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Medicare database reveals top-paid doctors

Written By Unknown on Rabu, 09 April 2014 | 23.14

WASHINGTON — Medicare paid a tiny group of doctors $3 million or more apiece in 2012. One got nearly $21 million.

Those are among the findings of an Associated Press analysis of physician data released Wednesday by the Obama administration, part of a move to open the books on health care financing.

Topping Medicare's list was Florida ophthalmologist Salomon Melgen, whose relationship with Sen. Robert Menendez, D-N.J., made headlines last year after news broke that the lawmaker used the doctor's personal jet for trips to the Dominican Republic.

Medicare paid Melgen $20.8 million. His lawyer said the doctor's billing conformed with Medicare rules and is a reflection of high drug costs.

AP's analysis found that a small sliver of the more than 825,000 individual physicians in Medicare's claims data base — just 344 physicians — took in top dollar, at least $3 million apiece for a total of nearly $1.5 billion.

AP picked the $3 million threshold because that was the figure used by the Health and Human Services inspector general in an audit last year that recommended Medicare automatically scrutinize total billings above a set level. Medicare says it's working on that recommendation.

About 1 in 4 of the top-paid doctors — 87 of them — practice in Florida, a state known both for high Medicare spending and widespread fraud. Rounding out the top five states were California with 38 doctors in the top group, New Jersey with 27, Texas with 23, and New York with 18.

In the $3 million-plus club, 151 ophthalmologists — eye specialists — accounted for nearly $658 million in Medicare payments, leading other disciplines. Cancer doctors rounded out the top four specialty groups, accounting for a combined total of more than $477 million in payments.

The high number of ophthalmologists in the top tier may reflect the doctors' choice of medications to treat patients with eye problems. Studies have shown that Lucentis, a pricey drug specially formulated for treating macular degeneration, works no better than a much cheaper one, Avastin. But lower-cost Avastin must be specially prepared for use in the eye, and problems with sterility have led many doctors to stick with Lucentis.

Overall, Medicare paid individual physicians nearly $64 billion in 2012.

The median payment — the point at which half the amounts are higher and half are lower — was $30,265.

AP's analysis focused on individual physicians, excluding about 55,000 organizations that also appear in the database, such as ambulance services. None of those entities was paid $3 million or more.

The Medicare claims database is considered the richest trove of information on doctors, surpassing what major insurance companies have in their files. Although Medicare is financed by taxpayers, the data have been off limits to the public for decades. Physician organizations went to court to block its release, arguing it would amount to an invasion of doctors' privacy.

Employers, insurers, consumer groups and media organizations pressed for release. Together with other sources of information, they argued that the data could help guide patients to doctors who provide quality, cost-effective care. A federal judge last year lifted the main legal obstacle to release, and the Obama administration recently informed the American Medical Association it would open up the claims data.

"It will allow us to start putting the pieces together," said Dianne Munevar, a top researcher at the health care data firm Avalare Health. "That is the basis of what payment delivery reform is about."

Doctors' decision-making patterns are of intense interest to researchers who study what drives the nation's $2.8-trillion-a-year health care system. Within the system, physicians act as the main representatives of patients, and their decisions about how to treat determine spending.

"Currently, consumers have limited information about how physicians and other health care professionals practice medicine," said HHS secretary Kathleen Sebelius. "This data will help fill that gap."

The American Medical Association, which has long opposed release of the Medicare database, is warning it will do more harm than good.

The AMA says the files may contain inaccurate information. And even if the payment amounts are correct, the AMA says they do not provide meaningful insights into the quality of care.

"We believe that the broad data dump ... has significant shortcomings regarding the accuracy and value of the medical services rendered by physicians," AMA president Ardis Dee Hoven said. "Releasing the data without context will likely lead to inaccuracies, misinterpretations, false conclusions and other unintended consequences."

The AMA had asked the government to allow individual doctors to review their information prior to its release.

Over time, as researchers learn to mine the Medicare data, it could change the way medicine is practiced in the U.S. Doctor ratings, often based on the opinions of other physicians, would be driven by hard data, like statistics on baseball players. Consumers could become better educated about the doctors in their communities.

For example, if your father is about to undergo heart bypass, you could find out how many operations his surgeon has done in the last year. Research shows that for many procedures, patients are better off going to a surgeon who performs them frequently.

The data could also be used to spot fraud, such as doctors billing for seeing more patients in a day than their office could reasonably be expected to care for.

Medical practice would have to change to accommodate big data. Acting as intermediaries for employers and government programs, insurers could use the Medicare numbers to demand that low-performing doctors measure up. If the data indicated a particular doctor's diabetic patients were having unusually high rates of complications, that doctor might face questions.

Such oversight would probably accelerate trends toward large medical groups and doctors working as employees instead of in small practices.

Melgen, the top-paid physician in 2012, has already come under scrutiny. In addition to allowing the use of his jet, the eye specialist was the top political donor for Menendez as the New Jersey Democrat sought re-election to the Senate that year.

Menendez's relationship with Melgen prompted Senate Ethics and Justice Department investigations. Menendez reimbursed Melgen more than $70,000 for plane trips.

The issue exploded in late January 2013, after the FBI conducted a search of Melgen's West Palm Beach offices. Agents carted away evidence, but law enforcement officials have refused to say why. Authorities declined to comment on the open investigation.

___

Associated Press writer Kelli Kennedy in Miami and Marilynn Marchione contributed to this report.


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New technology unwraps mummies' ancient mysteries

LONDON — Our fascination with mummies never gets old. Now the British Museum is using the latest technology to unwrap their ancient mysteries.

Scientists at the museum have used CT scans and sophisticated imaging software to go beneath the bandages, revealing skin, bones, preserved internal organs — and in one case a brain-scooping rod left inside a skull by embalmers.

The findings go on display next month in an exhibition that sets eight of the museum's mummies alongside detailed three-dimensional images of their insides and 3-D printed replicas of some of the items buried with them.

Bio-archaeologist Daniel Antoine said Wednesday that the goal is to present these long-dead individuals "not as mummies but as human beings."

Mummies have been one of the British Museum's biggest draws ever since it opened in 1759. Director Neil MacGregor said 6.8 million people visited the London institution last year, "and every one asked one of my colleagues, 'Where are the mummies?'"

The museum has been X-raying its mummies since the 1960s, but modern CT scanners give a vastly sharper image. Just like live patients, the mummies chosen for the exhibition were scanned at London hospitals — though they were wheeled in after hours.

Volume graphics software, originally designed for car engineering, was then used to put flesh on the bones of the scans — showing skeletons, adding soft tissue, exploring the nooks and cavities inside.

The eight mummies belong to individuals who lived in Egypt or Sudan between 3,500 B.C. and 700 A.D. They range from poor people naturally preserved in sand — the cheapest burial option — to high-ranking Egyptians given elaborate ceremonial funerals.

"You got what you paid for, basically," said museum mummy expert John Taylor. "There were different grades of mummification."

Embalmers were exceptionally skilled, extracting the brain of the deceased through the nose, although they sometimes made mistakes.

The museum's scientists were thrilled to discover a spatula-like probe still inside one man's skull, along with a blob of brain.

"The tool at the back of the skull was quite a revelation, because embalmers' tools are something that we don't know much about," Taylor said. "To find one actually inside a mummy is an enormous advance."

The man, who died around 600 BC., also had painful dental abscesses that might have killed him. Another mummy, a woman who lived in Sudan around 700 A.D. was a Christian with a tattoo of the Archangel Michael's name on her inner thigh.

The star of the show is Tamut, a temple singer from a family of high-ranking priests who died in Thebes around 900 B.C. Her brightly decorated casket, covered in images of birds and gods, has never been opened, but the scans have revealed in extraordinary detail her well-preserved body, down to her face and short-cropped hair.

Tamut was in her 30s or 40s when she died, and had calcified plaque inside her arteries — a sign of a fatty diet, and high social status. She may well have died from a heart attack or stroke.

Several amulets carefully are arranged on her body, including a figure of a goddess with its wings spread protectively across her throat. It's even possible to see beeswax figurines of gods placed inside her chest to protect the internal organs in the afterlife.

"The clarity of the images is advancing very rapidly," Taylor said. "As the technology advances, we have hopes that we may be able to read even hieroglyphic inscriptions on objects inside mummies."

MacGregor said the museum plans eventually to scan all 120 of its Egyptian and Sudanese mummies, and to reveal even more about their lives.

"Come back in another five years and you will hear Tamut sing," he said.

___

"Ancient Lives: New Discoveries" opens at the British Museum on May 22 and runs to Nov. 30.

___

Follow Jill Lawless at http://Twitter.com/JillLawless


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Toyota recalls about 6.4 million vehicles globally

TOKYO — Toyota Motor Corp. is recalling 6.39 million vehicles globally for a variety of problems spanning nearly 30 models in Japan, the U.S., Europe and other places.

No injuries or crashes have been reported related to the recalls announced Wednesday. But two reports of fires are linked to one of the problems, a defective engine starter that can keep the motor running.

Some vehicles were recalled for more than one problem. The recall cases total 6.76 million vehicles for 27 Toyota models, the Pontiac Vibe and the Subaru Trezia, produced from April 2004 through August 2013.

The Pontiac Vibe, which is a General Motors Co. model, is also involved because Toyota and GM made cars at the same plant in California and the recalled model is the same as the Toyota Matrix. It was recalled for a problem with a spiral cable attached to an air-bag. It is unrelated to a separate GM recall over ignition switches linked to at least 13 deaths.

Subaru is partly owned by Toyota, and the model was the same as the Toyota Ractis.

For the recall, Toyota also reported problems with seat rails, the bracket holding the steering column in place, the windshield-wiper motor and a cable attached to the air-bag module.

The recalls affect a large range of models, including the Corolla, RAV4, Matrix, Yaris, Highlander, and Tacoma.

By region, the latest recall affects 2.3 million vehicles in North America, 1.09 million vehicles in Japan and 810,000 vehicles in Europe. Other regions affected by the recall include Africa, South America and the Middle East.

Toyota was embroiled in a massive recall crisis in the U.S. starting in late 2009 and continuing through 2010, covering a wide range of problems including faulty floor mats, sticky gas pedals and defective brakes. In response, it has become quicker to issue recalls.

Last month, the Japanese automaker reached a settlement with the U.S. Justice Department to pay a $1.2 billion penalty for hiding information about defects in its cars. It earlier paid fines of more than $66 million for delays in reporting unintended acceleration problems.

The National Highway Traffic Safety Administration never found defects in electronics or software in Toyota cars, which had been targeted as a possible cause.

The focus in the U.S. auto industry has recently shifted to another major recall problem, this time with defective ignitions in compact cars made by GM.

___

Follow Yuri Kageyama on Twitter at twitter.com/yurikageyama


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Walsh launching public Wi-Fi program

The City of Boston will announce a new public Wi-Fi program today to bring free internet access to the city's neighborhood business districts.

Starting later this year, the city will install public wireless networks in 20 "Main Streets" business districts, a move the city says will add another selling point for businesses in those neighborhoods.

"There's no better place to launch this in our small business districts," Mayor Martin J. Walsh said. "It's a way for us to support our small businesses."

The city said careful choices were made about where to roll out the service.

"We're looking to make very targeted, strategic investments," said Justin Holmes, Interim CIO for the City of Boston. "What we're not interested in doing is blanket coverage across the city."

The network, which Holmes said will have the same security and filters as City Hall's network, will cost about $500,000 to install. That cost, largely up-front purchases of equipment, is already in Walsh's 2015 budget.

Walsh said increasing connectivity is a "priority."

Adie Tomer, a senior research associate at the Brookings Institution Metropolitan Policy Program, said the proposal puts Boston ahead of many other cities.

"Most cities don't have these large-scale, free, public Wi-Fi networks," Tomer said. "It's going to be a necessary step."

Tomer said increased Wi-Fi, especially in neighborhoods, can increase "digital literacy."

"Things like free public Wi-Fi offer another opportunity for folks to say, 'Here's how you can benefit from the Internet,'" Tomer said. "It's critical for their economic opportunities down the road. This is a very equitable move by the city."

Still, other high profile public Wi-Fi networks have hit snags or fallen apart entirely. In Philadelphia, the service fell apart after the city's partner bailed out. Boston's network will be built on top of the city-owned fiber optic network that connects city buildings. Because of this, Holmes said, maintenance and recurring costs will be small and the network will not be dependent on a third party.

Boston has completed its largest public wireless hot-spot in Grove Hall, a 1.5 square mile area that includes two of the 20 Main Streets districts.

Also today, Walsh will re-brand existing public wireless networks as "Wicked Free WiFi," designed to encourage more people to use the service.

"We want Boston to be seen as a place that has fun, free 21st century commodities," Holmes said.


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US wholesale stockpiles up 0.5 percent in February

WASHINGTON — U.S. wholesale businesses increased their stockpiles for an eighth consecutive month in February as their sales rose at the fastest clip since November, good signs for future economic growth.

Wholesale businesses boosted stockpiles by 0.5 percent in February following an increase of 0.8 percent in January, the Commerce Department reported Wednesday.

Sales rose 0.7 percent in February, rebounding from a sharp 1.8 percent drop in January which had been blamed in part on severe weather that cut into demand.

The solid gain in sales should encourage businesses to keep restocking their shelves to meet rising demand. That will mean increased orders to factories and rising production which would boost economic growth.

Many economists say that the economy slowed in the January-March quarter but will rebound this quarter.

The government tracks inventories held by wholesalers, manufacturers and retailers. The report covering all inventory levels will be issued next Monday.

For wholesale inventories, stockpiles of autos and auto parts rose 0.5 percent while lumber stockpiles increased 1.2 percent.

Many economists expect that the economy, which grew at a 2.6 percent rate in the October-December quarter, slowed in the January-March period, likely growing somewhere between 1.5 percent and 2 percent.

That forecast is based on a view that the harsh winter weather cut into various types of economic activity from shopping at the mall to factory production. Some estimate that the weather cut growth by about 1 percentage point in the first quarter, but will add 1 percentage point to activity in the April-June quarter as the economy is spurred by pent-up demand in such areas as auto sales.

Another factor that affected first quarter growth is a slowdown in the pace of restocking following a huge surge last summer.

Inventory building had contributed 1.6 percentage point to economic growth in the third quarter when the economy had grown at a 4.1 percent rate. By the fourth quarter, that contribution had dwindled to just 0.03 percentage point. Analysts are not looking for inventories to add much to first quarter growth.

But for the rest of the year there is optimism that growth will rebound to a solid rate of around 3 percent. That could make 2014 the best growth year for the economy since 2005.

The expectation is that stronger hiring will boost incomes and that will spur consumer spending, which accounts for 70 percent of all economic activity.

There was good news on the hiring front in the past two months. Employers added 192,000 jobs in March, just below a revised 197,000 increase in February. Those gains suggest that the economy has recovered from the hiring slowdown caused by severe winter storms in December and January.


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Feds say oil trains should have two-man crews

WASHINGTON — Responding to a series of fiery train derailments, federal regulators said Wednesday they will propose that trains transporting crude oil have at least two-man crews as part of new requirements aimed at preventing parked train cars from coming loose and causing an accident like one in July that killed 47 people.

The Federal Railroad Administration had asked a freight rail industry advisory committee to make recommendations on whether two-man crews should be required, but the industry officials were unable to reach a consensus. Federal officials said they decided to move ahead with the two-crew member requirement anyway.

"We believe that safety is enhanced with the use of a multiple person crew — safety dictates that you never allow a single point of failure," Joseph Szabo, head of the railroad administration, said in a statement.

While existing federal regulations don't address how many crew members freight trains must have, the general practice among the largest freight railroads is to have a minimum of two crew members for trains while in service. However, that isn't always the case for regional and short-line railroads.

The crew proposal was prompted by an accident last July in the town of Lac-Megantic in Quebec, Canada. A train transporting oil from the Bakken region of North Dakota was left unattended by its lone crew member while parked near the town. The train came loose and sped downhill into Lac-Megantic. More than 60 tank cars derailed and caught fire, and several exploded, killing 47 people and destroying much of the town.


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NBCUniversal names Alison Moore head of TV Everywhere, after shutting down DailyCandy

NBCUniversal has named Alison Moore -- previously GM of DailyCandy, the female-focused website the Peacock shuttered last week -- general manager and EVP of TV Everywhere in the company's content distribution group.

In the newly created role, Moore will be responsible for NBCU's TV Everywhere initiatives, including developing marketing and strategy to increase audience awareness, adoption and usage across the company's networks.

NBCU hired Moore in 2012 as exec VP and general manager of DailyCandy. She was previously with HBO, where as SVP of digital products she led development and operations of the premium cabler's digital platforms, including HBO Go, HBO.com and HBO On Demand. Prior to HBO, Moore worked at Cablevision Systems and Turner Broadcasting, and two startups, DatSat and Flooz.com.

Moore will work with NBCU exec VP Ron Lamprecht, whose duties will expand to focus on driving deals with current and future linear TV providers, operational delivery and the current season TV windowing strategy for the company's new media platforms. Moore and Lamprecht will both report directly to Matt Bond, EVP of content distribution.

"Alison's proven leadership in digital media -- from small startups to major media companies -- adds tremendous value to our rapidly evolving content distribution effort," Bond said. "With Alison's experience we're going to keep growing the amount of content available to consumers and take TV Everywhere to the next level."

In 2013, NBCU distributed 140 TV series via TV Everywhere authenticated services, up more than 50% from the previous year. Currently, 16 networks deliver 6,000 episodes per year to pay-TV partners. According to NBCU, over the last year it has reached distribution deals with pay-TV providers serving 80% of the market.

Comcast had acquired DailyCandy in 2008 for $125 million from investment firm Pilot Group. The idea at the time was that the fashion-and-lifestyle digital publication for women would mesh with Comcast cable networks like E!. Since then, Comcast acquired NBCU -- which has female-focused networks like Bravo and Oxygen -- but the hoped-for synergies with DailyCandy never materialized.

NBCU also pulled the plug on Television Without Pity, saying in a statement that the TV recap site and DailyCandy "are no longer viable businesses for our company."

(C) 2014 Variety Media, LLC, a subsidiary of Penske Business Media; Distributed by Tribune Content Agency, LLC


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CVS goes cold turkey; may pressure rivals, or not

It has long been gospel among retailers that tobacco pulls so much business into stores, with smokers also picking up water, gum or a bag of chips, that dumping it would be a sales killer.

However, with pressure from anti-smoking forces growing, tobacco use waning and now a national drugstore chain jettisoning cigarettes for good, is this calculus starting to crack?

It's probably too early to say, but major retailers will be paying close attention to the sales numbers after CVS Caremark pulls tobacco from its shelves by October. If the old retail rules governing tobacco have not changed outright, they are at least coming up for review.

Since the nation's second-largest drugstore chain announced it would dump tobacco just over two months ago, its shares have hit new all-time highs 10 times.

That's not to say that the CVS case is unique.

CVS Caremark Corp. is part of a booming industry. In that same stretch since early February, shares of rivals Walgreen Co. and Rite Aid Corp. have surged as well.

And most of last year's $126 billion in revenue at CVS came from its pharmacy benefits management business. That sets it apart because it doesn't depend so much, like other drugstores, on tobacco to draw customers through the door.

But when CVS Caremark Corp. announced it was going cold turkey, it caught almost everyone by surprise.

The retailer will be giving up $2 billion in annual revenue a year, it estimates. About a half billion of that would come from non-tobacco products, the additional items that smokers pick up when they come in to buy smokes.

The response from Wall Street? Something between a yawn and a shrug. CVS stock is up about 11 percent since the announcement. That's quite a run for a company that just announced it was giving up $2 billion in revenue annually, and during a period in which all major U.S. indexes have been under pressure.

Yet while CVS is not the first major retailer to give up tobacco, most industry analysts do not see the flood gates opening.

Target Corp. gave up tobacco in 1996, citing a "commitment to the health and well-being of our communities," and no one followed it through the anti-tobacco exit door.

Each retailer has to weigh the bottom line against the message, but that has been going on for some time now, said Craig R. Johnson, president of retail consultant Customer Growth Partners.

"This isn't just a bolt out of the blue," Johnson said. "They've done the plusses and minuses, and they haven't decided to do it."

Some have chosen the opposite path. Discounters like Family Dollar have actually started selling tobacco in the past few years.

Just last month Walgreen CEO Greg Wasson, when asked by an industry analyst if tobacco had become a long-term liability given the CVS decision, signaled that the nation's largest drugstore would not be following suit.

Instead, the CEO said that Walgreen, which still sells tobacco, will focus on helping people quit.

Yet there are at least two forces adding weight to the no-tobacco side of the scale: one internal, one external.

Internally, the cigarette business has become tougher in the face of tax hikes, smoking bans, health concerns and social stigma. Plus, the number of U.S. adults who smoke dropped below 20 percent between 2005 and 2012, according to the Centers for Disease Control and Prevention.

The drugstores and major retailers angling to grab a bigger slice of the health care spending pie as the American population ages are looking at margins as well.

Cigarettes probably generate a profit margin of 3 percent to 7 percent. Generic drugs, in contrast, can fetch margins of 20 percent or more, said Burt P. Flickinger III, managing director of the retail and consumer brands consultant Strategic Resource Group.

The question of whether retailers and drugstores can sell both health and tobacco raises the issue of those external forces that have been building for some time.

The presence of tobacco behind checkout counters creates an image problem for an industry that says it puts a priority on helping provide healthier lifestyle options for customers.

There is a push to hold retailers to their word on that score.

In the wake of the CVS announcement, attorneys general from 28 states wrote to executives at the nation's largest retailers, including Walgreen, Rite Aid, Wal-Mart, Kroger and Safeway, urging them to follow the CVS lead.

"Pharmacies and drug stores, which increasingly market themselves as a source for community health care, send a mixed message by continuing to sell deadly tobacco products," said New York Attorney General Eric Schneiderman.

Which retailers can afford to kick the habit, if any, may play out over the next year as CVS posts sales numbers. Investors won't get their first look at a full CVS quarter without tobacco revenue until February 2015.

"Retail is notorious for copycat marketing, meaning if somebody is successful at doing this, others will follow quickly," said Marshal Cohen, chief industry analyst at market researcher NPD Group.

___

AP Tobacco Writer Michael Felberbaum contributed to this report from Richmond, Va.


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US stocks move higher as earnings get underway

NEW YORK — Stocks rose for a second day in a row Wednesday, helped by a surprisingly strong earnings report from the giant aluminum company Alcoa. Technology stocks recovered after taking a drubbing over the past week.

KEEPING SCORE: The Standard & Poor's 500 index rose three points, or 0.2 percent, to 1,855 as of 11 a.m. Eastern. The Dow Jones industrial average rose 28 points, or 0.2 percent, to 16,282 and the Nasdaq composite rose 20 points, or 0.5 percent, to 4,133.

A IS FOR: Alcoa, a former Dow member, earned 9 cents per share in the first quarter excluding one-time items. The results came in well ahead of analysts' expectations. Alcoa is typically the first large company to report its results every quarter. Alcoa rose 46 cents, or 3.7 percent, to $12.99, one of the biggest gains in the S&P 500.

EARNINGS WORRIES: Investor enthusiasm for this upcoming earnings season has been hampered by the severe weather that plagued most of the country this winter. Corporate earnings are expected to fall 1.6 percent from a year ago, according to financial data provider FactSet. If earnings do fall year-over-year, it would be the first time corporate profits have fallen since the third quarter of 2012.

MATERIAL WORLD: Alcoa's strong results helped push other mining and material stocks higher. U.S. Steel rose 2 percent, industrial parts company W.W. Grainger rose 1.5 percent and auto parts company Delphi increased 1.5 percent.

DOCTOR IN THE HOUSE? Intuitive Surgical, the maker of robotic surgical equipment, slumped $35.26, or 7 percent, to $454.58 after the company warned investors that its first-quarter sales would be drastically lower than previously expected. Intuitive Surgical, like many other biotechnology stocks, has had some steep drops recently. It traded as high as $541.23 last Thursday.

HOTEL VACANCY: La Quinta Holdings, the parent company of the hotel chain La Quinta Inns, rose 16 cents, or 1 percent, to $17.16 on its first day of trading. La Quinta is owned by the private equity firm Blackstone Group and was taken public this week in a $650 million IPO.

ECONOMY WATCH: The Federal Reserve will release minutes from its March policy meeting later Wednesday. Also, the government reported that U.S. wholesale businesses increased their stockpiles for an eighth consecutive month in February. Their sales rose at the fastest pace since November.

BONDS AND COMMODITIES: Bond prices fell. The yield on the 10-year Treasury note edged up to 2.70 percent from 2.68 percent late Tuesday. The price of crude oil was flat at $102 a barrel. Gold fell $3 to $1,306 an ounce.


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Stocks open higher; Alcoa leads the way

NEW YORK — Stocks are opening higher on Wall Street as corporate earnings begin on a positive note.

Aluminum maker Alcoa rose the most of major U.S. stocks after reporting earnings that were better than investors were expecting. Alcoa rose 3 percent in early trading. Other materials stocks also rose.

The Standard & Poor's 500 index rose three points, or 0.2 percent, to 1,855 in the first few minutes of trading Wednesday.

The Dow Jones industrial average rose 27 points, or 0.2 percent, to 16,284. The Nasdaq composite rose 19 points, or 0.5 percent, to 4,132.

Technology stocks, which fell sharply over the past week, were among the biggest gainers. Facebook rose 2 percent and Microsoft rose 1 percent.

Bond prices fell. The yield on the 10-year Treasury note rose to 2.70 percent.


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