es behind. So proficiency would be greatly appreciated. Thank you. Thank you. Is the person being clean up? I will be as efficient as I can. I want to echo Jess and Maureen in saying thank you for what you're doing here. It's a very complex design build and not only are you designing and building it as you're doing it, but you're having to come and tell us all about it while you're doing it. And I'm very much appreciated for the effort today. This is a big thing and I'll forget the 20 and 22 and if you're successful, it will be well worth it for many. I just have a couple of quick questions. One is just curious in terms of methods having to do with Rise Vermont. And it just seems like it's a program that can develop different personalities in different hospital service areas. And I'm wondering how you expect to be able to tease from the population health data any kind of incremental benefits or effects or changes that are engineered by the Rise of Vermont. Thank you. I think you hit it right on the head. What we're trying to do here is balance the statewide approach with that local care delivery. And so what we've done to Rise of Vermont is work with a steering committee to develop a set of standard metrics that we'll be looking at across the state and really looking for where there are improvements, where's their variation will help inform future planning. At the same time, there is flexibility and opportunity through these amplify grants to be able to invest in particular activities that we think can really spark and highlight, accelerate the pace of change at a local level. And we need to pay attention to those and really evaluate which ones are more effective and make sure that we're sharing that information as we move forward. And is there any connectivity between your investments in public contribution health and those that be approved in the hospital budget process with additional 4-tents of 1% spend or are these kind of in your experience if you set the rules? Yeah, I mean, they're meant to be complementary. And in that, we don't want to have to fund all the needs for local community that sort of provides the structure and some resources that otherwise we go wanting. We hope and expect that the incentives that we drive to do this and do this well will meet local communities, will figure out ways to fund programs on their own as well. And so, you know, they're meant to be complementary and not only look at it, but I think that there's a role for both. Finally, for me, I'm just looking at the Medicaid total cost of care spend rate. I think it's, you don't have to turn there, but it's on the slide 16. And it's relatively flat as you move from 2019 to 2018, it's 1.5 to 1% per member per month. And the year prior to 2018, it was about the same. And I just want to understand, and then if you look at that growth rate relative to Medicare and commercial for Medicare, it's a little bit higher at 1.08% and for the commercial it's 4.73%. So I just want to understand if I'm looking at anything that pertains to the cost of care. Is it that the Medicare rate is driven by the cost of the payer, which Diva controls, or is it driven by the actual medical cost incurred by providers? Well, I mean, it has both. So anytime you've got a medical expense trend that's made up of utilization changes and not the reimbursement changes. And Diva doesn't do reimbursement changes that often. And it increases, so that does lead to some flatness. Our efforts to do good population health management have managed to stem and utilization increases fairly effectively. One thing that if you really want to tell the truth that 3.5% doesn't meanize us from the cost shift, right? And for every dollar that Medicaid can provide an increase even if it's just a cover inflation for provider expenses that they absorb would have a direct impact on how much we need to do for commercial, right? That always was part of the model. As a matter of fact, the all-payer model if Medicaid were to increase sheen of reimbursement rates were hella harmless from that against the target growth rate because they definitely didn't want to do anything to keep us from doing that. I know that from being in the room that CMMI, the Innovation Center at CMS was concerned that the most fatal flaw of the all-payer model, how we constructed it would be that Medicaid would underpay or even go backwards and that therefore it looked like it wasn't providing affordability for Medicare in commercial. The non-negative rough, the quick calculation looking at what if just a hypothetical if the Medicare remember for month rate was growing at 2.5% it seems within a reasonable amount and that would, if it grew at that amount it would be an increase of 3.8 million in the Medicaid allotment but that would allow for a reduction of the commercial rate from 4.7% to 2.6%.  And finally, just it's been an experience in my life that's probably given me a few of these white hairs but how do you think your all-payer model will respond in the next recession when the state budget really tightens up caseloads and Medicaid increase? And as opposed to now we're experiencing a situation where caseloads are decreasing, your time is good, people are getting jobs in the private sector but that's not always going to be the case. Yeah, that's a hard one to answer. I mean, what cycles we saw become this five year period are going to be interesting and we hope that none of them will be so profound as to break the model and the dedication to it. I do believe this resonates with the provider community and this is the way we want to deliver care the population health management route. I think that having some economics that are at the top of the spending premium and challenging us to live within those while improving the system is exciting work and we have a lot of support for it but there are cycles to these things and some of them are related to business and general economic cycles. Even so bad though can move in different directions because positive economic conditions might mean fewer social safety net spending on one end but it also means people want to spend against their deductible when they have commercial insurance and it sort of has a suppression rate on the commercial utilization. So we'll have to see where we're going. I think one of the more important things that seems to be happening is through some combination of those cycles, long-term investments in Vermont and things like the blueprint for health and the efforts of one care to really sharpen the incentives. We seem to be in a good place on Medicare where we're gonna have decent Medicare economics that help us fund the transformation, drive the incentives and really do something of a reverse cost shift for, you know, you should root for Medicare to be above that 3.5% as it injects itself into this map. So hopefully that one won't continue for a few more years and we continue to have success with that really flat Medicare growth that we've seen since 2016 which is on the actual pure claim spend is a pretty amazing story for a Medicare population. Starting for a minute to attribution numbers. So I wanted to get your thoughts on how you would react if the attribution estimates were significantly different than what you're currently anticipating. For example, last year your Medicare numbers were much higher than you expected which I think influenced your decision about which risk sharing model to sign up for. So I'd be curious to know what you're thinking in terms of potential changes there. Yeah, very good question. Every year we learn a little bit more about what to project for attribution. I think the things that are the most likely to change, I was getting feelers for this, it's not all that substantiated, it is. Medicaid, we're working on the methodology for attribution. I wouldn't be surprised to just go up a little bit which would be a great thing. The biggest single change I think we'd experience is if we don't get a self-funded program off the line that would be the most material downside risk to the attribution model. The one-care business model itself, all scales with attribution, most things will flow with the total cost of care, the risk, the PHF spending that we make. There are some, probably more on the operation side which is a relatively small portion of the whole budget that are more fixed and not so dependent on attribution but even contracts we have with our software vendors or informatics schools often flow with attribution. So if we were to lose the curative lives we would have some expense there too. So it is designed to be a model that can absorb that type of change not only when we start applying here but throughout the year as we have nutrition. A couple questions related to care management and I think both Jess and Maureen and Kevin all touched on this. So maybe what I'll do is just make a comment and then we can move on. But I think the care model and the care management information is hard to absorb in a written format and I think that presentation actually is very helpful in terms of really giving us the flavor of it. But one of the things that I've been thinking about that I'm just gonna throw out there for you to think about moving forward is whether we should have our staff do a little bit more of a deep dive to understand more of the nuances with you around the balance between the analytical approach where you wanna make sure that you have consistency in terms of achieving metrics across the state while also allowing some tailoring on the local level. So no need to comment right now. I just wanted to throw that out there for you to think about so it's not a surprise if I talk about it later. I did have a question around the share care plan uptake, I know when you came in earlier in the year you talked a little bit about how the ramp up was taking a little more time in 2018 than you'd initially anticipated. I'm guessing that that's why your primary care spend is coming in on the lower side because of those $15 payments being tied to the shared care plans. And I know this is the hardest work of all. But I wanted to know if you could talk a little bit about lessons learned and what you may adapt or change through 2019 to increase that take up rate. Sure, so I think core infrastructure that we've been building and supporting is really an effective mechanism for us to continue to leverage. So we're talking about those care coordination trainings. We had piloted what we call care coordination core teams and really expanded those this year so that we have a North team and a South team. And those are really well attended. We rotate the locations of those events and there's tremendous pride and accomplishment in what's happening at the local level that's able to be shared around that. So I think those are some of the things that we're going to continue to capitalize on. Couple of the things that took us a bit by surprise or that were not as well anticipated is the stat turnover in some of the local organizations has been larger than we expected. So when we look, and I thought back to our discussions a year ago together about where might we expect the need to train more individuals in the use of care navigator and I believe I said something to the effect of maybe 150 more individuals might need that because we're moving into some smaller communities. In fact, it's been hundreds and hundreds. I've looked through my notes but I believe it's over 300 individuals that needed training. So that's refresher. Some of that is people who have been in organization moving into new roles but a tremendous amount has been turnover or transitions in local organizations and I think it speaks to the larger question about workforce development capacity, the aging workforce, all issues that I know are all interested in addressing. Thank you. It's also helpful to think about for the high risk patients, ultimately we do want a share care plan which means the patients involved in the plan and setting and the goals and that's the 15% number. That doesn't mean that we don't want to get resources to get medical homes in combination with their local community partners to have a plan of care for high risk patients even if the patient's not ready to fully engage in a shared care plan. So part of this is also to get resources out there to help the medical homes develop plans to care with their local community members. So just to that point, because we can cut the data in so many different ways, one of the statistics we provided for you was that 46% of those high and very high risk individuals actually have activity documented in the system which indicates to us that trajectory has started, progress is being made. It just hasn't gotten to the rigor of our definition of what a completed shared care plan really looks like. Thank you. And the hospital budget hearings, we've had two hospitals talk about using their OEHRs and an integrated shared care plan.  So we're actively discussing exactly that into health service areas. We had conversations about what the core criteria are that need to be met and they shouldn't be any surprises. It has to do with making sure that the entire continuum of care partners have access and the ability to effectively engage in that care plan development and achievement of those goals. It also requires that data be sent back to us that we can then integrate into our care coordination software. And so we're continuing those conversations. I do think we'll move forward with at least one pilot in 2019. Great. Can you speak to what you're using the state HIT investment for? So we have a large set of activities and deliverables that relate to that HIT investment. We'd be happy to share a more exhausted list but it really has to do with the ability for us to be able to take in this information and still have the slides showing a complicated system here. But it's developing new visualizations. It's new ways to develop standard reporting packages as well as address what we call ad hoc or kind of one-time requests from individuals that might be highly nuanced and really need the talents and advanced analytic skills of our team to be able to get to a new answer that can drive that change in improvement. We'd be happy to give you further examples. Not now. I just have one more question for you. I wanted to just talk a little bit more about the commercial program, particularly the Blue Cross QHP program, which I know you're currently negotiating. I think it's what so and in your slide around how you were looking at the QHP when you finally compared to the trend rate. I know you indicated that you hadn't risk adjusted but many of the adjustments that are built in really are in my mind designed to do the same thing as a risk adjustment model, which is to address the fact that the population that you might have in your commercial ACO program may not mirror the population that Blue Cross has either in the entire QHP market or in all of their focus business. So I was just curious if you could speak to that a little bit more and also as part of that, as we move forward with more inherent volatility and lack of stability in the QHP market due to federal and state policy decisions around the Affordable Care Act, I would anticipate that premium setting becomes a much less precise, it's not particularly precise now I would say, but it is even less precise as you add volatility into the market. So that means me to question whether the QHP program in a premium estimation process is even really the right place to start. So that is one of the things that we're struggling with both Blue Cross and White Care in trying to figure out what is the right methodology. We do have contractual terms that has language that talks about mirroring the filing, understanding though there are two components to the filing. The filing is taking premiums from 2017 to 2018, which is different than taking a claims expense. This 2018 filing will be based on 2016 members that cost a pair from 2016. So they need to take, define the pieces that affect the cost of care and its unit cost, its utilization, its elimination of the individual mandate, it's the ability to move the QHP. It becomes very, very complicated. Before you even factor in, what does the one care cohort look like compared to the Blue Cross cohort? So we have exchanged a lot of data between the faith to try to come up with something and then also say, okay, well here's where our contract set in 2018, what do we want to do for 2019? And so we're actually re-engaging, just actually doing a start over if you will, let's just look at both the years and try to figure out what's a model that makes sense. QHP is really difficult, it is the most volatile of any of the commercial programs, any of the programs that we have for a lot of reasons. So it's not an easy task to try to get a lot of different actuaries agreeing on really what should be adjusted. We just took our best shot at saying, okay, we're starting with our 2016 actual cost of claims, trending at four, we used about approximately 10% for unit cost utilization increases and then used estimates for AHP, elimination of the federal mandate, a population morbidity, that excludes- The 10% was across two years, so two cycles again. Absolutely, it's 2016 to 2018 on the claims side, which is our center target. That excludes the risk transfers that happens between the payers that we don't have. So Todd kind of alluded to this a little bit earlier and that it's a lot more complex. The Green Bank care board made some decisions with regard to the process rate filing, with regard to the fact it has reserves, it's getting a $16.6 million tax refund, those are not things we have to offset costs, we have to look at it, what do we really think our costs are going to be? And so that's, it's a complicated discussion, so we've spent a lot of time and effort trying to figure out what is the right answer, what is fair, and what's fair to both parties. I think we'll get there, it's just taken a lot longer than one could hope. Thank you. So at this point I'll ask Jackie Lee, if she has any questions. Yeah, thank you, I do. I have a quick question about the, I was really liking 521, where you did the blended total cost for charity CD change. And I think I've read into a confusion as you have been moved forward by, just based on the same data, but there's a different number, they were just about on the 479 versus, like a 490 number on the other side. Can you tell me about what the differences between those? Yeah, sure, okay. So, slide 21 is a training of our benchmarks, and we're using that because ultimately in the year, that is the number to which we break it down. So we're high, we go back to the payer, it gets us down to that benchmark, and then below we receive a shared savings check, and that gets us to that benchmark. So slide 21 is a benchmark to benchmark projection comparison, which I think is the right treatment as I mentioned, we're happy to all of our sleeves to figure out really exactly how we want to measure overall trend. The other slide you referenced is really our spend estimates, and particularly because of the shared savings carry forward for Medicare, they're not the same. We're expecting a different spend number for Medicare, just on a claims basis, and that's what slide 26 of our trade is as compared to the benchmark, which is the trade, and that's slide 21. So because the shared savings in Medicare go against our target, or our all-care model map, that's the reason why we put in the benchmark in there at the higher number, but this is the first time the actuarial model against one of our targets makes us think we're gonna spend less on claims than what the target is. Now, I guess last year, or this year, it has been true of the medic with the blueprint conservatism, but it's even augmented further with the urged shared savings that we're rolling forward on top of the SM. Anything else, Jack and Lee? No, thank you. Mike Barber. Great, so we're gonna turn this point to the healthcare advocate, Mike Fisher. Thank you, thank you, Kevin. Thank you, it's good to be hearing about good to be about this conversation. I think rather than asking, this is a question I'll sort of make in the statement, and ask you a similar concern, when I think about one care having a reserve, and understanding that the payers have to have a reserve, and understanding that the hospitals have to have cash on hand, and then also looking at the risk that hospitals are taking on, and having heard some of the conversation in the hospital budget process about hospitals, maybe they need to have some reserve. From a consumer's perspective, it gets pretty concerning that everyone wants to hold my money for good reasons on each level, but I don't know how to reconcile that, and I just would welcome your thoughts about that. Well, let's be clear that one care doesn't have a balance sheet other than what we can have available to us, or have pledged to us, right? And so, we have legal obligations to write checks back up to $34 million, yeah, more is right that the debt did come in that, we wouldn't have to write that back to have some risk mitigation. But what we've done is delegated that to hospitals to cover that risk, and like I said earlier, some of that risk is new type of risk that the hospitals are taking on that previously was held by the Medicare Trust Fund, the state budget of Vermont, and the reserves at a commercial payer. We don't have the ability to force getting some of that extra money on top of the spending target from any of those three parties. In a perfect world, probably there would be what would be considered separate from even administrative payments against the infrastructure to manage the risk, but there's a risk component, a risk premium, part of the premium that goes toward risk, would be built on top of the claim spend. That's just not the way it works. Medicare service set the precedent for you want to take risk, it's based on the claim spend, and you got to absorb the risk management expenses you worth yourselves. So, you know, it's easy for me to say, I've been to one care as a CEO in isolation, say I've got to have a business model that works. I have fully delegated through contract, 100% of my risk to hospitals, but if they default on that, one care still legally owes the money, and so having some reserves of one care at the very least prevents against that what is actually called credit risk that the people who've pledged against our obligations would default. So, you know, that's the reason why our reserves at one care have been pretty modest to date. I do, like I said, in my closing comment after the formal presentation, do wonder as we gain scale and these levels of risk get higher, you got how we want to do that, but I think we do need to talk about should one care have a risk premium, you know, might be transferred through that method, you know, so reserves that are held from the payers, you know, over one care and we can figure out with our hospitals you want us to flow it to you and give you higher levels of pledged risk versus keep your levels of pledged risk low knowing that you've got this box of money and one care to supplement that. I'm not really sure I've answered the concern, but you know, all I can do is tell you what one care needs to do it's business model needs legal obligations. And your agent makes total sense from the one care perspective and that's why I phrased it system wide. Yeah. I don't know that the mic is working, so I hope people can hear me. Speak loudly, we can hear you, but I'm not sure if people in the back of the room can. Talk about AHVs for a minute and whether there's a, was it an offer to have AHVs participate in one care? Whether there was discussions with Blue Cross about that? We did talk to Blue Cross about that and they were going to look that into their large group market and that's a market that has again a lot of volatility and we offered to do a one year, do a multi year contract that have no downside risk the first year so we could get into the model see how that population differs from what we have now, know how we might model the target. That was unacceptable for 2019 and I think also given that we really needed to focus efforts on the QHP because that's a plan that we already participated in and making sure we can come to terms and we just decided to focus efforts there. We're open to doing that in the future though, yeah. Okay. Absolutely. And then I think lastly for me, this also goes to a high level question. If one care works with self-employed insured, I'm sorry, self-insured groups and takes on or manages some of the risk for them, I just become, I have a very basic question of at what point does an ACO start to look like an insurer? That's a great question. Almost by definition, self-funded accounts are, the employer bears 100% of the risk for the claim spent and it's a fee for service model, right? And that's part of the reason why it's really, really challenging to gain in growth in that market because maybe I already do something different. We have one potential contract with a carrier that 10 years ago started to include some sort of sharing of outcomes and affordability and quality in their contracts that they're willing to share with us that could qualify for scale targets and share it with us. But you're exactly right now. And the one thing that the self-employed employers do want to do is they still want to be fully combined with the risk of law and be subject to the advantages and protections of that, including tax deductibility. But there are, there's a long well-trotten path of how to bring value-based models into that still consistent with the risk of law. The hardest part is convincing the employers and the brokers and the HR departments and the CFOs that it's working with something more complex and just same fee for service. And the reason why they are doubly tempted to do that is all the stuff we're doing from these 170,000 lives that we invested in Vermont seem to be working, right? And so it'd be really easy for them to be free buyers and say, oh yeah, we'll just write our fee for service bank account claims because of the growth rate seems to be pretty reasonable compared to what it was five years ago and certainly better than it was 10 years ago. So they aren't feeling as much as the burning platform on affordability as they were. So that's gonna be the tough nut to crack is convince them that they really need to inoculate themselves going forward from returning to that. But really, how do we get them to pay their share against this and contribute their lives into what we all agree is the real promise of this is using having an informatics driven healthcare system of the populace health manager approach where we've got a great game plan for everybody that keeps them healthy and happy and productive and that's gonna yield a sustainable low growth rate for healthcare services. Thank you. I'd also add if you look on slide 42, the risk sharing corridor is much lower in the self-funded program. And that's because we need to have at least 30% to qualify for scale target. So we're keeping the risk corridors low, keeping the risk sharing at that maximum 30 because we wanna qualify for scale targets. So that's really the conversation we've had try to minimize our risk, we're not trying to take over the world but still haven't qualified. So that's a bounce we have to consider when we're doing this too. But that's why you'll notice it has a net 1.8% risk. Thank you. Julia has a question or two more. So we talked a little bit already about how the commercial growth rate is higher than the aggregate target of 3.5% Now we're gonna need to just speak a little bit to whether you believe that growth target part of the commercial and self-funded payers is sustainable in terms of the profitability of that. Yeah. My personal opinion is something probably has to get that we can't afford five, six percent increases for whatever they have to be affordable. However, we also need to make sure that there's a healthcare delivery system that's available when people need it. And really having been in a room for some of the conversations we see on that's around the 3.5% growth rate. The concern three years ago was, wow, was that too low? I mean, all-care model agreement actually allows us to go up to 4.3% in this target in 3.5 overall. And really their concern was to try to grow a statewide healthcare delivery system at general inflation has probably never happened since the Medicare Act in 1964 on a statewide basis. Healthcare inflation's national growth rate has been high. Some of it has been the incentives of a volume-based reward system. But some of it is just there's been a high degree of growth in technology, pharmaceutical technology, biotechnology, electronic health records, quality improvement efforts, much higher skilled labor in healthcare than in the average industry that is very mobile and has very transferable skills. So a lot of reasons that you can convince yourself that the national rate of healthcare is an industry compared to other industries, you would expect to be higher than general inflation. And so the idea was we don't want to cut muscle from the system as we try to live in this growth rate. So that's the reason why we set course for this 3.5% felt like the right balance of it. Underneath the covers, does it somewhat codify the cost shift? Yeah, because Medicare made their deal on what they're going to contribute. It's the national rate of growth minus the 0.2%. Medicaid, like I said, there's a lot of discussions in terms of this could be bad. If Medicaid doesn't try to get as close to the 3.5% as it could, but we all know the challenges of the Vermont state budget make that extremely, extremely hard to anticipate. And so we backed into a bit of a commercial increase that keeps us in the ballpark. Like I said, at least the way we do the math, we think we didn't even, we didn't ask for under-PMPM for our commercial all the way up to what we think would be a 3.5% consistent with a state-wide 3.5%. So we're trying to do our best to really offer as much value as possible and live within a growth rate that would keep providers at the table and tell them that these are fair business models for them. Do you see your model as making the cost just worse or better or just being the same? Well, I think having lower utilization, keeping people healthy, delivering care in lower cost settings that are modeled and structured both in sense and designs processes to do can only help. I do believe the state now has made a great deal on Medicare that if we didn't have one care we're willing to say yes to the Vermont Medicare ACO initiative and it's building in the blueprint for health sustainability and our ability to have a rate of growth that seems to be at least right now in excess of what the rate of growth we can deliver as a system for each of your lives. It is, you know, that I think we're in a much better place than if we would have had to decide how do we want to sustain blueprint investments as we believe in them. That would have fallen probably to the commercial mayors who's been in place to get it. So you mentioned that in the model you're held harmless if Medicaid rates do rise. So if that were to happen would you anticipate there would be pressure on the commercial side or would you anticipate just a higher overall? Yeah, it's the state that's held harmless on that and it's 3.5% in terms of how would that translate to one care really all we want is a fair target from Medicaid and that they increase reimbursement rates and we did everything else right and the only reason we'd see that target was that they paid more. We do believe that you should adjust our target to accommodate that to make sure the incentives aren't again under water from day one because it's really funny the underwater incentives are what cost people to not even try. They feel that they can't even do everything right and have it reward their efforts. That's what they don't try. To what the implications are of the way that the all-parent model calculates the 3.5% trend as compared to the methodology that you presented on slide 21. So we're concerned that the growing Medicaid population with its low growth rate could result in an increased cost shift on the consumer-to-buy commercial insurance based on how the all-parent model calculates the 3.5% that you need to work on. Yeah, so I think the adjustments that we made in the way that we developed slide 21 is intended to adjust for where the growth by payer program happens. So if we're seeing more lives increase in Medicaid, it actually looks like our blood pan pan is going down because we said more of the lower cost people in there. So the intent of slide 21 was to level the playing field and say if we had the same payer mix, here's one true blood and growth rate would be. In terms of how that translates into the model payer model, we did that supplement exercise. It wasn't slide here, we applied our trends to the payer mix of the state of Vermont to say if everyone had the same trend rate into the state, here's what this would look like on the macro level. He had a 3.0% and I was encouraged and signed to say that if this model scale statewide, this is what it would look like. I think doing those two separate things are important. Yeah, we could see some shift in payer mix statewide, meaning more Medicaid patients through economic factors or just overall economic growth. What's in the ACL is just much more dynamic. We get a community that comes to Medicaid, only we're gonna see a much steeper growth rate in that program in the state of the sea. So right inside of those two we have a very clean analysis. I think it's an important step. Okay, thank you. And then, so in all to that, it's been an understanding that the 3.5 target statewide is meant to cover the entire population. So if one care is managing to that target while excluding some of the expensive populations like newborns to Medicaid risk, wouldn't that cause the overall rate to be higher if it were going on? Yeah, and we looked at, when we did our analysis for the statewide, we looked at the scale target report that the three non-care board developed that said there's 550,000 remontres eligible for scale target measurement. I actually broke it down into self-insured Medicare and Medicaid populations. It was also a Medicare advantage, small segment as well. But really that's part of the challenge of trying to regulate our population to give us a fair target. You've got to sort of understand, is the population we have relatively higher or lower risk? So in Medicaid it could be lower risk because we don't absorb some of those expenses for the newborns in our model. And really the reason we exclude that is more volatility than it is that the spending's not there, right? It just is, if there's 10 more newborns that we have to cover, who bears that risk? And certainly if it happens and it's sustained, that would be a higher growth rate outside of these. But your point is well taken and that is part of the challenge of trying to regulate us as a subset consistent with the whole system needs to grow up to 3.5%. That's exactly the challenge that we've been talking about in time and time today. Good, thank you. I'll give you a few additional all questions that are more technical and I'm sure so because I came with you all and those in writing, I'd like to see more. Yeah, we look forward to it. We've gotten really good at it. Quickly, and some responses to any questions we'll report in the healthcare analytics. Thank you, thank you. Thank you, Julian and Mike. Appreciate the efficiency. At this point we're gonna open it up to the public for comments. Susan. Susan Ernoff from the Vermont Developmental and this is really a common question for the board. One Karen's presentation referred to their quality performance for 2017 and they referred to a score that I think we're all gonna be hearing a lot about. This is about my third time hearing it. They received 85%. It's really important to know that they received for that 85%, 40% of the reporting measures, four out of 10 of their reporting measures had no national benchmarks. So they could have gotten zero points for that. They could have been reporting measures. They could have gotten one point but someone who ever contracted with them said if there's not a national benchmark you'll get full credit. So 40% of that 85% was them getting full credit on nothing. There were no benchmarks. So one measure that they got 0% on that they actually earned 0% on, the only measure they earned a zero on and they earned it because they scored less than the national 25th percentile, that measure was initiating substance use disorder treatment. Probably the most important population health goal of Vermont has set for itself. So they're seeing 85% on quality but they got zero for a quality measure that really matters. 40% of a free pass. And you guys are at a disadvantage because you're considering this material about the quality performance and their Medicare performance and the quadrant, the scattered out. You're considering that in the context of your budget deliberations but you haven't yet received a report either from Diva or from OneCare or from Blue Cross on their 2017 performance. Their 2017 performance which was the first time ever in next gen, Medicaid next gen, it's really important to see how that played out and what the quality is. 2017 they were still in sort of shared savings with Medicare. They have some data up there. We go to the Medicare website. There's no data out yet publicly for 2017. So my request, please something for the board is to schedule soon but before you vote on their budget a full airing of their performance for 2017. The report on the 2017 shared savings was really late on Diva's end. It was gonna be in June then August and September. It's out now. And it's being shown around some places. Part of it was presented at the need but interestingly enough when Alicia Cooper from Diva and Tyler Gathier from OneCare presented at me on that quality slide that was in August. Those materials were not posted until today and they were only posted. Connor you'll only appreciate this. They were only posted because I've sent, I don't know, six emails and was at the meab retreat on Mondays and could you please post these materials? I'm usually using that slide in a presentation tomorrow and wanted to have a publicly available publicly citable source for it. So between Diva contracting on very favorable terms with OneCare and the Green Mountain Care Board not hearing the results, I feel like the two entities that are supposed to be regulating OneCare are still very much seem to be either promoting it, supporting it anyway, not holding an accountable, not reviewing its quality information. So if that information is gonna be in the budget presentation which I sort of question why it is, but it's in there. I think it really deserves the full hearing here. So I appreciate your comments very much. This is the thing that keeps me up at the most at night is worrying about how we're gonna meet the goals when it relates to suicide and overdose. So I think you really nailed that one pretty good. I think the board hears your comments and will take that to heart. All right, there are other members of the public who wish to comment. Seeing none, I wanna thank the team from OneCare for a very informative presentation. And we can keep moving forward in this grand experiment of driving the strengths of health care. And I thank you for what you're doing each and every day. I think we'll try to make this happen. Thank you. So hearing no new business. I'm gonna consider both business and new business way without objection. Seeing no objection, is there a motion to adjourn? No motion. Thank you. The board is set to adjourn. All those in favor, second time to say no. Aye. Any opposed? Thank you everyone. Have a great day. Thank you.


No How's it going everybody dots it away here, and that is right after a week off We have decided to come back to what I once called basically dragon ball fighters to the dragon ball fighters turbo mod We're back with Deon aka sirrex once again I woke up feeling dangerously stupid. There's still a large amount of the cast I'm still very interested in trying, but I'm gonna start it off with I'm a go at yet All right, if your first pick is TN the second pick in the in the draft draft pink. Oh, I'm feeling a little unique today We'll see if I regret or we regret. I don't know if you warmed up, but not warming up at all I'm just hoping child. Where's Chelsea done? Fucking They gotta make a favorite duo fighters, too, they gotta make chow's who's on character All right, let's see if this like don't don't oh my god No, it didn't work not the combo. Oh, thank God Whoa, I didn't know they had armor. Oh, no, I didn't mean to do this. It got a little bit of armor All right, all right, can I do you feeling today? Let's see. Oh It didn't work new plan new plan. Oh, no, okay. Stop. Stop Dude, stop you play too much. Chow's you Chow's you please Please this character is the only one I know how to turbo with oh, no, I double tapped it stop Don't all right. You don't all right build different. I did not expect that. I'm getting comboed again Don't do this. Oh, don't do this Yes, oh, no, it looks like somebody didn't warm up today First my first homie drop of the evening, you know first turbo mistake Got us gotta start my day off, right? This is the real character. I think we all knew I wanted to play I Did not expect you use the sea assist that close At least we're in this mode because it locks off that one assist. I don't have to work That's just a little sparking trunk Much longer recovery from that. Oh, no, come on yet again sit down I'm you're taking my best turbo character away from me Go ahead, attack out then All right, what would turbo Broly do exactly what regular role it would do That's probably true Turbo Broly sit down I need you in the corner do this to me need you in the corner, please don't What wait what? Let's go. All right.  Now. Here's my big plan ready the mix. I can't cancel. I can't cancel I did it again at a Don't know what I can do from this angle You know what how did you get over there? Stop?  I still got dreams and ambitions armor whoa No What's the TN combo? I canceled it way too early No No, the volleyball movement was correct. It was just too slow. I should have canceled out of that sooner. No Forgive me forgiveness Commas, please they're untackable Did that's why oh, I'm dead.  No, please Poor TN, dude Now trunks turbo trunks hold on this character's just a mixed monster. I should have just let that rock That hit me Plumbing fast fall. Okay. I forgive this forgive this you are trying to I Keep missing that conversion Wait, I tried to slice it through you too What?  This makes me feel safe.  Oh so fast Trunks the mix-up game. I don't want to go down zero two. That's not how I want to I forgot it was Broly versus Broly, so I just remember Broly what stop. Oh block that This guy is beefy No I'm feeling good now. I'm feeling great. Stop. I don't like when you feel good make sense. Oh, no, no. Yes I don't know why the screeching all Broly came to make me laugh so much the throwing punches. Oh Yeah, here we go. Oh, it's just it's just a Broly kind of Wait, do you you win off? Yeah? That's I really Don't attend.  Yep. Yep. Yep. Yep You know, we're one homie drop the one I gotta figure out a TN strad nothing seems to be working No, that dad that was not the strat. I keep thinking volleyball is the key But it's not Until it's too late I have good ready to don't okay. At least I'm out of the corner I'll take it What what's happened?  What? No, don't cancel. I try to use trunks assist. I forgot that's not in the game. Ah My TN is trash and turbo I know I need to figure I need to find the tech All right, but I do I do know the tech with this character. I just drop it Let me spark or a little early, you know I don't think there it is There was no turbo did there was no turbo needed wanted you to drop it.  I'm not a professional choice player. I was feeling it right there a little bit of a turbo cancel after the Don't combo me. Don't You were literally doing that. What overhead? racism Sit down.  Oh, no Bad flip.  Oh, no, I got an idea Just even for the savage, I'm just punching him What I I should not have cancelled that makes sense. Oh, oh, I actually know what I should I'm sorry.  I hope you can at least live it. It's living. Oh my god Why did that that that's like it's 70% I was at 70% off me limit break My god, okay. Is it so what to to no wait to one it has the score right there I might have tried to fudge the numbers just a bit It's gotta be a secret dude. There's gotta be a TN secret. Let's go spark if you're real I Didn't want to oh Okay, a little something there little Keyblast extension. Ah, well, you know, not everything's meant to last forever He blasts rather when you can cancel it as fast. Oh No, what you got turbo was okay Oh my god Where where do I where do I have the turbo stop sit down? Oh, no, it was pressure I might have hit Keyblast nice No Yes What if I were to tell you I didn't mean to what are you doing? I was just got flex of my legs a little bit No, now I did I'm sorry TN can apologize. He could change I turbo trunks. I have I still want to just go with that one mix All right, didn't really think that one through did I I can't believe that hit me Not in the corner what how did you what I tried to cancel it?   The flip is the key. Oh, no, I need him.  There's still more terrible things to try Stop Well That's The speeds you can achieve do anything. Are you doing anything turbo with trunks right now? Double yeah, I double ex flipped in the air. So I did what he ex-flipper than another for maximum speed All right, well this came down to three Two-to-two right now. It's the last one takes it. Oh, I feel like I'm I'm sufficiently warmed up now So my trunks about a snap the end is still questionable. Oh god. No wait Give me one dude. Just give me one. All right, how would I make the most of this? All right, that didn't work. Oh, no All right, what if I cancel my super-dash? That's right I Thought you'd crack I thought you get nervous. Oh Hate combos see a sister's wealth. This is not fair. This is not legal No, whoa He's fast. I tried to switch out the trunks. Come on. No No, no, I missed I fired and missed Oh That was sick that wasn't even turbo that was just jeering. I mean Man gets countered once and thinks of jeering Is that it All right, I could cancel a little three's technically right Let me cancel Broly's level three. It's not fair. Other people get to do it.  I've asked a lot of you this set. Oh, come on. Whoa No I'm really trying my best to just outmaneuver you there. I can just stomp you a couple times.  I will. Oh, that's fine the movement tech. Oh The 50-50s are coming No, you just didn't know the trunks 50-50s were on their way. I don't like it here Let me see if I can't mix in a little more. I think trunks is dead If I don't have you in the corner, there's not much I can do no I Gotta change the future And I'm just going through right now. Oh my gosh That was I appreciated it Can I combo from this? No, I can't no trunks. No, that was so sick Super dad Bro, can I turbo into a second spark or what I can't reach you up there No, no It just had one really solid weakness.  I'm sorry Die Yeah, I actually was I had already made the mistake Tied takes it. They're the only ones still here. Yeah, I slept on Wait, I actually Was just going off But that's going to be it for another turbo video if you guys want to keep see these just let me know down below in the Comment section of course also make sure to the like button and check out some of the other turbo videos It should be on your screen right now. Yeah, and then I'm definitely not gonna record another one right now No, we would never do that.


All right, here we go. Now, hey everybody, Lee Lowell here from smartoptionseller.com. Welcome to our Saturday synopsis for Saturday, February 5th, 2022. What do we do here? We look at charts. That's what we do. I've been in the business for 30 years. I'm a technical analyst, I'm a chart reader chart watcher, whatever you wanna call it. It's what I use to help me time my trades, get in and out of trades. So I'm here to show you what I do, what I see, and try to help you become a better trader with these videos. So what do we do? We look at charts, we look at individual stocks, we look at indexes, we look at support and resistance, we look at technical indicators, try to figure out what's been happening in the market, what's been, or what's going to happen in the future. Not a guarantee, no individual investment vice here. All opinions are my own. So just take that with a grain of salt. But anyway, let's just jump right in and see what's been happening. We always start with the SPY, which is the exchange traded fund for the SP500. On the screen here is the chart that I look at. I look at a daily chart for the most part. Daily chart is one day's worth of trading for each one of these lines that you see in the chart. This scans about two years' worth back in time. I only have a few indicators on the charts. I have a couple moving averages. I have a 20 day, 50 day, and 200 day moving average, all simple moving averages down here. I have the RSI, which is an overbought oversold indicator. And if you've been watching for a while, you may have noticed that I moved myself, my beautiful little self right up here in the top corner. I used to be down here. Someone asked me this past week, maybe I can move the video here a little bit to a different spot. So trying this one out, let me know what you think. Anyway, RSI, 14 day RSI, I have the 80 and 20 levels as my overbought oversold areas. And you'll see on the charts, I have lots of markings. I have channels. I have patterns, resistance levels, support levels, triangles, all these different things that you'll see on the chart over time when I pull them up. So let's take a look at the SPY, which is the exchange traded fund for the SP500. I believe it gives us the best overall view of the whole market. So what's been happening? If you were here with us last weekend, this was our trading week all of last week. These five days right here, very volatile, very large intraday swings right here. The market had been coming off since the beginning of the new year, January. Let me just check the date here. So January, yep, January. First week of January right here, we had this big kind of waterfall down move, quick down move. And you'll see most of the time as we talk about the market stair steps is way higher and then takes the elevator down. You'll notice that when we have down moves, they're very quick, very painful for some people. It happens very quickly and that scares a lot of people. You spend all this time going up and then just in a couple of days, it gives all those gains back. So that's something that you'll have to fight within the market if you're a shorter term trader. If you're a long term trader, I talk about this all the time, I'm long term. I'm in the SPY, I buy the SPY for my long term portfolio, buy on dips, buy in pullbacks, buy during the month to have long term holds. Over the long term, we're talking years and years, the market's going to go up.  If you're both, these pullbacks hurt, right? You know, intraday traders, all this chop can hurt as well. You can get whipsawed back and forth. So it all depends on what kind of trader you are and that will determine your results as well. I'm long term in the SPY, but of course I run the newsletter, our newsletters I should say, that are shorter term, couple months at a clip. But one thing that we always try to do is, and this is going to be a theme today, is we try to trade in between earnings announcements. So most of our trades are not more than three months because companies announce earnings every three months. And I never want to hold a position over an earnings announcements. And I think a lot of you may have seen why this week we'll take a look at some of the big movers from their earnings announcements this week.  Always have to know when the company's announcing their earnings because you may have a position on and you can get totally wiped out. So we'll look at some stocks that had big earnings this past week. But anyway, so here where we were last week, all this movement right here, and I'll just pull the chart back. So this is what we had. This is where we were last Saturday when I was looking at the charts. And I said, here's the 200 day moving average right here. This is the biggie, this is the granddaddy. And most of the time when you have a big move in the market and it goes below the 200 day support moving average, it won't stay down for long. I mean, that's a big move that's, there's great opportunities in cases like this after market falls pretty big like that. And the large players hedge funds, mutual funds, investment banks, they have to be in the market. They have to be in the market. The stock market's given the best returns out of any asset class. So they're not going to stay out of the market for long. And when you have an opportunity after a big sell off like this, they're going to be bottom fishers. The people are going to buy it back up. But there's also the case where we could have had or we could still have this one huge washout. I talked about it last week, the one big one day down move where everybody just throws in the towel. And that's typically where the bottom is made. So I said last Saturday, right after here, I said, you know, I don't see this staying down here for too much longer, but we still could get that washout or we could move right back up. I was a little wishy-washy, but that's where that's what happens when you have periods of indecision. You're not really sure what's going to happen yet. And that's fine. And we stay out of the market during times like that. In our newsletters, we were very light on our positions because we weren't sure whether that one day washout was still going to occur or we were going to get a move higher this past week. So we're sort of on the sidelines and what happened this past week? Well, we rallied. We rallied a bit. Monday was a great day. And so unless that was when Apple, I think Apple had their earnings last week. So that helped drive the market higher. Let me see what day this was. This was the 28th. Yeah, so this was last Friday. This was all last week. So we had a good Monday, Tuesday, Wednesday this week. And then towards the end of the week, we fell back down. So I like what I saw this past week. We got back above the 200-day moving average. Here's the 200-day moving average. So we're trading above it, trading above it, which was good. And then Friday, yesterday, pulled back almost touched it again. You can see here's Friday's trading, this one bar right here. And the bottom of the bar is the low of the day. So it almost tagged the 200-day moving average again. But it stayed above it, which is good. So here we are right here. And I like how it finished above the 200-day moving average. That's constructive. This was a nice constructive move this week. Got back above the 200-day moving average and held above it for the rest of the week. That's good. So we're still a little light. Wanna see what's going to happen? Let's take a quick look at the NASDAQ because that's where a lot of the activity and a lot of movement has been occurring. Large, large swings. And you can see I've marked up this chart pretty good. You know what? Let's take away some of these because it can be distracting by seeing all these channels and other channels within the channels. And I'll even take this last channel away here. So we kind of have a cleaner looking chart to look at. So here's the NASDAQ. This is, we use the QQQ. The triple Q's as our proxy for the NASDAQ. So had the big waterfall down, just like the S&P 500 and had to move back up this week. But the NASDAQ did not make it back above the 200-day moving average. But that's okay because when it has big moves, it can catch up to where the S&P 500 is above the 200-day. The NASDAQ could to get itself back up very quickly as well. You can see here it popped up. This was I think Wednesday this week, but it came back down Thursday and Friday. And that's because we had some pretty large earnings that pulled us back down a little bit. So the NASDAQ's still below the 200-day, not that concerned about it. We still have that opportunity. We can have that one-day washout. But the longer it remains above or close to the 200-day, we may not see that. Now, just going back to the SPY real quick, we see it's above the 200-day. Now, let's look at the Dow Jones. And this is the Diamond's DIA. So this is the ETF for the Dow Jones Industrial. Looks pretty similar to the S&P 500. It got back above the 200-day. Here's yesterday, Friday, February 4th, right here, this one bar, this is the day. So it finished above the 200-day moving average. Here's the 200-day moving average. There's a little dash mark on the right side of the bar. It means the closing price of the day. Closing prices are very important. Very important because it tells us where we finished for the day and whether it was above or below certain resistance or technical indicators. So it finished above the 200-day moving average. So that's good. We like that. Our only concern is the NASDAQ, the QQQ. And here, let's take a look at some individual stocks and see what happened. And let me once again reiterate why it's very important if you're playing shorter-term, you want to not have at least large positions on before earnings. And let's take a look at stock number one. We'll go back to Netflix because Netflix was last week, all right? And obviously we saw what happened in Netflix after their earnings. It dropped all the way down to $350 a share. It got super oversold on the RSI.   So if you were long or bullish or thought Netflix was going to have good earnings, this hurt really bad. So that's the drawback of trying to hold a position over earnings. But one of the big ones this week was Facebook. Okay, so they had earnings the other day and here's where it was before earnings right here around $323 a share and then it just got knocked down, lost almost $100 a share. That's a huge move for Facebook. I think it's probably the largest move it ever had. This big air pocket here, that hurts. That hurts for a lot of people if you had bullish positions on. So you gotta be careful. You gotta be careful if you're playing the earnings game. So this, and for those of you who may have bought put options congratulations, that was a great move and you probably made a decent amount of money but that doesn't happen very often.  It could go higher or it could go lower and you could pick wrong direction every time. Anyway, so you got this big air pocket. So you have mostly the Fang stocks, Facebook, Apple, Amazon, Netflix and Google. So you got Facebook and Netflix just didn't, you know, they did not have a good earnings. But then we had Google, right? Google nailed it pretty good too. They rallied a couple hundred dollars after the earnings announcement went from here all the way up here, but it did pull back. But the big one was Amazon. Amazon this week, you know, let's take a look at what we have here. So Amazon's been in this channel for so long, so long it's been in this sideways channel. And then what happened Thursday after the bell, they had their earnings, but before Thursday came around, let's pull this back a little. So it had dropped, you know, a couple hundred dollars a share, it was trading at under $2,800 right before earnings. And then the earnings came Thursday after the bell and it popped it back up for $500 a share. That's just a massive move. So you've got these whipsaws in Amazon. Got the move down, the move up, the move down, the air pocket here, and then the air pocket back up. So that's just, that's some serious whipsaw right there. If we can look at the five minute chart on Amazon, just see what it looked like. So here we were Thursday at the close right down here, around $2,778 a share. And Amazon was looking weak. And I think there was a lot of people piling on, buying put options, think it was going to just, you know, have the big down move like Netflix had. And then it just popped. Went from, you know, $2,800 all the way up to $3,250. Got up to $3,300. Now some of these long, these long tails here, those are just bad prints by my data vendor here. But anyway, it went from 2,800 all the way up to 3,300, just, you know, a few minutes after announcing earnings. So that was a good $500 swing right there. And so Amazon back up, here it is, back in the channel. So you got these massive moves. And of course, Apple, Apple had their earnings last week, which pulled the whole market up that day, which was nice. So Apple has got back into this channel here. Anyway, so earnings seasons can be a crapshoot if you're trying to play it. But longer term, we're trying to figure out, okay, what's the next direction for these stocks?  We're waiting for some of these earnings to get out of the way before we try to figure out where we're gonna be with our new trades. So I'm always on the hunt for new trades, selling naked puts, safely selling naked puts on quality stocks and selling put option credit spreads. So what do we see? What do we see? So Apple, so let's take a look at Apple and try to gauge what we're doing here. So Apple had a nice move after earnings. So it's now back in this channel. And I think the only move up, the only move for Apple is going to be higher in the long term. It's got some consolidation here. I think once the market figures out, we need to start going up again, then Apple will start to go up too. Let's talk about Netflix again. And I know I'm concentrating on these big stocks because people wanna know, I've got a lot of questions, emails this week. Should I buy Netflix on this sell off? Should I buy Facebook on the sell off? What do you think? Well, I mean, you've had some big moves that got way oversold on the RSI. So nibbling down here could have been a decent play because it rallied another $100 a share, but then it also pulled back $50 a share by the end of the week. So you got the ups, downs, it's whipsaw-y, right? You can get whipsawed out. Do you wanna hold Netflix for the long run?  But if you're trying to do these short-term trades, like one week option trades, it's too hard. This is a lot of damage has been done here. So it has to consolidate around these lows for a while to figure out where it wants to go next. And if it's time to go back up yet, you know, can Netflix show us or prove to us that it's worthy to buy back up by the shares. So it, and if it'll move back up, there's controversy, there's questions. There's, you know, after a big move like this, nobody's really sure what to do. So it takes a little while to figure out what's gonna happen. And then I think eventually Netflix will go back higher. Same thing with Facebook. You know, people ask, should I buy some?  Maybe it's time to buy some Facebook and nibble at the bottom. You know, you try to pick a bottom if you want. That's up to you. Let's go back to the monthly and see, let me move myself here a little bit so I can get to the monthly chart. You know, where does Facebook fall in the monthly chart? Well, okay, so it's tagging on the 50 day or 50 week, 50 month moving average right here. So it's the 50 period, whatever chart you're looking at, whether it's a daily chart, one minute chart, weekly chart, it becomes the period. So this is the 50 period. In this case, it's the 50 month moving average. And it looks like Facebook just tagged it right here, just came right in contact to it. So maybe it'll show some support. You can see the only times that Facebook's come down to the 50 month moving average here and it popped pretty good. So maybe nibbling down here as it's touching the 50 period moving average here might be a place to nibble a little bit. You can see it bounced the other times. So I don't know, you know, if that's your thing, if you want to try to nibble at the bottom, eh, what the heck?  You know, obviously this is not individual investment buy, so it's up to you to decide if that's right for you. Same thing. Same thing with Netflix. I don't know, maybe you nibble a little bit and see what happens. But Google and Amazon and Apple, they all went higher. You know, they had good earnings. So we're in the midst of earnings season, so it's a little tricky. All right, let's take a look at some other stocks. Let's look at AMD, which is another favorite of mine.  I had bought some personally as it came down to the 200-day moving average here. So I had bought some between $100 and $110 a share in this little move here, and we had the nice pop back all the way back up to $130, which is nice. But it pulled back to $10 or so over the last couple of days of this week. But, you know, I'm a fan of AMD in the long run. I'm hoping to try to get something going for our newsletters soon after we figure out what the overall market wants to do. We like AMD. And in terms of, you know, people asked me about Intel as well. I'm not a huge fan of Intel. You know, I like AMD better in that sector. And Intel, you know, just crapped out again. It looked like it was going strong here in this little segment here, got above the 200-day moving average, this little pocket of trades, and then it just got crapped on again. So not a big fan of Intel as far as making trades yet. I like AMD better. Let's take a look at Clorox because I mentioned that I had been getting into trades with Clorox and they had earnings that came out yesterday as well. And I think it could have been one of the biggest one-day moves for Clorox, just got crushed, okay? So I had mentioned that I had gotten long. We had talked about the big down move, the sideways action, ready to try to decide if Clorox was making a bottom here. I got in around the 175, 176 level, started tracking up. I thought things were looking good. And then it just started to come off again. And then the other day it just had, it dropped like 20 something dollars a share, huge move for Clorox. I got out. And I took the loss, just not all trades work out. So you gotta make sure you know that when you're getting into a trade, you gotta have a plan, you gotta have your exit area. And I got out. I got out in here, somewhere around here in the after market or the pre-market when it was trading within this range. We can go look at a one minute chart. You can see that here is when earnings were released and there was some trades happening in here. So I got in here in the after market or the pre-market. I'm not sure what time it was. And so I was able to get out and I was able to get out. I didn't have to wait until the regular open because these stocks trade in the pre-market and the after market. So you can always trade during those times. So I got out within this range and here in this air pocket range and took my lumps, got out. So you never know. And unfortunately I did break my rule. I held over an earnings announcement. I thought that Clarks would do better. And I broke one of my own rules and I paid the price. Nothing you can do.  And so it's just another lesson for me to learn even after 30 years. I took a risk and it didn't work out. So you gotta be prepared for the lumps. What other stocks? Let's take a look at other stocks, Tesla. And I'm not afraid to admit mistakes. As long as you could admit mistakes, you can grow as a trader, all right? So it's okay to admit when you're wrong. Let's take a look at Tesla. Tesla still a fan favorite. Kind of still holding this 900 area level. Did pop below it bounced off the 200 day moving average and came back above the support line very quickly. So Tesla still holding above 900, sort of in this down channel here. But it seems like Tesla never wants to go down. I still don't have a real commitment on what to do with Tesla. I don't make any trades on Tesla except I sell some very few far out of the money puts every once in a while, if they're trading real high. And another thing, if you follow me on Twitter, you may have seen a post I made, Amazon's downside puts were just incredible. Amazon's trading $2,800 a share, one day put options, the 1700 strike, that was the lowest strike that was listed, 1700 strike put options, $1,100 away in one day. And thoughts were, can Amazon drop $1,100 in one day? And these downside puts were trading for such high prices, unbelievable. I don't think I've ever seen anything like that. It was incredible. I scalped a few, made a little money, but to me, it wasn't worth the risk. Even though I know an $1,100 move in Amazon would not have happened in one day, it's still kind of scary to put yourself in that situation. Amazon is a very expensive stock. Do you wanna put yourself on the hook to potentially buy $170,000 worth of Amazon stock? But anyway, so that's what happens in the options market, but getting back to Tesla, it's just fun to watch because it's so volatile and people love it. I don't have a stake either way. So Tesla, trying to hold this $900 support line, that's where I see it right now. If the market could get on its way back up, the overall market, Tesla should follow to higher to the upside as well. Let's go through our list here and take a look at some other stocks, see what's good, if my thing will cooperate with me here. All right, let's go through our list here. Let's see, let's talk about the VIX. Let's talk about the VIX again because we discussed that recently as well. Last week, when we had a few days of those, that very volatile back and forth on the downside, we talked about how the VIX rallied. The VIX is the fear indicator. When the market sells off, the VIX goes higher. It moves inversely to the overall market. So VIX jumps, that means the market's dropping. And when the market starts to rally back up, the VIX comes off again. So we note that the VIX has these quick couple-day spikes, right, couple-day spikes. And if you follow the VIX, you know, once it spikes up, it's only a matter of a couple days at most before the market turns itself around and the VIX goes lower again. So if you're a market watcher and you're seeing these down moves in the market and you're wondering, is it time to buy? Should I nibble here at the bottom? Take a look at the VIX. If you see the VIX starting to retreat in the next day or so, you know that that bottom, for that time, is probably in. And you can more safely buy stocks or the indexes at that time because the VIX is going to retreat pretty quickly. You can see all these spikes only last a couple days at most. So you only have a couple days of pain in the market on these down moves, okay? So that's the VIX. Let's see what else we've got going on. Let's look at the list again. Microsoft, I'm trying to find some good charts to show you some patterns or Oracle. Let's see what else we got here. Walmart, we always like Walmart. I like Walmart. You know, I have drawn the 135 level, what seems to be near-term support, at least for now. So every time Walmart's come down to this 135 level, since about a year now, it has bounced. The latest one was this day, what day was this? This was the last day of January, and it's popped back up. So Walmart, if you're looking to get into Walmart, you can use this 135 level as a potential buy area support level. Let's see what else we got on the list here. Disney, like Disney, Disney had come off. So it's still kind of lingering near the bottom, figuring out what to do. But I think in the long run, I think we all know that Disney's a quality stock. It's gonna go back up over time. I've been nibbling on the bottom here, waiting for it to go back up. The healthcare stocks, Lily, BMY, Pfizer, they're all, a lot of these stocks are, I'm waiting for the overall market to figure out where it wants to go, and then we can get into some of these other trades. Kellogg's come off pretty good. Maybe get into some support here. I'll keep a look on that one. Verizon still, Verizon, we talk about Verizon a lot. Been pretty volatile, had been in this long down trending channel. I've talked about Verizon at length over these weeks, waiting for it to move up, had the bull flag here did go higher, came back down, but came back up again. So now it's hitting resistance right at the down trending, down sloping 200 day moving average. The slope of the moving averages is pretty important too. It's down sloping. That makes it harder for a stock to get through it. But once the stock gets through it, I wanna see some action above the moving average. You wanna see some couple of days worth of trading at least above it to have some conviction, okay, maybe it's finally turning the corner. So I'm not completely convinced yet, getting close. It tried to get above it here and got knocked back down. Will it do it here or will it get knocked back down? So I wanna see Verizon get maybe above 55, close to $56 for a number of days before I can say, okay, maybe it's time for a higher probability trade of getting into Verizon. Excuse me. But while a stock's in a downtrend, it's not good to get a full on position because it could keep going down. It could just keep going down. Why put your money out there before the market's ready to tell you it's time that it wants to go higher for the long term here? All right, so let's see what other stocks we got on the list here. Oh, PayPal is another. PayPal and Square kind of disappointing to me that they've been coming off so much. I also am long some PayPal shares here, getting very close to me stopping out. I thought the sideways action here was gonna take us up and through and it's just been falling. I got a very, very, very small position, nothing to write home about. A little disappointing. I'm hoping that we're gonna see that this is the bottom here and rally back up. If not, then I'm just gonna get out of my little teeny position because it's not worth me holding on anymore. But I know for the long run, PayPal and Square are, these are the biggies in the payment space. Look at this downtrending channel for Square. It did get oversold here. It popped back up just a little bit but came back down again. So I would wait to see Square come out of here. PayPal has already made the down move. I'm gonna hold for a little bit longer just to see because I do like the sector. Maybe I'll just hold for a long period of time but it's a very small position for me. Let's see what other stocks are on the list here. Costco, McDonald's, Pepsi. Pepsi's been pretty strong. Pepsi's been kind of hugging the 50-day moving average, filing support at the 50-day moving average. Pepsi's been a nice, nice, slow moving upswing. Pepsi's been pretty strong. So if you've been a long Pepsi, that's been good for you. Home Depot, here's Warren Buffett's Berkshire Hathaway. Twitter, another one about Twitter. People ask me because what happened was Facebook came off and then all the other social media stocks got hurt a little bit as well but Snapchat had a nice move up. After Facebook came out, here's Snapchat came down. Trading just below 25 looked like it was just gonna just get crapped on but its earnings came out and it rallied really good. So you never know. You never know what's gonna happen with these stocks. This is Snapchat had a nice bounce back. Twitter, let's take a quick look at Twitter. Twitter is kind of still in the downtrend. It's just in a down move. Are you willing to pick bottoms and try to wait and see if it goes higher and just frustrate yourself? It's hard. You wanna wait to see when stocks start to move back up and I still do this as well. Sometimes I try to pick bottoms but I'm aware of the risks and I should always remember my rules. Don't trade over an earnings announcement if it's a short term trade. If I'm there for the long haul, it's fine. When I buy the SPY for the long haul, I know there's going to be dips but when you're playing with individual stocks, the risk is much greater because you have the chance for these nasty, nasty large moves in earnings. So that's why I like from a long term to be in the SPY because it's got 500 stocks in it. So one bad move by one stock won't kill the whole investment but when you're playing with individual stocks, you have to be a little bit more careful. So Twitter still in down move, maybe trying to make a little bit of a sideways action here. I'd wait to see it start to curl higher, see the price action moving up before maybe I'd get into Twitter. So not much happening for me on Twitter. I'm not making any recommendations on Twitter yet. Let's see what else we talked about. Facebook, Google, we looked at. So GameStop, AMC, you don't really talk about those much anymore. I still have them on the list. That's, I think that their time has finally come. Here's AMC, it's just been moving down. The Bitcoin stocks, Riot, Mara, it's just following Bitcoin. Bitcoin has actually been going up a late, which is good. So Riot and Mara had some little up moves the last couple of days. Peloton still down in the dumps. Talked about Clorox, Coca-Cola always still a solid player I have for my long-term portfolio. Let's look at Coke and then wrap this up. Let's go out to the monthly chart. See where Coke's been. Monthly, so Coke, just nice. Here we got all-time new highs this past week in Coke. Really nice. Go back to the daily chart. Here's Coca-Cola, I'll move this over here so we can all know what it is. All-time new highs just hit on, looks like Thursday this week. It's a great dividend stock. Just the kind of a slow mover. These are things that you wanna have for the long-term holds. Nice, slow, steady moves over the long-term. All right, well that's about it. Let's look at the SPY. One more time, wrap it up here. For us, for the most part newsletter, we're still kind of in that holding pattern. Wanna make sure that this 200-day moving average is going to hold and see the market bounce next week possibly. The QQQ is really the only wild card here because it's still underneath the 200-day moving average. You can see it here. It's below the 200-day moving average. Couple big moves and a couple big stocks can pump it right back up and move it back in line with the Dow and the S&P 500. So which ones are gonna win out? Is the S&P 500 and Dow gonna pull up the NASDAQ or is the NASDAQ gonna pull everything else down with it? These are, a lot of these stocks have a lot of weight. These few stocks, NASDAQ at least, you got the Facebook and Amazon, Google, Netflix, they all have a huge influence on that index itself. So big moves by just a small handful of stocks can really move the market. So if those stocks could get off their butts and start to move higher, the NASDAQ will catch up very quickly to the Dow and the S&P 500. So we'll see. All right, that's all for our little Saturday synopsis here. Let's take a quick look at our website, smartopsinceller.com, go to our website. We always talk about put selling, that's what we do. Here's our put selling basics free guide. You can put your name and email address down here or anywhere else on our website. Each page has one of these little things here. You can put your name and email address. We'll send you a free copy because that's what we specialize in, put selling. We love to sell puts and we sell put options spreads. Here's our services here. We have two newsletters and our coaching sessions if you need help. All right, hope this video has been helpful to you. Give me a thumbs up. Leave me a comment. Ask me a question, send me an email. Love hearing from you. Don't forget to subscribe if you'd like. You can hit that red subscribe button in the bottom right hand corner of this YouTube video. All right, that's all for me today. I hope everyone has a great weekend and a great trading week ahead. This is Lee Lowell signing off.


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