mean, and how does this affect physicians? This article examines the economic pressures influencing health spending and how it impacts physicians. It also provides valuable strategies physicians can implement to combat the adverse effects of these healthcare spending trends.

Health spending growth

According to the latest national health expenditure (NHE) data, health spending topped $4.5 trillion in 2022, a 4.1% growth from 2021. This represents the total cash spent on health care and its related activities like research and administration.

The data also shows that the economy-wide inflation rate was higher than that affecting the health sector in 2022. Adjusted for inflation affecting the rest of the economy, health spending reduced -2.2% year-over-year (YoY).

However, the NHE deflator compilation data asserts that the real NHE grew by 0.9% during the period. The deflator takes into account the aggregate of consumer and producer price indices for services and commodities.

Overall spending on health in 2022 increased by $175 billion from 2021. Spending on health rose across most categories except federal and state public health, which decreased by $2 billion. The top three categories that registered the highest spending were prescription drugs, hospital expenses, administration costs, and physicians and clinics.

Federal spending on public health

The biggest victim of the pandemic-era spending cuts was federal health spending, which dropped in consecutive years. The data shows it fell from $101 billion in 2021 to $92 billion in 2022 (a 9% dip) on the back of expired federal policies supporting COVID-19 eradication.

This lower spend is still higher than in the pre-pandemic era, so there could be more federal budgetary cuts in the future. Conversely, local and state public spending rose by 6.3% over the same period.

Per person health spending

Research reveals that the US spends nearly twice as much on health per person as its peers. The average per person spend was $13,493 in 2022, with rising medical services prices the primary catalyst for the upward trajectory.

For example, Medicaid spending reached $805.7 billion in 2022. This 9.6% growth over the previous year represents an 18% chunk of the total NHE. Similarly, Medicare expenses were $944.3 billion, a 5.9% growth YoY, accounting for 21% of the NHE.

Private health insurance spending also rose 5.9%, costing $1.28 trillion, accounting for 29% of the NHE.

What is fueling the high cost?

Americans are paying more for similar services as citizens in 12 comparative countries in the OECD are receiving, paying as much as 15% more in some instances.

1. Administrative costs

Administrative costs have ballooned into the largest component of excess spending, representing the biggest catalyst of healthcare expenditure growth. US citizens are paying about 30% more in NHE administrative costs. For instance, hospital care expenses rose 2.2% to $1.4 trillion in 2022.

Further, the number of administrators has grown disproportionally compared to healthcare workers. According to data from the Physicians for a National Health Program using data from the BLS, the number of physicians grew 200% between 1970 and 2019 compared to a 3,800% rise in administrators during the same period.

While the physician growth rate is in line with the population growth, the lopsided increase in administrators has led to the current situation where there are 10 hospital administrators for every physician.Healthcare Administrators Far Outpace Physicians in GrowthAnd hospital bills on a per-person basis have followed the same trajectory, rising 3,100%. Healthcare costs were $353 in 1970 compared to $11,453 in 2019, adjusted for inflation.

Americans spend about 15% more on health insurance-related costs like rework, eligibility, submission, and coding. Additionally, they pay 15% more for human resources, general administration, accreditation, and quality reporting.

total-national-health-expenditures-1970-2022

2. Nurses

American registered nurses make about 1.5 times their peers, translating to about 15% more than in comparative countries.

Travel nurses’ compensation has skyrocketed, with some out-earning physicians. While the median pay for registered nurses is $86,070 annually, travel nurses make $109,564 on average, up to a maximum of $543,048. This is higher than in pediatrics, geriatrics, occupational medicine, and preventive medicine.

The Commonwealth Fund pegs this down to higher educational debt and the context of the American labor market.

3. Prescription drugs

The US spends about double on retail prescription drugs per person than comparable jurisdictions. Further, retail prescriptions range between 2-3 times more expensive than similar offerings in peer countries in the OECD.

Branded drugs cost more and account for about 80% of retail prescription drug purchases. Generic drug prices are almost at par with comparable countries.

The start of every year usually triggers a run of price increases, and 2024 was no different. Research by 46Brooklyn Research reveals there’ve been 962 price hikes on all drugs by the end of March 2024, affecting 72% of all Medicaid brand name drug spend.

After the price changes, the cost per claim of brand-name drugs before the Medicaid rebate has risen to an all-time high of $1,348, up from $1,329 in 2023.

The reason prices are going up is because of rebates, which have been rising as well. Manufacturers’ take-home is shrinking as the average rebate is about 52%. Some medicine makers receive as little as $0.48 on the dollar.

Some manufacturers have been forced to reduce their list prices under the threat of severe penalties imposed by the American Rescue Plan Act. List prices for drugs like inhalers and insulin have dropped by 70%-80%. So, medicine manufacturers are raising drug prices across the board to stay profitable.

4. Per capita out-of-pocket expenditures

The OECD reports that the US fares favorably against its member countries under this category, with American patients forking 11% of health expenditure from their pockets compared to the 18% average across the OECD in 2023.

However, the latest CMS NHE data for 2022 shows out-of-pocket (OOP) spending rose to $471.4 billion (6.6%) in 2022, accounting for 11% of total NHE. This works out to about $1,425 per capita on average, a slight decrease from $1,428 in 2021.

Some OOP expenses, like durable medical equipment, dental services, and physician and clinical services, decreased in 2022, accounting for 34% of the entire OOP expenses.

Note that out-of-pocket expenditure does not include contributions towards health insurance premiums.

Health spending growth vs GDP growth

As noted earlier, NHE spending in 2022 stood at $4.5 trillion, representing 17.3% of the gross domestic product (GDP). Juxtaposed against the consumer price index (CPI), medical care prices rose 3% by June 2023 over the same period in 2022, according to the Bureau of Labor Statistics (BLS).

However, inflation outpaced healthcare prices. This went against the established trend of the past two decades, where medical care prices generally climbed faster than inflation.

Notably, prices for all goods and services, less medical care, rose 3.2%. Primary residential rent experienced the highest growth at 8.3%, with food (5.7%) and electricity (5.4%) the next biggest movers. Gasoline (all types) experienced the largest drop (-26.5%). Core inflation (food and energy excluded) stood at 4.8%.

CPI measures the average change in the prices consumers pay for goods and services over a yearly period. Similarly, Medical care CPI considers changes in medical care prices, including OOP costs and what insurers pay pharmacies and providers.

The latest data shows the CPI for all urban consumers (CPI-U) rose by 0.4% between March and February 2024, while the unadjusted 12-month CPI-U for all items in the year ended March 2024 was 3.5%.

The annual unadjusted CPI-U for medical care commodities as of March 2024 was 2.5%, while medical care services CPI-U was 2.1% over the same period. Overall, the medical care index rose 2.2%.

Tracking health price growth

Physician services CPI for urban consumers grew by 0.5% but was outpaced by prescription drugs at 3.1% and nursing home services at 3.3%. Still, these could not match overall hospital services at 4.2%, with outpatient contributing 5.7% and inpatient chipping in with 3.7%.

If anything, physician’s inflation-adjusted income has been on a downward spiral for an extended period. A national study by the Center for Studying Health System Change reported that physician’s incomes were reduced by 7% between 1995 and 2003, while other professionals saw their incomes increase by 7% during the same period.

Physicians’ Net Income from Practice of Medicine, 1995, 1999 and 2003, and Percent Change, 1995-2003

Notes: The Bureau of Labor Statistics (BLS) Employment Cost Index of wages and salaries for private sector “professional, technical and specialty” workers was used to calculate estimates for these workers. Significance tests are not available for these estimates. All inflation-adjusted estimates were calculated using the BLS online inflation calculator. The composition of the physician population changed between 1995 and 2003—a fact that makes some estimates of percentage changes in real income appear inconsistent (for example, estimates of income changes for all patient care physicians not falling between estimates for primary care physicians and specialists). These data patterns occur because the proportion of medical specialists steadily increased from 1995 to 2003 (32% to 38%) while the proportions of primary care physicians and surgical specialists both declined by about 3 percentage points.

Further, a Doximity survey carried out between 2017 and 2021 shows although physicians’ compensation across all specializations increased during the period, the 3.15% inflation rate throughout that period meant only 53% of specialties experienced real compensation growth. However, the 7% inflation rate in 2021 wiped out any gains from wage increases.

Physician Gender Pay GapHealth insurance CPI dipped from an all-time-high annual increase of 28.2% in September 2022 to -24.9% in June 2023. Overall, medical care prices realized the slowest decades-long price gain in June 2023.In 2024, BLS data shows the CPI-U for medical care services index went up by 0.6% in March, up from the -0.1% recorded in February. Medical care commodities were up 0.2% in March, higher than the 0.1% recorded the previous month, although this is not seasonally adjusted.

Urban care consumers experienced the best returns in medical care commodities in January as prices dropped by -0.6%. Physicians’ services index rose by 0.1%, hospitals by 1%, and prescription drugs increased by 0.3%.

Urban consumers’ CPI vs health services producer prices

Unlike the general trend for the past decade, urban consumers’ health services producer price index (PPI) rose faster than the CPI. The PPI measures the price change inflation in medical services by physicians and other providers paid by third parties like employers.

PPI considers the actual transaction prices when considering changes in output costs. From June 2009 to June 2023, medical services CPI rose 49.6%, while health care PPI has only achieved a 35.3% growth. This data does not consider medical equipment and prescription drugs PPI and CPI.

What this means for physicians

The growing cost of health spending can only mean medical care is becoming increasingly unaffordable. Patients must contend with medical inflation, rising OOP expenses, and a higher-than-expected consumer inflation rate.

A study found that 74% of Americans worried about their ability to pay off an emergency medical bill. Almost half of American adults surveyed said they couldn’t settle a $500 emergency bill without taking on debt.

Surprisingly, even those with medical insurance coverage or higher incomes are also feeling the pinch. 47% of insured adults say they are having difficulties affording health care costs compared to 85% for the uninsured. 21% of households with incomes over $90,000 reportedly struggle to afford their healthcare costs.

The steady increase in medical costs, especially OOP expenses, has diminished their ability to settle medical bills. For example, commercially insured patients used to be the rock-solid basis of providers’ payer mix, but this has changed drastically over the past few years.

In 2018, for instance, 11% of hospital’s bad debt came from self-pay insured accounts. That figure crept up to 58% by 2022.

Patients were encouraged to utilize OOP to offset rising copayment costs. Most decided to seek over-the-counter (OTC) treatments before visiting the physician. However, insurance premiums crept higher, leaving OTC as the only economically viable choice for patients keen on keeping premium costs low.

As employers delivered lower premiums to workers, this had the unintended consequence of increasing the medical cost burden on employees who needed more care than OTC could provide. This category of employers would be forced to take on co-insurance and higher deductibles.

Commercially insured patients took on more medical debt, which inevitably led to them opting out of essential medical care out of fear of incurring more debt.

What physicians can do to mitigate inflationary pressures

One way physicians can deal with thinning revenue is to stop providing financing in the first place. There are new financing models that take the pressure out of securing medical debts while safeguarding their pay.

These new medical plans safeguard patients from unusually high repayment plans while ensuring healthcare providers receive their full payments promptly. Moreover, the new approach also settles patients’ OOP costs.

Specialist medical payment providers streamline the payment process by paying providers upfront and assuming the long-term payment option with patients.

All this means physicians won’t have to follow up or hire additional staff and collection agencies to chase after bills.

Patients will also seek medical attention when they need it, not when their pocket allows it. This could lead to healthcare providers receiving a steady stream of patients, enhancing their revenues.

Final word

Americans are paying more for less, and physicians are paying the price. The unfavorable economic climate means fewer adults can afford medical care, so they avoid physician office visits even when necessary.

Physicians should adopt new financing models that shift credit risk to third parties who settle their bills upfront and have the expertise and resources to follow up on errant borrowers. This frees up more time for physicians to care for their patients.

To secure your financial future, enroll for our Real Estate Investing Course for Physicians.

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Blogs Real Estate Real Estate Syndication

Navigating Risks of Real Estate Syndication for Physicians

As a physician or medical professional, you may be considering real estate syndications as an alternative investment to diversify your portfolio and hedge against economic uncertainty. However, it is crucial to understand the risks of real estate syndication before diving in. In this comprehensive blog post, we will explore various aspects of these investments and provide insights on how to mitigate potential pitfalls.

We will delve into the importance of trust between investors and sponsors, performing due diligence checks on deals and sponsors, mitigating market volatility risks through stable cash-flowing assets, reducing exposure through diversification and property selection criteria. Additionally, we will discuss navigating legislative constraints by partnering with experienced legal teams and ensuring adequate insurance coverage.

Lastly, we’ll examine the suitability and limitations of real estate syndications for passive investors like yourself – addressing concerns such as illiquidity issues, high minimum investment requirements, and limited control over property management decisions. By understanding the risks of real estate syndication thoroughly beforehand, you can make informed decisions that align with your long-term investment goals.

Table of Contents:

  • How Real Estate Syndication Works
  • Pooling Resources for Larger Investments
  • Partnering with Experienced Syndicators
  • Why Real Estate Syndications are Safer than Direct Ownership
    • Expertise of Seasoned Operators
    • Mitigating Market Volatility Risks
  • Real Estate Syndication: Pros and Cons
    • Diversification Benefits
    • Illiquidity Concerns
    • High Minimum Investment Requirements
  • Navigating Transparency and Communication Risks
    • Open Conversations with Sponsors
    • Reviewing PPMs for Informed Decision-Making
  • Assessing Market Fluctuations Risk
    • Diverse Employment Opportunities
    • High Median Household Incomes
    • Low Crime Rates
  • Proper Debt Financing Strategies for Real Estate Syndications
  • Legal Risks in Real Estate Syndications
  • FAQs in Relation to Risks of Real Estate Syndication
    • What are the risks of syndicated real estate?
    • What is the risk of syndication?
    • Can you lose money with real estate syndication?
  • Conclusion

How Real Estate Syndication Works

Real estate syndication is a popular investment option that allows passive investors to pool their resources and invest in larger, more lucrative properties like multifamily units.

Pooling Resources for Larger Investments

Multiple passive investors come together to raise capital needed for acquiring high-quality real estate assets, enabling them to participate in deals that would otherwise be inaccessible due to high costs.

Partnering with Experienced Syndicators

Working alongside seasoned professionals within the industry maximizes returns while mitigating risks involved in the process.

  • Diversification: Participating in multiple projects spreads financial exposure across various types of properties and geographic locations.
  • Economies of Scale: Investing alongside other passive investor partners provides increased buying power and cost savings related to property management fees or maintenance expenses.
  • Professional Management: Syndicators have a team of experienced professionals who handle all aspects of property management, allowing passive investors to enjoy the benefits of real estate investment without dealing with day-to-day responsibilities.

Real estate syndications offer passive investors the opportunity to invest in real estate deals without the hassle of property management or the risks involved in direct ownership.

Despite the potential issues, like changes in market conditions, rent control and Section 8 housing impacting returns on investment, real estate syndications remain a popular option for investors aiming to diversify their portfolio and generate passive income from rental properties.

Despite these risks, real estate syndications remain a popular choice for those looking to diversify their investment portfolio and generate passive income through rental properties.

For more information on real estate syndications and the risks involved, check out these credible sources:

  • Investopedia
  • Forbes
  • Bigger Pockets

Why Real Estate Syndications are Safer than Direct Ownership

Real estate syndications are a safer investment option than direct ownership because they allow passive investors to minimize risks by relying on the expertise of seasoned operators.

Expertise of Seasoned Operators

Partnering with experienced sponsors who have a proven track record in acquiring and managing properties reduces the likelihood of costly mistakes often made by inexperienced property owners.

Mitigating Market Volatility Risks

  • Diversification: Investing in multiple properties across different markets provides diversification benefits that help protect against economic downturns or localized issues affecting one specific area.
  • Cash Flow Stability: Real estate generates consistent rental income from tenants, offering more predictable returns even during uncertain times.
  • Hedge Against Inflation: As inflation rises, so do rents – making real estate an effective hedge against rising prices over time.

Real estate syndications offer strategies that can help investors navigate economic uncertainty while still achieving their investment goals.

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Real Estate Syndication: Pros and Cons

Real estate syndication can provide a good opportunity for passive investors to expand their investment portfolio, yet there are some difficulties associated with it.

Diversification Benefits

Spreading your investment across multiple properties can reduce the impact of any single underperforming asset on your overall portfolio.

Illiquidity Concerns

Real estate syndications tend to be less liquid than stocks or bonds, but this can be mitigated by focusing on deals with shorter hold periods or partnering with sponsors who offer secondary market options for selling your shares.

High Minimum Investment Requirements

  • Raised capital: Many real estate syndications require a significant initial investment, which could deter some potential passive investors from participating.
  • Potential pitfalls: Thoroughly vet each opportunity before committing any funds, even if it means passing on a deal with a high minimum investment.

Before investing in real estate syndications, consider your investment goals, market conditions, and potential risks involved, such as rent control, rental rates, and section 8 housing.

Navigating Transparency and Communication Risks

Real estate syndications can be risky due to lack of transparency or poor communication from sponsors, so it’s crucial to engage in open conversations and review Private Placement Memorandums (PPMs) before investing.

Open Conversations with Sponsors

Ask questions about the sponsor’s experience, track record, and the specific details of the deal to establish a strong relationship and avoid potential pitfalls.

Reviewing PPMs for Informed Decision-Making

  • Analyze financial projections: Look for conservative estimates and review rental income forecasts and property management expenses.
  • Evaluate market conditions: Assess factors such as rent control policies, local employment rates, or Section 8 housing regulations that may impact future rental rates.
  • Determine investment goals alignment: Ensure that each sponsor’s strategy aligns with your personal financial objectives by comparing how raised capital will be allocated across various deals.

By taking these steps, you can mitigate transparency issues and establish proper communication channels throughout your real estate syndication journey.

Assessing Market Fluctuations Risk

Investing in realty may involve hazard, yet there are ways to reduce exposure to market swings.

Diverse Employment Opportunities

Target properties in regions with a variety of industries and job sectors to maintain rental demand.

High Median Household Incomes

Properties in areas with high median household incomes attract tenants who can afford higher rental rates and are less likely to default on rent payments.

Low Crime Rates

  • A safer neighborhood attracts more potential renters and increases property value over time.
  • Tenants are more inclined towards long-term leases in low-crime areas as they feel secure living there.
  • Property management costs may be lower due to reduced vandalism or theft-related expenses.

Assessing market fluctuation risks is crucial when passively investing in real estate syndications. By focusing on properties located in areas with diverse employment opportunities, high median household incomes, and low crime rates, investors can better protect their investments from potential pitfalls. Real estate syndications can be a great way to invest in real estate without the hassle of property management, but it’s important to understand the risks involved and set clear investment goals

Proper Debt Financing Strategies for Real Estate Syndications

Using debt financing through floating-rate loans can accelerate returns on equity without jeopardizing financial stability.

Investors should ensure their chosen syndicator has a proven track record of implementing value-add strategies and adhering to conservative loan-to-value ratios (LTV).

Floating-rate loans provide flexibility in managing debt payments while maximizing potential returns.

Conservative LTV ratios reduce risks involved in case market conditions change unfavorably.

Investors should look for multifamily syndications where the sponsor maintains an LTV within the range of 60-70%.

Partner with sponsors who prioritize transparency and communication throughout all stages of your investment journey.

Stay informed about any changes or updates related to your passive investor status, property management, or rent control policies affecting your rental income stream. Debt financing can be a valuable tool for real estate investors, but it’s important to understand the potential pitfalls and risks involved.

Short-term rentals, rent control policies, and Section 8 housing can all impact rental rates and potential returns.

Investors should have clear investment goals and understand the potential risks before passively investing in real estate syndications.

By partnering with experienced sponsors and carefully evaluating debt financing strategies, investors can raise capital and achieve their investment goals.

Legal Risks in Real Estate Syndications

Legislative constraints may pose risks in real estate syndications, making it crucial for investors to partner with sponsors who have experienced legal teams on staff and appropriate insurance coverage.

A strong legal team is essential when investing in real estate syndications.

Partnering with a sponsor that has an experienced legal team ensures they understand the complexities of these transactions, minimizing your exposure to potential pitfalls.

It’s vital that your chosen sponsor carries adequate insurance coverage to protect against unforeseen events such as property damage or lawsuits from tenants.

Make sure you inquire about their insurance coverage, so you’re confident they have sufficient safeguards in place.

Passive investors should educate themselves on relevant regulations governing real estate investments to better understand how these factors could impact their investment goals.

By staying informed and working with experienced professionals, you can mitigate the legal risks involved in real estate syndications and confidently pursue this lucrative investment strategy.

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FAQs in Relation to Risks of Real Estate Syndication

What are the risks of syndicated real estate?

Investing in syndicated real estate can be risky due to illiquidity, limited control over property management decisions, reliance on sponsor’s expertise, and market volatility. It’s important to perform due diligence checks on sponsors and deals, diversify investments, and ensure value-add strategies with conservative loan-to-value ratios to mitigate these risks. source

What is the risk of syndication?

Syndication risk refers to potential losses in a pooled investment vehicle like real estate syndications, which can arise from poor property selection or management by the sponsor, economic downturns, or legislative changes impacting operations or financing options. source

Can you lose money with real estate syndication?

Yes, investors can lose money in real estate syndications if properties underperform due to market conditions or mismanagement by sponsors. To minimize this risk, it’s crucial for investors to conduct thorough research on both the deal and the track record of its sponsoring team before committing capital. source

What are 4 major real estate risk concerns?

  1. Economic Risk: Market fluctuations affecting demand for rentals and property values.
  2. Sponsor Risk: Incompetence or fraud by managing partners responsible for project execution.
  3. Leverage Risk: Overuse of debt financing leading to increased vulnerability during downturns.
  4. Liquidity Risk: Inability to quickly sell an asset without substantial loss in value.

Conclusion

Real estate syndication risks can be reduced through proper due diligence, diversification, and careful selection of sponsors and investment properties.

While some investors may worry about relinquishing control over investments, building trust with sponsors and ensuring transparency can help ease these concerns.

It’s important to consider market volatility risks and the suitability of real estate syndication as an illiquid investment option, but stable cash-flowing assets and responsible use of debt financing can provide long-term benefits.

Partnering with experienced legal teams and maintaining adequate insurance coverage can help investors navigate legislative constraints that may arise.

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Blogs Property Investors Real Estate

Why You Should Be Thinking About Alternative Investments

In uncertain times, financial advisors often encourage investors to turn to low-risk, fixed-income investment options, such as CDs, money market funds, and high-yield savings accounts. They reason that these safe investments will preserve your assets as they provide positive returns. But do they?

Investing in the stock market and receiving a 60% loss is a no-no, so the financial advisors would rather you invest on a 10-year treasury yield, making 3.7%. While it may seem the investment is making you money, you have to consider that the annual inflation rate rose to 8.2% in September 2022. That means you are losing money (-4.5% annually).

While all investment options seem pointless at the moment, one criminally underutilized segment is viable during market downturns. Did you know you can make as much as 12% returns using alternative investing?

According to Prequin’s 2022 Global Alternatives Report, the alternatives AUM concluded at $13 trillion in 2021 and is projected to expand to 11.7% ($23 trillion) by 2026. This is a look at what alternative investing is all about.

What Are Alternative Investments?

Alternative investments have no basis on traditional financial products like stocks, bonds, or cash. Most alternative investments don’t receive as much regulation from the SEC and could be more illiquid.

Types Of Alternative Investments

As more and more alternatives become available to retail or individual investors, it pays for investors to have a solid understanding of these options. The following are some examples of alternative investments:

1. Private Equity

Private equity is a term that describes investments in businesses not traded on a public market like the New York Stock Exchange or NASDAQ.

The goal of private equity firms is to generate returns for their investors by making strategic investments in private companies with the assumption that the value of those investments will increase by a certain time. You can further break private equity down into these categories:

  • Venture capital
  • Buyouts
  • Growth equity

These asset classes typically require long-term investments of substantial capital, so only institutions and wealthy individuals can participate.

2. Hedge Funds

A hedge fund is a type of pooled investment partnership that trades liquid assets using various investment strategies to generate a high rate of return for its investors. Entrepreneurs can invest in a wider variety of securities, as hedge funds are not subject to the same regulations as mutual funds.

Compared to other alternative investments, hedge funds are notable for their high liquidity ratio. Because they have a higher concentration of liquid securities, you can liquidate the funds in minutes. Due to the high costs and risks involved, only wealthy individuals and institutional investors, like pension funds, typically invest in hedge funds.

3. Structured Products

Structured products are a type of investment that involves pairing a debt instrument (such as a bond or CDs) with one or more derivative instruments tied to an underlying asset class or a collection of assets such as stocks, market indices, currencies, or interest rates.

Despite their complexity and potential for loss, structured products allow investors to create a uniquely tailored portfolio to their needs. Typically, investment banks produce them and offer them to institutional, corporate, and individual clients.

4. Private Debt

Private debt consists of loans from sources other than traditional banks. Businesses often use private debt for expansion, working capital increases, or real estate construction and development.

Given the historically low returns on government bonds, direct lending to businesses can provide a sizable premium over the cash flows accessible from liquid fixed-income products. Private debt funds, the firms that provide the funding, make money through two main channels: interest payments and the eventual repayment of the loan.

A private debt fund may also focus on senior, junior, or mezzanine debt, among other strategies, such as direct lending, venture debt, and exceptional situations.

5. Real Estate

Many Americans already have a stake in this asset class because they are homeowners, making real estate the most viable alternative investment. Real estate investments can take the form of direct property ownership or indirect investments.

Properties like apartment buildings and shopping centers provide regular rental income to their owners, and they hope for price increases over time.

Investors who want a more hands-off approach might buy shares of private real estate investment trusts (REITs) through a broker. REITs that trade publicly do so through the stock market.

In addition to its diversification benefits, real estate offers investors a hedge against inflation and favorable tax advantages.

6. Commodities

Commodities are tradable items that have both direct and indirect economic uses. Examples of commonly traded commodities include gold, farm animals, precious metals, wool, oil, gas, wood, and uranium.

Given their relative immunity to fluctuations in the public equity market, investors often use commodities as a hedge against inflation. Commodity prices fluctuate based on supply and demand market forces; increased demand will lead to higher prices and greater returns for investors. You can invest in commodities in several ways, including:

  • Futures Contract
  • Stock
  • Physical commodities

7. Collectibles

When you invest in collectibles, you aim to generate a return on your money through long-term appreciation of the items you own. Some of the common types of collectibles include:

  • Books
  • Rare wine
  • Stamps
  • Antiques
  • Trading coins
  • Art
  • Coins
  • Baseball cards
  • Toys

To succeed in this alternative investment strategy, you need an extensive understanding of the sector and the patience to hold on to your investment for a long time. It is not easy to predict how much a work of art, or a collection will increase in value because both can decline in worth or get destroyed.

Some collectors treat their collections as investments on par with their homes or cars, and their collections make up a significant portion of their net worth. Adding collectibles to a portfolio is a great way to diversify your investment base and spread your risk.

Final Word

Many investors are increasingly looking to alternative investments to diversify their portfolios, maximize their returns, and accomplish other financial objectives. That is why it is so important for investors to have a firm grasp of the options they have to adopt alternative investments into their portfolios successfully.

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Why You Should Consider Buying Real Estate During A Recession

The inflation rate as of November 2022 is 8.202%, well above the long-term average of 3.26%. Mortgage rates are still rising, exceeding 7.44%, and there’s a good chance the Fed will increase lending rates by 50 to75 basis points in the December 14-15 FOMC meeting, and an additional 25 to 50 basis points in the January 31-Feb 2 2023 FOMC meeting. This could result in Mortgage rates close to 9% by February 2023.

All of these point to a intentional recession. If anything, TD securities think there’s a more than 50% chance the US will enter a recession within the next 18 months.

While a recession means people don’t have the money to purchase a home, it presents mouthwatering opportunities for a real estate buyer, as long as the buyer can maintain financial solvency through the 18 to 24 months of a recession. Keep reading to learn why buying real estate assets during a recession might be a good idea.

Advantages Of Buying A Real Estate During A Recession
Purchasing Real Estate during a recession has some benefits, such as:

A) Lower Prices
House prices usually fall dramatically during economic downturns. Such an economic environment means people can barely afford the bare essentials, so splashing hundreds of thousands of dollars on a home is out of the question. This has a trickle-down effect on the Multifamily real estate market and even other real estate asset classes.

A lack of interested purchasers can lead to prolonged selling times, so sellers may feel compelled to cut their asking prices to move the assets. Foreclosures also force homeowners to sell, increasing the supply of homes and further driving down prices.

While home prices have not dropped significantly as of August 2022, Moody’s Analytics forecasts that home prices in highly “overvalued” housing markets might fall by 15% to 20% should a recession hit, while nationwide home prices would decrease by roughly 5%.

B). Mortgage Is Cheaper
During a typical recession, business stagnates, so the Fed’s go-to solution to spur the economy and get people to spend is lowering interest rates. That typically leads to more affordable mortgage rates, which is your cue to hit the market in search of a home. This Fed pivot will not occur until we are firmly entrenched in a recession, and consumer confidence has severely been impacted, often seem as a reduction in the hyper liquid stock market open futures.

The National Bureau of Economic Research (NBER) still has not called this a recession despite two consecutive depressed financial quarters, which explains why the interest rates are still high.

If the economy does tip into a recession, expect mortgage rates to plummet, but only after the stock market capitulates and the average investor is running for the exits. That would be the perfect time to get a mortgage and grab a house.

C) Low Competition
In 2020 and 2021, homes were flying off the shelf, some site-unseen. Homes found buyers in as little as one week. A depressed economy, however, means people don’t have purchasing power, so expect little competition for home listings.

The high mortgage rates and exorbitant home prices also mean supply will increase, so you will have plenty of homes to pick from, if you can afford it.

Tips For Buying A Real Estate In A Recession

Here are some tips if you want to purchase a home during a recession:

1. Do Your Homework
Sure, property will generally be cheaper, but that doesn’t mean you can’t get a better deal. Scour the internet and visit local listings. You might net the bargain of the century and maximize profits if you decide to sell the home later.

2. Know When To Walk Away
Just because it’s your dream doesn’t mean you should compromise everything to get the deal over the line. If you find an asset that meets all your requirements but is too expensive, ask the seller to lower the price. If they can’t, walk away. There are plenty of gems like that waiting to be discovered. Take your time to negotiate.

3. Get Your Finances In Order
First, you need a budget, a limit of what you can afford to purchase any property. That will act as a guide whenever you’re conflicted about how much you should spend.

That also means ensuring you have a good credit score to secure a mortgage, pay all the taxes, and have enough savings to stump up the down payment.

4. Shop Around For A Mortgage Deal
Yes, mortgage rates are lower than usual, but you can still get a better deal than most people. Considering mortgages involve vast sums of money, you’d be surprised how much money a few changes in decimal numbers will save you.

Go around looking at the deals mortgage providers offer to find one that suits you best. That would also be a good time to enlist a mortgage broker as they know the best places you can land a mortgage deal after considering your financial circumstances.

5. Hire A Real Estate Agent
Hiring a real estate agent is a great way to expand your reach in the real estate market. Agents have access to more properties than you could find by yourself and know where to strike a deal. They can also provide valuable advice, offer guidance, and negotiate on your behalf.

6. Obtain Concessions
Due to the market downturn, you should take advantage of all the rebates and real estate deals that come your way. Owners are under pressure to sell their properties as quickly as possible due to the drop in prices. Consult with your real estate agent to request concessions from the seller, but keep in mind the agents goal is to generate a commission, their incentive is to generate a sale.

7. Avoid A Bidding War
One benefit of purchasing in a down market is obtaining a reasonable price. Don’t let your emotions get you into a bidding war, as that will mean spending more than you had anticipated. An excellent way to go about this is to set a budget and adhere to it.

8. Realign Your Investment Strategy
As you’ve probably noticed, it is a down market, so properties aren’t moving fast. Therefore, you should approach a purchase knowing that you may not offload for a long time. It would be best if you reassessed your investment strategy.

If your strategy is flipping property, that may not work in a down market, its akin to catching a falling knife. It would help if you thought of long-term strategies, such as renting the property. That entails gauging the viability of the property as a rental unit before deciding to purchase.

Therefore, don’t spend your last dollar on a property hoping to get instant returns. Since you’ll be holding onto the property for some time, you should also ensure you have the finances to take care of maintenance and taxes.

Final Words

For the right investor, purchasing real estate during a recession makes sense. While mortgage rates are forced up to control inflation and create unemployment, they typically fall during the recession; once unemployment skyrockets up and the stock market tanks. Further, there are a lot of listings to choose from as there’s little competition.

I recommend you use the stock market as an early indicator of economic duress, the housing market as a less volatile marker, and the multifamily market as a lagging indicator; unless of course, a black swan happens to swim by and we have major demographic changes.

If you have the financial liquidity, you can grab a once-in-a-lifetime deal, especially if you enlist the services of experienced guides who have navigated a few economic cycles. However, you may have to keep the asset for some time since it may be a prolonged down market.