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The latest news from Business Insider

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    global fintech funding

    Digital disruption is affecting every aspect of the fintech industry.

    Over the past five years, fintech has established itself as a fundamental part of the global financial services ecosystem.

    Fintech startups have raised, and continue to raise, billions of dollars annually, pushing incumbent financial institutions to get in on the action. Legacy players have begun using fintech to remain competitive in a rapidly evolving financial services landscape.

    So what's next?

    Business Insider Intelligence, Business Insider's premium research service, explores recent innovations in the fintech space as well as what might be coming in the future in our brand new exclusive slide deck, The Future of Fintech: How Fintech Is Taking Over The World and What Comes Next.

    To get your copy of this free slide deck, click here.

    Join the conversation about this story »


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    bii us telehealth lumascape

    This is a preview of a research report from Business insider Intelligence, Business Insider's premium research service. To learn more about Business Insider Intelligence, click here

    Telehealth — the use of mobile technology to deliver health-related services, such as remote doctor consultations and patient monitoring — is enabling healthcare providers and payers to address the US healthcare industry’s growing list of problems.

    The proliferation and rapid advancement of mobile technology are spurring telehealth adoption, and many believe that 2018 could be the tipping point for the telehealth market.

    In this report, Business Insider Intelligence defines the opaque US telehealth market, forecasts the market growth potential and value, outlines the key drivers behind usage and adoption, and evaluates the opportunity telehealth solutions will afford all stakeholders. We also identify key barriers to continued telehealth adoption, and discuss how providers, payers, and telehealth companies are working to overcome these hurdles.

    Here are some of the key takeaways:

    • Telehealth is enabling healthcare providers and payers to address the US healthcare industry’s growing list of problems, including rising healthcare costs, an aging population, and the transformation of healthcare from service-centric to consumer-centric, which is straining healthcare system resources and threatening to drive up payer costs.
    • Although telehealth solutions aren't suitable for all patients, right now, about 45% of the US population, or 147 million consumers, falls within the addressable market.
    • Despite low usage rates, most consumers are open to using telehealth solutions, according to the 2018 Business Insider Intelligence Insurance Technology Study. 
    • A range of companies are well-positioned to generate savings in terms of revenue and avoid potential pitfalls by deploying telehealth solutions.

     In full, the report:

    • Offers an overview of different types of telehealth services and their applications in the US healthcare ecosystem. 
    • Highlights the growth drivers and opportunities of these applications.
    • Includes exclusive data and insights from the 2018 Business Insider Intelligence Insurance Technology Study. 
    • Provides examples of key players in the telehealth market, including insurers, medical device makers, and health networks. 
    • Gives recommendations on how health networks and payers should approach using and deploying telehealth solutions.

    Subscribe to an All-Access pass to Business Insider Intelligence and gain immediate access to:

    This report and more than 250 other expertly researched reports
    Access to all future reports and daily newsletters
    Forecasts of new and emerging technologies in your industry
    And more!
    Learn More

    Purchase & download the full report from our research store

    Join the conversation about this story »


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    • After a shaky start, wearables like smartwatches and fitness trackers have gained traction in healthcare, with US consumer use jumping from 9% in 2014 to 33% in 2018.
    • More than 80% of consumers are willing to wear tech that measures health data — and penetration should continue to climb.
    • The maturation of the wearable market will put more wearables in the hands of consumers and US businesses.

    The US healthcare industry as it exists today is not sustainable. An aging patient population and rising burden of chronic disease have caused healthcare costs to skyrocket and left providers struggling to keep up with demand for care. 

    FORECAST: Fitness Tracker and Health-Based Wearable Installed Base

    Meanwhile, digital technologies in nearly every consumer experience outside of healthcare have raised patients’ expectations for good service to be higher than ever.

    One of the key mechanisms through which healthcare providers can finally evolve their outdated practices and exceed these expectations is wearable technology.

    Presently, 33% of US consumers have adopted wearables, such as smartwatches and fitness trackers, to play a more active role in managing their health. In turn, insurers, providers, and employers are poised to become just as active leveraging these devices – and the data they capture – to abandon the traditional reimbursement model and improve patient outcomes with personalized, value-based care.

    Adoption is going to keep climbing, as more than 80% of consumers are willing to wear tech that measures health data, according to Accenture — though they have reservations about who exactly should access it.

    A new report from Business Insider Intelligence, Business Insider’s premium research service, follows the growing adoption of wearables and breadth of functions they offer to outline how healthcare organizations and stakeholders can overcome this challenge and add greater value with wearable technology.

    For insurers, providers, and employers, wearables present three distinct opportunities:

    • Insurers can use wearable data to enhance risk assessments and drive customer lifetime value. One study shows that wearables can incentivize healthier behavior associated with a 30% reduction in risk of cardiovascular events and death.
    • Providers can use the remote patient monitoring capabilities of wearable technology to improve chronic disease management, lessen the burden of staff shortages, and navigate a changing reimbursement model. And since 90% of patients no longer feel obligated to stay with providers that don't deliver a satisfactory digital experience, wearables could help to attract and retain them.
    • Employers can combine wearables with cash incentives to lower insurance costs and improve employee productivity. For example, The Greater Dayton Regional Transit Authority yielded $5 million in healthcare cost savings through a wearable-based employee wellness program.

    Want to Learn More?

    The Wearables in US Healthcare Report details the current and future market landscape of wearables in the US healthcare sector. It explores the key drivers behind wearable usage by insurers, healthcare providers, and employers, and the opportunities wearables afford to each of these stakeholders. 

    By outlining a successful case study from each stakeholder, the report highlights best practices in implementing wearables to reduce healthcare claims, improve patient outcomes, and drive insurance cost savings, as well as how the evolution of the market will create new, untapped opportunities for businesses.

     

     

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    Servers for data storage are seen at Advania's Thor Data Center in Hafnarfjordur, Iceland August 7, 2015.  REUTERS/Sigtryggur Ari

    • Western companies routinely sell their old tech hardware to private companies in foreign countries, without wiping the sensitive data on them first.
    • A Business Insider source found a large database of the Dutch public health insurance system on old equipment abandoned after a hardware upgrade.
    • He also found the codes for controlling the traffic lights in multiple Spanish cities. 
    • It's pointless worrying about hackers breaking into our systems if we're giving away data to anyone with a credit card in the hardware refurbishing business, the source says.

    Western companies routinely abandon confidential, sensitive, and personally identifying information to private companies in foreign countries when they upgrade their servers, workstations, and networking gear for new hardware, a source tells Business Insider.

    The unprotected data is a goldmine for hackers.

    The source, based in Romania, approached us after reading our December 22 article on whether hackers had the ability to take entire countries offline. The source runs an IT hardware refurbishment company that buys up old equipment from countries such as Spain, the Benelux area, and the UK, and sells it to customers who don't need top-spec equipment. Typically he is buying truckloads of old servers, "stuff that is past its prime or out of warranty, but it is still perfectly usable. The procedure is simple: hardware comes in, gets evaluated, fixed, wiped, sold," the source says.

    The problem, our source says, is that even when the incoming hardware has been marked as being already wiped clean it often is not. 

    A "mostly complete" directory of "passwords for a major European aerospace manufacturer"

    "Over the last 3 years I have found a lot of crazy things," the source says, including:

    • A mostly complete database of the Dutch public health insurance system, with social security data, billing, addresses, medical histories. "Imagine the social engineering scams you could do with this data," the source says.
    • Codes, software and procedures for the traffic lights and railway signalling "for a few major Spanish cities.""Imagine the potentially deadly effects of this getting where it shouldn’t," he adds.
    • Customer credit card data including addresses and shopping habits for a major UK supermarket chain.
    • And, alarmingly, "a mostly complete (and as far as I could tell, still up to date and functional) employee directory with access codes / badges / smartcards / passwords for a major European aerospace manufacturer."

    Our source asked for anonymity because his company and its clients would be angered if their identities appeared in an article about lax security.

    But two independent sources with industrial cybersecurity expertise — Nir Giller, the CTO of CyberX and Darktrace Director of Technology Andrew Tonschev — both confirmed to Business Insider that the Romanian source's scenario was both common and plausible.

    "Right now, I’m looking at the sensor listing, their IP’s and access data"

    "Even now, I am processing the remains of a server farm that until a month or so ago, was part of a power company in France," our source says. The buyer noted the ability of hackers to burn down factories simply by accessing unprotected systems which control things like temperature sensors that prevent equipment from burning out. "Guess what, data [from the French company] is still there," the source claims. "Right now, I’m looking at the sensor listing, their IP’s and access data. Obviously, I’m sanitizing everything before passing it on, but it never should have gotten into my hands in the first place."

    The source says that sometimes the data he finds is so critical that he contacts the originating company to alert them to that they have a problem with security. "In most cases the reaction was one of disbelief, 'no, it cannot happen to us, we’re well protected!'"

    As more companies lease server space, fewer of them know what happens when those leases end

    The problem exists because of the way server space is discarded by large corporations. Few companies want the bother of maintaining their own server farms. So they lease space from specialists. At the end of a lease, companies can walk away from their contracts — leaving the servers with the vendor, which is supposed to carefully destroy the data. Alternatively, when older servers reach the end of their warranty they are replaced in "forklift" upgrades, en masse. In both cases, the disused servers are supposed to be wiped by certified experts using special software and approved processes. In reality, it's quicker to skip steps, or not do it properly, or let mistakes go. The result is that the original data is often accessible even when an old server has been certified clean. 

    "The West is failing at an institutional level to keep their critical data safe," the source says "No need for CSI-worthy hacking stories, just a credit card to buy up your used hardware – odds are the data will be still there, even if someone marked them as already wiped."

    Join the conversation about this story »

    NOW WATCH: 7 science-backed ways to a happier and healthier 2019 that you can do the first week of the new year


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    Ad blockchain diagram

    This is a preview of a research report from Business Insider Intelligence. Current subscribers can read the report here.

    Blockchain technology promises to transform how nearly all industries manage data. Since roaring onto the scene as the engine behind Bitcoin in 2009, it's become applicable to a diverse array of industries beyond financial services, including industrial manufacturing, healthcare, and logistics.

    The common thread between these industries is that they all feature complex supply chains, large numbers of interconnected players, and vast amounts of data. The digital advertising industry shares those characteristics as well. These characteristics, combined with the industry's transparency issues, make advertising a prime candidate for blockchain solutions.

    Blockchain can help solve one of the advertising industry’s biggest challenges: opaque advertising practices.  Publishers, advertisers, and ad tech vendors are exploring blockchain as a tool to boost transparency around ad practices, with the end goal of reducing fraud. Ad fraud is expected to cost the industry $44 billion by 2022, up from $19 billion this year, according to Juniper Research estimates. Through its function as a public database, blockchain can store information about a digital advertisement, like who has created it, while sharing it with everyone else on the network in a verifiable and immutable way. For digital advertising, that means ad impressions can be tracked along the supply chain, and advertisers can record where an ad is delivered. 

    In this report, Business Insider Intelligence will explain what blockchain technology is and how it can inject transparency into the advertising supply chain. We will then highlight the significant hurdles to adoption, and propose different ways the industry could navigate those challenges. Finally, the report will profile companies that are at the forefront of the blockchain advertising space to give advertisers an idea of what blockchain looks like in practice today.

    The companies mentioned in this report are: Basic Attention Token (BAT), IBM, Kochava, and MetaX

    Here are some of the key takeaways from the report: 

    • Blockchain promises to mitigate ad fraud through its function as an immutable public database, which allows it to store and validate previously murky information about digital ads.
    • Despite this promise, just 11% of advertisers and agency executives have completed an ad buy using blockchain technology, according to an Advertiser Perceptions survey.
    • Limited adoption is the result of several significant hurdles — like ad executives' skepticism around the technology's usefulness — which must be overcome before blockchain is widely accepted.
    • Blockchain is heralded as a transformative technology, and while it has that potential, it's not quite there yet for advertisers.
    • Still, it shouldn't be dismissed as "pie in the sky"— blockchain presents several short-term use cases for advertisers, and those who take advantage will be set up for long-term success as the technology matures.

    In full, the report: 

    • Highlights how blockchain technology works, and how it can be integrated into the advertising supply chain to improve transparency. 
    • Outlines practical, low-risk ways marketers can prepare themselves to benefit from blockchain including using smart contracts, registering domain names, and exploring tokens that reward consumers for use of their data. 
    • Profiles several companies at the forefront of the blockchain advertising space, gaining industry-wide recognition as thought leaders.

    Join the conversation about this story »


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    In the last few years, there’s been a major shift as to how consumers interact with social media.

    Rather than posting content that lives on the platform in perpetuity, users are now posting and viewing more “Stories,” video or images that live for only 24 hours.The Stories Slide Deck

    Many platforms have introduced some form of Stories format — whether it be Facebook, Instagram, Snapchat or WhatsApp. Snapchat was the company to introduce it to the world, but Instagram has surpassed it in terms of volume and perhaps usability.

    Business Insider Intelligence has compiled a slide deck that looks into how Stories work on Instagram and Snapchat, and how brands and publishers should be using the Stories feature to reach their audiences.

    This exclusive deck can be yours for FREE today. As an added bonus, you will gain immediate access to our exclusive BI Intelligence Daily newsletter.

    To get your copy of the FREE slide deck, simply click here.

    Join the conversation about this story »


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    zuckerberg sad upset

    • The tech-heavy Nasdaq Composite index has taken a serious beating since reaching a record high in late August, falling 17% from its peak. And that includes Friday's big rally.
    • Vincent Deluard, a macro strategist at INTL FCStone, explains why tech-sector pain is just getting started — and why the sector is "no longer special."

    Don't let Friday's torrid rally fool you. Tech stocks are in a whole heap of trouble.

    Sure, the tech-heavy Nasdaq Composite index soared as much as 5% on Friday, but it's still down a whopping 17% from a record high reached in late August.

    The reasons are plentiful. The most recent shot across tech's bow came this past week, when Apple shockingly cut its sales forecast, citing an economic slowdown in China and lingering trade-war tensions. That dragged Apple's stock down as much as 10% in a single day, bringing it almost 40% from all-time highs.

    Facebook experienced a growth scare of its own back in mid-2018, when the company also warned of a significant slowdown in revenue expansion. That whole ordeal set Facebook shares back 19% in a single trading session. And have yet to recover, still down 37% from those July levels.

    Those are just the sector's two lightning rods. They both have entire ecosystems of smaller firms that depend on their continued strength for their own sustainability.

    Not to mention other tech companies are exposed to the exact same risks as Apple and Facebook. At this point it's just a matter of when they issue their own slowdown warnings, and then receive the subsequent market beatdown.

    And then there's the matter of the sector's valuations, which have come down from eye-bleeding territory, but still remain elevated relative to history. No matter how you slice it, tech is vulnerable.

    Read more:We interviewed Wall Street's 8 top-performing investors to get their best ideas for 2019

    Unfortunately for those still holding out hope, one expert sees the damage in tech getting even worse. That would be Vincent Deluard, a macro strategist at INTL FCStone. In a recent report entitled "The Age of Technology Is Over," he argues that tech's long-running stretch of dominance will soon be over.

    He traces tech's alleged fall from grace back to Sept. 28, 2018, which the "information technology" sector was split between "consumer discretionary" (eBay, Netflix) and "telecommunications services" (Facebook, Google). 

    "Portfolio re-balancing may have destabilized markets, but I think the more important consequence of the Global Industry Classification Standard (GICS) change was the public admission that technology is no longer special," Deluard wrote in a recent note to clients.

    Deluard attributes tech's loss of luster to the incorporation of technology into long-standing, "old economy" businesses. That means a company like Walmart, which has adapted admirably to the e-commerce era, and now generates roughly the same level of sales online as Apple.

    He also questions why Netflix is trading at a price-to-earnings (P/E) ratio that's nearly six times that of Disney, since both companies "use technology to tell stories." The same skepticism expands to the auto industry, where Deluard shakes his head at Tesla's outsized valuation when compared to other luxury automakers like BMW. 

    But perhaps the most damning attribute of tech stocks is that — even after briefly tumbling into a bear market — they're still commanding a 16% premium over the S&P 500 on a forward price-to-earnings basis. Sure, that figure has come way down, but it's still a major leg up. The chart below shows this dynamic in action.

    Deluard expects this ongoing repricing to continue in earnest throughout 2019, which would mean more deep selling across the tech sector. In his concluding remarks, he pulls no punches.

    "If technology is everywhere, the tech sector no longer exists," Deluard said. "If the tech sector no longer exists, its premium is no longer justified."

    Screen Shot 2019 01 04 at 2.41.08 PM

    SEE ALSO: The world's biggest stock bear explains why the battered market is still doomed to lose another 50%

    Join the conversation about this story »

    NOW WATCH: The equity chief at $6.3 trillion BlackRock weighs in on the trade war, a possible recession, and offers her best investing advice for a tricky 2019 landscape


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    Theresa May

    • Theresa May warns that Brexit may not happen if MPs vote down her deal.
    • The prime minister tells the Andrew Marr show that Britain is heading for "unchartered territory."
    • MPs from all parties have vowed to vote down the deal when it returns to parliament in a week's time.
    • However, May denies reports that she is planning to delay the vote for a second time.

    LONDON — Britain is heading for "unchartered territory," with Brexit potentially being cancelled if MPs vote down Theresa May's Brexit deal later this month, the prime minister said today.

    May warned Conservative MPs who are planning to vote down her deal that they risked triggering "no Brexit" at all.

    "Don’t let the search for the perfect [Brexit] become the enemy of good," May told the BBC's Andrew Marr Show.

    "We would be in uncharted territory... no one knows what will happen"

    The prime minister denied reports on Sunday that she is preparing to delay the vote on the deal she has secured from the EU for a second time, suggesting that it will happen on the week of the 14th.

    "We will be holding the vote," May insisted.

    She also refused denied that she plans to seek an extension of the two-year Article 50 process, suggesting that calls for an extension were really an attempt to prevent Brexit happening at all.

    The prime minister was forced to abandon plans to hold a vote on the deal in December after more than a hundred Conservative MPs and the Democratic Unionist Party, which props up May's minority government, vowed to vote against it.

    She was subsequently hit by a failed leadership challenge in which more than a third of Conservative MPs registered their lack of confidence in her leadership.

    The prime minister survived the challenge by promising to stand down before the next election.

    She repeated the pledge this morning, telling Marr that "I'm not going to be calling a snap election and I'm not going to lead [the Conservatives] into the general election."

    Downing Street had hoped that MPs would return to their constituencies at Christmas and be told by party members to get behind the prime minister.

    However, polling released on Friday suggest that Tory members are even more opposed to May's deal than their MPs, with a majority calling on parliament to vote it down later this month.

    Reports this weekend suggest that Downing Street are planning to put the deal before parliament up to 30 times in an attempt to bludgeon MPs into backing it in order to prevent a no-deal Brexit.

    Join the conversation about this story »

    NOW WATCH: MSNBC host Chris Hayes thinks President Trump's stance on China is 'not at all crazy'


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    Samsung CRG9 Gaming Monitor 2

    • Samsung's recently announced CRG9 "super" ultra-wide gamingmonitor comes with a sharper QHD resolution than the original model's FHD resolution that was released in 2017. 
    • With an aspect ratio of 32:9, the CRG9 is the equivalent of two 27-inch QHD monitors.
    • The CRG9 comes with HDR10 support for better colors, a 120Hz refresh rate, as well as AMD Freesync 2 for smoother gameplay.

    Samsung announced a new member to the "super" ultra-wide gaming monitor family with a higher resolution quad-HD model that's sharper than the regular full-HD model that the company originally released back in 2017. 

    Super ultra-wide monitors have an aspect ratio of 32:9. Put into plain English, that's exactly two normal monitors put together. Measuring 49 inches diagonally, the CRG9 is the equivalent of two 27-inch monitors side-by-side.  

    The CRG9 has a resolution of 5120 x 1440. It's a welcome upgrade for those who thought the original 2017 model's 3840 x 1080 — two FHD monitors — wasn't sharp enough for their video games, and anything else for that matter. 

    Samsung CRG9 Gaming Monitor 1 Indeed, the CRG9 monitor is designed with PC gamers in mind with its smooth 120Hz refresh rate that allows up to 120 frames-per-second on games. Typical non-gaming monitors have a 60Hz refresh rate, which is also smooth, but PC gamers like to go beyond the standard specs. The CRG9 also comes with AMD's Freesync 2 technology that helps with smoother and more stable gameplay when used with AMD's graphics cards. 

    HDR10 is also supported on the CRG9 monitor, which makes for better colors, better detail in dark shaded scenes, and better contrast overall between light and dark areas of a scene.

    Samsung CRG9 Gaming Monitor 3

    There's no pricing or release date to speak of yet. If the original CHG90 monitor from 2017 is anything to go by, the new CRG9 could cost north of $1,000.

    Anyone interested in a gaming super ultra-wide monitor now that it's available in QHD resolution should note that they'll need a pretty beefy PC to play games smoothly, especially if they want to set their games' graphics options to higher settings. The CRG9's 5120 x 1440 resolution isn't too far off a 4K monitor's 3840 x 2160 resolution, and you need pretty serious high-end and expensive hardware to play games smoothly at 4K. To make the most of this monitor, your PC will need brawny hardware like Intel's Core i7 range of processors and Nvidia's GTX 1080Ti or RTX 2080 or higher.

    Despite support for AMD's game-smoothing Freesync 2 technology, very few — if any — of AMD's graphics cards would be able to make the most of the CRG9 monitor. The only AMD card that could have a chance is the Vega 64, which is best suited for a single QHD monitor. But whether it can handle the equivalent of two QHD monitors at 120 frames-per-second at higher graphics settings is perhaps questionable. 

    SEE ALSO: Here's what it's like to play video games on the widest computer monitor in the world

    Join the conversation about this story »

    NOW WATCH: We tried gaming on the Samsung CHG90 ultrawide gaming monitor


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    maturity of AI solutions

    This is a preview of a research report from Business Insider Intelligence, Business Insider's premium research service. To learn more about Business Insider Intelligence, click here

    Artificial intelligence (AI) is one of the most commonly referenced terms by financial institutions (FIs) and payments firms when describing their vision for the future of financial services. 

    AI can be applied in almost every area of financial services, but the combination of its potential and complexity has made AI a buzzword, and led to its inclusion in many descriptions of new software, solutions, and systems.

    This report from Business Insider Intelligence, Business Insider's premium research service, cuts through the hype to offer an overview of different types of AI, and where they have potential applications within banking and payments. It also emphasizes which applications are most mature, provides recommendations of how FIs should approach using the technology, and offers examples of where FIs and payments firms are already leveraging AI. The report draws on executive interviews Business Insider Intelligence conducted with leading financial services providers, such as Bank of America, Capital One, and Mastercard, as well as top AI vendors like Feedzai, Expert System, and Kasisto.

    Here are some of the key takeaways:

    • AI, or technologies that simulate human intelligence, is a trending topic in banking and payments circles. It comes in many different forms, and is lauded by many CEOs, CTOs, and strategy teams as their saving grace in a rapidly changing financial ecosystem.
    • Banks are using AI on the front end to secure customer identities, mimic bank employees, deepen digital interactions, and engage customers across channels.
    • Banks are also using AI on the back end to aid employees, automate processes, and preempt problems.
    • In payments, AI is being used in fraud prevention and detection, anti-money laundering (AML), and to grow conversational payments volume.

     In full, the report:

    • Offers an overview of different types of AI and their applications in payments and banking. 
    • Highlights which of these applications are most mature.
    • Offers examples where FIs and payments firms are already using the technology. 
    • Provides descriptions of vendors of different AI-based solutions that FIs may want to consider using.
    • Gives recommendations of how FIs and payments firms should approach using the technology.

    Subscribe to an All-Access membership to Business Insider Intelligence and gain immediate access to:

    This report and more than 250 other expertly researched reports
    Access to all future reports and daily newsletters
    Forecasts of new and emerging technologies in your industry
    And more!
    Learn More

    Purchase & download the full report from our research store

    Join the conversation about this story »


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    running

    • To build better habits, you should understand how your brain reacts to your behavior
    • When we are pleased by the results of an action, dopamine is released, which makes us feel good. Over time, this association with feeling good can make a behavior automatic. 
    • The key to building habits is to establish a good foundation that makes better behaviors automatic. 
    • Know how to build in failure, focus on time-based activities, find pockets of underutilized time, and avoid cues that trigger bad habits.

    It's that time of year when we put the empty Champagne bottles into the recycling bin and haul out the resolutions. Unfortunately, these best-laid plans often become waylaid, and before long, we tell ourselves, "Well, maybe next year."

    As a neurosurgeon, I know very well the brain's role in determining whether resolutions succeed or fail.

    Resolutions are typically about habits, and habit formation involves a part of the brain called the basal ganglia. Patterns of signals between neurons in the basal ganglia shift as we perform a new behavior. When we are pleased by the results — whether we're eating a delicious piece of cake or serving a tennis ball — there's a release of dopamine, a neurotransmitter that makes us feel good.

    Over time, this association with feeling good can make a behavior almost automatic.

    Read more: I'm a neurosurgeon, and the best morning routine I've found consists of just 3 simple steps

    Unfortunately, we often don't establish the right foundation to allow new, more desirable habits to become automatic. Taking an "all-or-nothing" position can derail our efforts and can result in discouragement when we fail to live up to our high expectations.

    We also may be unaware of cues that trigger our behavior. Neuroscientists at Johns Hopkins University demonstrated the power of those cues with a study, wherein 20 participants were given $1.50 for every red object and $0.25 for every green object they saw on a computer screen.

    The next day, while their brains were scanned, these same subjects were asked to spot certain shapes on a screen, regardless of color. The participants automatically focused on red objects when they appeared, even though no reward was given this time. As this was happening, dopamine was released into the part of the brain involved in attention; the good feeling from the day before had been retained.

    Knowing the cues for our behavior can help guide us to better habits. When trying to lose weight, for example, it may be a good idea to bypass the dessert aisle in a grocery store.

    The bottom line: You need to think about your behavior and its context differently if you really want to make a change. Here are four recommendations for giving a new habit staying power:

    1. Build in failure

    Bumps in the road are normal when changing behavior, so don't worry if things don't go exactly as planned. As Stephen Covey, the best-selling author of "The 7 Habits of Highly Effective People," tells us, an airplane in flight is off course at least 90% of the time. This doesn't matter, because the pilot or autopilot computers continually make adjustments to adhere to the overall flight plan and get to the destination on time.

    The same principle applies to other goals.

    Instead of telling yourself that you must meditate every day, try for five out of seven days a week. If you're beginning a new exercise regimen, start off with twice a week and then build up from there.

    Read more: A psychotherapist says there are 3 common reasons so many people's New Year's resolutions end in failure

    2. Focus on time-based, rather than task-based, activities  

    I often say to myself: "I'm going to read this chapter,""I'm going to clean my office," or "I'm going to clean out the car." Invariably, I run out of time because I underestimated the amount of work needed to complete the task and, instead, must run to my next commitment. Rather than feeling good that I was being productive, I feel like a failure because I didn't complete the task.

    I've found that instead of saying "I'm going to read this chapter," I tell myself  that I'm going to read for 30 minutes. Then even if I don't finish the chapter, I am able to feel good about completing my task. Chipping away at a big task ultimately leads to success.

    By setting a time and completing that commitment, I find I'm more successful in moving in the right direction.

    3. Find pockets of underutilized time

    Haven't got time to for your usual workout? It can take 15 minutes to eat a leisurely self-packed lunch bag. So, if you invest five minutes packing your own lunch, you can reward yourself with 45 minutes of free time during your lunch hour to work out or meditate.

    If your resolution is to exercise 30 minutes a day, you can rack up those minutes in a lot of ways, like taking a vigorous walk during your lunch hour. A friend of mine who works in a tall building walks up and down 15 flights a few times when he knows he must work late and won't get to the gym. The opportunities are always there … so be creative!

    4. Monitor your progress

    Smartphones and smartwatches can be great "assistants" for tracking your progress. And some new apps help you recognize where you waste your time. I've found the app Moment has been eye-opening, allowing me to see how much time I spend on social media.

    You can also use an alarm to trigger action at a desired time or a stopwatch to time your activity, so you feel more in control of your efforts. If you're not into using your smartphone for these activities, you can also keep track in a day planner that allows you to compare, at a glance, your performance from week to week.

    Of course, there's nothing magic about January for making resolutions. You can start a new habit any time.

    And you shouldn't be disheartened if you've been stuck in a bad habit for many years. As Charles Duhigg wrote in "The Power of Habit,""Habits are malleable throughout your entire life."

    Mark McLaughlin, MD, practices neurological surgery at Princeton Brain and Spine Care and believes that we can all use the core principles behind brain surgery and apply them to our daily lives. His mission is to use the lessons he has learned from his career to help others manage stressful situations and engage with problem-solving.

    Join the conversation about this story »

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    warren buffett

    • Warren Buffett, the chairman and CEO of Berkshire Hathaway, said in May he'd like to see the Apple's share price fall so he could step in and buy more.
    • Buffett said he'd "love to see Apple go down in price" at his annual shareholder meeting last May, and endorsed the company's buyback program.
    • The stock is down 21% since his comment, and down nearly 40% since the stock's all-time high last October.
    • Watch Apple trade live.

    Warren Buffett, the chairman and CEO of Berkshire Hathaway, said in May that he'd like to see Apple's share price fall so he could step in and buy more.

    With the stock plunging Thursday after Apple issued a warning on its quarterly revenue and down 21% since Buffett's comments last May, the billionaire investor may be looking to load up on more shares of the iPhone giant. pple said late Wednesday it would report up to $9 billion lower than originally expected in the first quarter of its 2019 financial year. It cited issues including an iPhone slowdown, primarily in China.

    "From our standpoint we would love to see Apple go down in price," Buffett said in May, at his annual shareholder meeting. "We very much approve of them repurchasing shares."

    Buffett's conglomerate owns 258.2 million shares of Apple, reflected in its most recent filing with the US Securities and Exchange Commission in September 2018. That represented a decline of 1.2 million shares compared to the prior filing.

    Read more: Technology suppliers are getting pounded after Apple's shock warnings about a China slowdown

    Apple's stock is down nearly 39% from its October 2018 all-time intraday high of $233.47. In August, the tech giant became the first US company with a market capitalization of more than $1 trillion. That was down to $749 billion at Wednesday's closing bell.

    An email request to Berkshire Hathaway for comment about Buffett's investments were not answered as of Thursday morning.

    Read more about Apple and its revenue guidance announcement:

    Apple shares.

    Join the conversation about this story »

    NOW WATCH: The equity chief at $6.3 trillion BlackRock weighs in on the trade war, a possible recession, and offers her best investing advice for a tricky 2019 landscape


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    Apple China

    • Apple on Wednesday lowered its first-quarter revenue guidance, attributing a sales slump at least partially to a slowdown in China.
    • Shares were down more than 9% on Thursday.
    • The tech giant's warning indicates that companies with heavy exposure to China are facing headwinds
    • Goldman Sachs previously identified 20 stocks that were particularly exposed to China.

    Apple shares were under pressure Thursday after the tech giant lowered its first-quarter revenue guidance and blamed slumping iPhone sales on a slowdown in China. 

    "While we anticipated some challenges in key emerging markets, we did not foresee the magnitude of the economic deceleration, particularly in Greater China," CEO Tim Cook wrote in a letter after Wednesday's closing bell, sending Apple stock down more than 9%.

    And it's not just Apple that is seeing weakness. The country's economic slowdown is visible in the data. During the third quarter, China's gross domestic product grew at its weakest pace in a decade. And in December, China's private-manufacturing sector contracted for the first time in 19 months.

    The macroeconomic slowdown in China and Apple's sales weakness are due to many related factors, according to the SunTrust Robinson Humphrey analyst William Stein.

    "These factors include: (1) US tariffs appear to be negatively impacting consumer confidence in China, (2) higher USD is likely denting demand in emerging economies, (3) competitive forces (both nationalistic and otherwise) from local vendors, particularly Huawei (private), may be triggering share loss away from AAPL, and (4) handset upgrade cycles may be slowing more than previously anticipated,"he said in a note out to clients on Thursday. 

    While it's hard to determine which factor has had the biggest impact, most of them indicate companies with heavy exposure to China are facing headwinds

    Luckily for investors, Goldman Sachs maintains an index of US companies that get the largest percentage of their revenue from China. The firm has identified 20 companies it thinks will take the biggest hit in an environment unfavorable for trade between the US and China.  

    Here are the 20 companies Goldman listed, in order from sales least exposed to China to the most. (Goldman published the list in late October.)

    20. Apple

    Ticker: AAPL

    Industry: Technologies

    Market cap: $738.58 billion

    % of China sales: 20%

     

    Source: Goldman Sachs & Markets Insider



    19. Avery Dennison

    Ticker:AVY

    Industry: Materials

    Market cap: $7.62 billion

    % of US sales: 20%

     

    Source: Goldman Sachs & Markets Insider



    18. Agilent Technologies

    Ticker:A

    Industry: Healthcare

    Market cap: $20.59 billion

    % of US sales: 20%

     

    Source: Goldman Sachs & Markets Insider



    See the rest of the story at Business Insider

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    financial independence early retirement

    • To achieve financial independence— or to no longer work to live — most millionaires follow a similar path, according to a researcher who has studied more than 600 millionaires.
    • They share three traits: spending below their means, finding a side hustle, and moving to self-employment.
    • These ultimately allow them to build wealth more quickly and reach financial independence sooner than most.

    Building enough wealth to achieve financial independence requires a lot of resilience and perseverance, but there's more to escaping the rat race than that.

    Sarah Stanley Fallaw, an author of the book "The Next Millionaire Next Door: Enduring Strategies for Building Wealth" and the director of research for the Affluent Market Institute, surveyed more than 600 millionaires in America and found that those who dusted off the 9-to-5 — whether they wanted to no longer work or to start working for themselves — followed a similar path to financial independence.

    "Millionaires have shared three themes related to removing yourself from the trap of working to live: creating margin in their lifestyle to allow for career moves, particularly significant ones (e.g., living off of savings while starting a business); exploring career opportunities while generating revenue from a traditional job (i.e., moonlighting); and making a move to self-employment," she wrote in her book.

    Here's a closer look at each of those themes:

    1. Spend below your means.

    Many of the millionaires Stanley Fallaw interviewed stressed the freedom that comes with spending below their means.

    "The freedom translates into opportunities to make career changes that provide either (a) more time and flexibility to pursue efforts outside of work, and/or (b) the potential for increase in revenue," she wrote.

    She added: "Spending above your means, spending instead of saving for retirement, spending in anticipation of becoming wealthy makes you a slave to the paycheck, even with a stellar level of income."

    Chris Reining, who retired at 37 as a self-made millionaire, previously told Business Insider that being rich and becoming financially independent isn't about a paycheck or how much money you have — it's about how much you spend and living below your means.

    "Getting rich, and staying rich, is overwhelmingly a game of living below your means," he said. "If you can do that you'll enjoy a freedom that people living rich will never experience."

    Read more: A researcher who studied over 600 millionaires found 2 qualities helped them get rich, and anyone can develop them

    2. Find a side hustle.

    Moonlighting, or taking on a side hustle, has been favored by many millionaires — it's a good way to explore options while remaining employed full time, according to Stanley Fallaw. But making a side hustle successful "requires resources, both time and money, to develop and maintain," she wrote.

    "Those who are able to create multiple opportunities to generate revenue, who can translate hobbies into income-producing activities, will be successful at becoming millionaires next door in the future," she added.

    Read more: The author of 'The Millionaire Next Door' explains 3 ways anyone can build more wealth

    It's possible to transform a side job into a full-time career if you have the hunger, execution, decisiveness, and perseverance for it, Susie Moore, a high-performance coach, consultant, and author, previously wrote in an article for Business Insider.

    One investor who plans to retire early found that earning an income with a side job is the path of least resistance for reaching financial independence.

    It can certainly help you get there faster — Business Insider recently spoke to a handful of people who have taken on side hustles, and they said they earned anywhere from an extra $1,000 to $30,000 a year. Invest that money, and the power of compound interest can lead to wealth.

    3. Become self-employed.

    Those who are financially independent can grow their wealth even more by working for themselves.

    The self-employed "millionaire next door" of tomorrow is likely to take risks to transform their resources into something of value, according to Stanley Fallaw, who said 42% of the millionaires she spoke with were self-employed.

    "The potential payoff for those career risks, specifically for the risk associated with starting one's own business, is the ability to generate revenue, more revenue often than would be possible working for someone else," she wrote.

    Stanley Fallaw found in her latest survey that self-employed millionaires had more than 1.5 times the median income of those who work for others. Their actual net worth minus their expected net worth is on average double that of those who work for others, she wrote.

    Stanley Fallaw said that investing in one's own business is a hallmark of the economically successful, as long as they have the right strengths — like perseverance and resilience — to survive the journey.

    SEE ALSO: An early retiree who interviewed 100 millionaires discovered nearly all of them got rich using the same 3-step strategy

    DON'T MISS: A self-made millionaire who interviewed 100 other millionaires found there's a surprising habit many have in common

    Join the conversation about this story »

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    one bedroom ritz carlton nyc

    • A billionaire who has produced movies including "Crazy Rich Asians" is selling a one-bedroom apartment in New York City for $39.5 million.
    • It takes up an entire floor of Manhattan's iconic Ritz-Carlton building and is one of just 11 homes at the Ritz-Carlton Residences.
    • The 8,000-square-foot home includes a 2,000-square-foot master suite, onyx and marble bathrooms, and a 53-foot terrace with front-and-center views of Central Park.

     

    A lavish one-bedroom apartment in New York City's iconic Ritz-Carlton building has hit the market for $39.5 million.

    The seller is Sidney Kimmel, a billionaire movie producer worth an estimated $1.3 billion, according to Forbes.

    His New York City apartment, one of just 11 residences in the Ritz-Carlton across the street from Central Park, is on the market for $39.5 million, listed by Corcoran. Kimmel and his wife bought the apartment in 2001 for $22.3 million, according to Curbed, and commissioned architect Thierry Despont to redesign the space, which includes a 2,000-square-foot master suite, two terraces, two elegant dressing rooms, a full gym, and two onyx and marble bathrooms. 

    Kimmel made his fortune in retail by founding Jones Group, an apparel company, that went on to sell brands including Stuart Weitzman and Nine West. More recently, he founded SK Global, an entertainment company, through which he was a producer for movies including the 2018 hit film "Crazy Rich Asians" along with "Moneyball" and "The Kite Runner."

    Here's a look inside the opulent home, with its unbeatable views of Central Park.

    SEE ALSO: This $245 million Los Angeles mansion is the most expensive home for sale in the US — and it costs 960 times more than a typical US home

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    The one-bedroom apartment is in the iconic and historic Ritz-Carlton building, a luxury hotel that includes 11 permanent residences.

    Instagram Embed:
    //instagram.com/p/Bqr_ssOhjlY/embed
    Width: 540px

    Source: Ritz Carlton, Corcoran



    The building at 50 Central Park South was originally the St. Moritz Hotel from 1930 to 1999. After extensive renovations, the hotel reopened in 2002 as the Ritz Carlton.

    Source: Ritz Carlton



    Sidney Kimmel's one-bedroom apartment takes up the entire 27th floor of the building, spanning more than 8,000 square feet. The grand entryway offers an elegant welcome to the home.

    Source: Corcoran



    See the rest of the story at Business Insider

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    Hotel TwentySeven amsterdam

    A hotel has the possibility to make or break your vacation — but, if it's one of the best boutique hotels in the world, chances are you'll be in very, very good hands.

    In 2018's Boutique Hotel Awards, fourteen hotels around the world took home top honors in a range of categories.

    The hotels were judged on "all aspects of the guest experience covering six categories: dining and entertainment, design, facilities, location and, most importantly, staff service and overall emotional impact," according to the news release.

    A hotel in Bali was named the best overall boutique hotel, while hotels in Portugal, South Africa, Greece, New Zealand, and other countries also won top spots. Categories include World's Best Beach or Coastal Hotel, Best Honeymoon Hideaway, Most Stunning Views, and more.

    Here are the top boutique hotels in the world, from a beachside retreat in the Maldives to a wellness resort in Austria.

    SEE ALSO: Disappointing photos show what 9 top luxury destinations look like in real life

    DON'T MISS: Inside the world's largest underwater restaurant, which has a 36-foot window that looks right out into the seabed so guests can watch marine life swim by as they eat

    World's Best Beach or Coastal Hotel: Reethi Faru Resort

    Location: Filaidhoo, Maldives
    Rates starting at: $171



    World's Best City Explorer: Corpo Santo Lisbon Historical Hotel

    Location: Lisbon, Portugal
    Rates starting at: $133



    World's Best Classic Elegance Hotel: Relais & Chateaux Hotel Heritage

    Location: Bruges, Belgium
    Rates starting at: $222



    See the rest of the story at Business Insider

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    artificial intelligence CES 2019

    • Artificial intelligence will be a major theme at this year's Consumer Electronics Show. 
    • AI is in everything from home products to entertainment to even sports equipment, with no sign of slowing down in 2019. 
    • Amazon's Alexa and Google Assistant will likely dominate this year's show, as both virtual assistants are now enabled in more than 10,000 devices. 

    Techies and gadget geeks alike have been talking about it for years already, but artificial intelligence made serious waves in 2018, showing up prominently in pop culture and our everyday devices.

    With companies like Apple, Google, Amazon, and Microsoft investing millions in AI, this will ultimately make it one of the major themes to look out for at the annual Consumer Electronics Show, which kicks off in Las Vegas next week.

    CES is an opportunity to showcase the consumer use for that technology, so much of what will be displayed are "smart" devices or "smart" products — take, for instance, this smart bathroom with voice-enabled lighting technology. 

    Read more:Here's all the major tech we're expecting at CES 2019, the biggest tech convention of the year

    While there are dozens of players in the AI space, we can expect that Google Assistant and Amazon's Alexa are going to dominate the show this year. Both voice assistants are compatible with more than 10,000 devices, which — as Wired noted— will make the showroom floor quite noisy.

    We'll also see smaller players introduce even more smart gadgets and other AI-powered gadgets you would and wouldn't expect, everything from TVs to security cameras, and even golf equipment. AI is likely to appear in every home product imaginable as well, from refrigerators to ovens to smart locks — Amazon already put it in a microwave, after all. Oh, and don't forget cars

    But the use for AI extends beyond everyday consumer goods. Artificially intelligent robots will effortlessly roam the show floor, and keynote speakers will make the case that robotics and AI could help solve the world's most complex problems. There's even an event entitled "Creating Tomorrow's Robotic Caregivers" showcasing just how important tech's relationship with health is becoming — late last year, for example, Optum, a healthcare company within UnitedHealth Group, announced it's using AI to help doctors answer complex patient questions.

    Beyond AI, we're expecting to see tons of new gadgets — and probably quite a few surprises from the companies behind these electronics — at this year's show. We'll be covering the show live from Las Vegas all week — you can follow all of our coverage right here.

    Join the conversation about this story »


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    healthy breakfast hungry

    • Many people think slimming down means being hungry all the time, but this isn't the case.
    • In fact, one personal trainer believes hunger is to be avoided at all costs if you're trying to lose fat.
    • This is because when you're ravenous, you're less likely to make healthy food choices.
    • However, other experts believe that feeling hungry sometimes is a normal part of the weight-loss process.

    If you're trying to lose fat, you might be tempted to think that feeling hungry is a necessary evil.

    It's true that some health professionals advocate embracing hunger — sports dietitian and nutrition coach Georgie Fear, for example, suggests slimmers wait until they've been feeling hungry for 30 to 60 minutes before eating.

    However, according to a top personal trainer, this is not a strategy that will help you achieve your goals. 

    The reason for this is that when you're ravenous, you're less likely to make healthy food choices.

    As a well-known nutty chocolate bar often points out, you're not you when you're hungry. And when you're hungry, you're more likely to reach for said bar rather than a more nourishing snack.

    "Hunger is to be avoided at all costs because it means you're at the bottom of a slump and emotionally you're probably out of control of what you're going to put in your mouth next," Rich Tidmarsh, owner and lead trainer of Reach Fitness in London, told INSIDER.

    A post shared by richtidmarsh (@richtidmarsh) on

    He believes that even the most disciplined people become animalistic when they're hungry and their blood sugar levels are dropping.

    "They eat the next thing in front of them, and for most people this ends up being sugary snacks," explains Tidmarsh, who has trained the likes of the England Rugby team and rapper Professor Green.

    Read more: 18 small changes you can make every day to lose weight

    Certified strength and conditioning coach Tidmarsh cites the example of people who come home from work, and instead of wait the 30 minutes until dinner is ready, raid the fridge or have a packet of chips because they're so ravenous.

    "These people haven't managed their food and hunger correctly," he says. "That's an additional 200-400 calories they're eating before their evening meal."

    Of course, this may not necessarily be a problem — but when you're trying to lose fat, it can make a huge difference.

    "If you're looking to lose weight healthily, you only need to be in a deficit of about 200-250 calories a day — if you do that every day you'll probably have lost around 2lbs of fat by the end of the week," Tidmarsh explains.

    But demolishing some leftover cheese because you feel out of control due to hunger can ruin your calorie deficit. 

    "You can blow all your hard work so easily by letting your hunger get the better of you and stress-eating at the end of the day," Tidmarsh adds.

    A post shared by richtidmarsh (@richtidmarsh) on

    Essentially, when you feel hungry, it's your body telling you to eat. Problems arise if people are constantly eating when they're not hungry.

    "Someone who is looking to lose weight via a steady mix of exercise and good nutrition shouldn't be looking to make themselves hungry," says Tidmarsh. "A lot of people think if they're hungry they're losing weight, but if your daily nutrition is leaving you hungry, you won't adhere to it. It's not sustainable."

    Not all health experts agree, however.

    While there's a general understanding that for any nutrition or fitness plan to be effective, you have to be able to stick to it, some disagree that you should pre-emptively eat to avoid hunger.

    Hannah Bright, a British nutritional adviser and certified personal trainer at DW Fitness First, believes that feeling hungry sometimes is to be expected if you're slimming down.

    "If you're trying to lose body fat, you need to be in a calorie deficit," she explains to INSIDER. "This means eating fewer calories then you burn in a day. It's very likely that you will therefore go through stages of feeling hungry, this is expected and normal."

    Bright believes that the key is managing your hunger so you're in a calorie deficit, not so ravenous that you delve into the cookie jar before dinner, and not so unhappy that you give up on it all.

    "You don't want to be so hungry whilst on a fat-loss diet that you can't sustain it for long enough to lose your target weight or fat," she explains.

    "You need to make sure you're in a calorie deficit that's big enough to lose weight but not so much that you're hungry all the time."

    She advises slimmers to fill themselves up by including lots of vegetables in their meals: "These are very low in calories but will help to fill you up and hopefully avoid you having to endure too much hunger when in a calorie deficit!"

    Join the conversation about this story »

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    movies streaming

    Consumers having been “cutting the cord,” or canceling their pay-TV subscriptions in favor of internet-delivered alternatives, for years now, but the trend reached new heights in 2017. 

    There’s little reason to believe that this phenomenon will slow down any time soon either, so pay-tv providers will have to find new ways to generate revenue as their primary source continues to erode. 

    One of the most prominent ways media companies are recuperating cord-cutting losses is by launching their own direct-to-consumer streaming services. 

    But what makes for a successful streaming video service? 

    The Business Insider Intelligence Digital Media research team has written a note breaking down the evolving landscape of streaming video on-demand (SVOD). The note looks at which characteristics consumers care about most in a streaming service and which are just "nice to have." 

    To get your FREE copy, click here.

    Join the conversation about this story »


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    Jamie Dimon

    Starting Monday, thousands of pharmaceutical industry executives, investors, bankers, and analysts will swarm into San Francisco for the J.P. Morgan Healthcare Conference.

    Now in its 37th year, the conference has ballooned from a small event with 150 attendees that was essentially the "birth of biotech," to an event attended by everyone from the biggest pharma company to the smallest biotech. JPMorgan said more than 485 companies are scheduled to present this year.

    It's a spot for these companies to meet with investors and each other, and can be the starting point for takeovers or other deals. 

    It's also a place where more deals — maybe even on the scale of Thursday's $74 billion merger between Bristol-Myers Squibb and Celgene— could get announced. 

    From confronting the threat of technology giants' healthcare advances to covering the cost of one-time treatments, here are some of the key topics we'll be asking about this week. 

    We'll be sending out our best stories from the week in Dispensed, our weekly dispatch of pharma, biotech, and healthcare news. Sign up here.

    Who’s next to merge?

    2018 saw a number of mega-deals, including the $77 billion Takeda-Shire merger. Now with the BMS-Celgene deal in place, the healthcare industry is wondering who might be next to pair up.

    "With large caps, generally, falling under pressure the last few years, one has to acknowledge the potential for additional consolidation of profitable companies," Baird Equity Research biotech analyst Brian Skorney wrote in a note Thursday. 

    Alternatively, Celgene could find another dance partner in a counter-bid.

    Alethia Young, an analyst at Cantor Fitzgerald remarked in a note Thursday that it's possible others go in to big on Celgene — specifically Amgen and Johnson & Johnson. That's in large part because of the two companies focus on hematology. Joining up with either of those two companies could create more synergies than the company has with BMS. 



    How will we pay for seven-figure drugs? What about other costly treatments?

    The issue of paying for medications is now a constant conversation for the drug industry, with prices continuing to go up even after political pressure in 2018. We'll definitely be keeping an eye on pharma's 2019 plans.

    But a new wrinkle that's quickly coming into focus: How are we going to pay for one-time treatments?

    Already, treatments like cell therapy for cancer treatments and a gene therapy for a hereditary form of blindness have tested the waters.

    But more are in the works. That includes Novartis' gene therapy for spinal muscular atrophy, a rare genetic condition that affects muscle movement in children and is the leading genetic cause of mortality in infants that could be approved in the US by as early as May 2019. When that happens, Novartis said it would be cost-effective at a price of between $4-5 million

    It might take some new payment arrangements to get health insurers on board to cover the cost of treatment, such as paying in installments over a set amount of time. What that looks like and who takes the lead on that will be a big question that should get answered in 2019. 



    How has the pharma-payer power dynamic shifted?

    In 2018, two massive healthcare deals closed, redrawing the lines around what defines a healthcare company: 

    The health insurer Cigna combined with Express Scripts, which manages pharmacy benefits. And CVS Health, a big pharmacy chain that also owns a drug benefits business, acquired the health insurer Aetna.

    We'll find out a lot more this year about the strategies of the combined companies. Both new firms will be looking for places to cut costs, as well as seeking to gain more control over how patients access healthcare. It's happening at a time when new medications are getting approved that challenge the way we pay for treatments.

    It remains to be seen how the two newly formed healthcare companies wield their new negotiating power, and how drugmakers will respond to that increased pressure. 



    See the rest of the story at Business Insider

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