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This is just funny…who was right person to send….mixed reactions?….No further explanation required an I think someone has a perception issue…just watch the video…I guess he could have brought up abortions…<grin>. BD
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http://www.msnbc.msn.com/id/26315908/vp/49127278#49127308
Are we talking Los Angeles here and not Boston? I say that as similar contracts with negotiating contracts and prices have occurred
there as well with Blue Cross leading the pack to discourage patients monetarily from going to the 5 highest priced hospitals in Boston. All the action today is going on with subsidiaries with insurance companies and it has been for quite a while and thus so I call some of these posts “subsidiary watch” as I have been doing for the last 2-3 years. I think this post I made a couple weeks ago with the title pretty much sums us the health insurance contract business.
Here’s a couple more examples with Blue Cross and some of the other government contacts that are disputed, changed or what ever. It goes on and on. So the city employees under this Blue Cross Plan no longer can go to Cedars or UCLA and some will have to change doctors.
With this happening here with Blue Cross one does wonder if others will follow suit in their negotiations like what is occurring in Los Angeles and Boston. If you didn’t read last week about the Blue Cross subsidiary acquisitions and want to be really confused on how some of this works, check in here.
Blue Cross though for all purposes is under a technology attack of algorithms and contracts though with United Healthcare all over the US and I keep reading about it. 
So what does that mean? Well both facilities are using Epic Medical records system which has a great reputation and does a good job. Ok so now lets look at some subsidiary action with United Healthcare…they get a piece of the action almost everywhere any more. Oops looks like Blue Cross could be lacking a subsidiary company that does clearinghouse and revenue cycling and may have to outsource it or another 3rd party company comes in for that so while this does not make any difference today, what’s the future with contracts on the next one?
You can read below where United (Optum) created a new subsidiary to do clearinghouse services….and guess what the touted EHR system is, Epic. Now I don’t know how these complicated contracts are negotiated but I know when I worked for Fortune 500 companies in sales we were encouraged to promote other sister companies and as a sale person who negotiated contracts I was able to give a bigger discount to bring in other subsidiaries.
I don’t know how United works but that was my experience and what I had to sell years ago with a big company that had a few subsidiaries. So it all comes down to bottom line money spent so maybe it’s a good question to ponder when it comes to competition as the complexities of insurance contracts grow?
So theoretically is this a bargaining point with promoting using other companies the overall corporate company owns? It makes one kind of think about it. Again Blue Cross has the contract and it is removing the two medical facilities but what’s the competition doing to get in the door in preparation for when the next time a contract comes up? You have to look today at who owns who and where they operate and what kind of Health IT services they offer.
When the contract comes up again will competitors be in a spot to where they could include Cedars and UCLA? This is just sales strategy projections to ponder. Like I said 
these insurance contracts are a bitch and the next contract negotiation may be one to watch. For right now the city employees are SOL for Cedars and UCLA with Blue Cross but those who have Kaiser don’t have to worry as that’s a separate contract and they have everything under one roof. Anthem's Select network excludes the doctor’s groups too so perhaps Cedars and UCLA will be back talking as Blue Shield did a while back?
To be fair though to UCLA though to they have a mix of a lot of Medicaid and Medicare patients and those revenues we know are lower and many hospitals depend on the commercial insurers to make up the difference in such demographic spreads and UCLA provides some medical services and treatments that you can’t get elsewhere so when a referral goes to UCLA it’s a good probability it’s a specialist’s specialist to be seen by the patient. A company in the OC was already quoted with not honoring UCLA or Cedars with via an employer plan with United. BD
In a bold cost-cutting move, Anthem Blue Cross has eliminated doctors affiliated with the hospitals from a health plan offered to about 60,000 employees and dependents at the cash-strapped city of Los Angeles.
The city opted for Anthem's plan because it will save $7.6 million in annual premiums next year by excluding physicians from the two institutions known for tending to the Southland's rich and famous. About 2,200 city workers and family members are expected to lose access to their doctors under the plan.
http://www.latimes.com/business/la-fi-hospital-costs-20120921,0,4069159,full.story
You would have to be living under a rock today to not have heard at least one news article about the NIH and the FDA needing more funding and
in this article we have the absurdity here with cutting their funds? In the mean time we have corporate USA brokering and selling a lot of data they collect about consumers and the error factors are increasing with the inclusion of non credible data today so we are all “data chasers” that work for free to fix what corporate USA misrepresents with a lot of this. Biotech companies go broke before they can even get an FDA approval and what are we losing here, I might guess to say plenty.
In the meantime we are all somewhat Algo Duped on what data is important and what has value and there’s just flat out crap out there too, everyone knows that but they still seem to spin market crap. It’s totally 
amazing that corporate USA (this includes companies, banks, trading firms, social media and ton of other entities) are just flat out getting rich from selling data. In addition state governments who do license some of these mining bots are now having a new expense with it, software to limit the bots so you and I as consumers can still get access. A while back North Carolina tossed out Core Logic due to this and the fact that they were not updating and paying timely for updated information. Have you as a “consumer data chaser” had the experience of getting corrected information fixed and then wait and wait and wait until it gets updated? This is part of the reason.
Again I’ll use my Walgreen example here that showed in 2010 that the corporation made short of $800 million, from the intangible data selling only so how big is this pot, huge. I have been beating this horse around here for a while now and we don’t seem to have folks in DC who can come to terms with this as it’s not visible and doesn’t create the stir that talking about abortions created, so when the digital illiterates get over their heads, this is the useless rhetoric we get and it’s pathetically all over the news and folks that know better just shake their heads in disgust, self included here as it represents no productivity at all and nothing for the “good” of mankind, just a bunch of old crabby folks out of touch that are stuck in the 70s.
Not too long ago we had this story on how Congress
was going to look at the data sellers and again 70s mentality here prevails as they are only looking at trying to create a law to regulate, but anyone living in the current world knows it’s like next to impossible and for a comparison look at the same scenario with the SEC, private industry outdoes them the next day with loopholes and ways to get around it as the laws are written by attorneys and they lack some big technology input and realities…garbage in other words. If you look at the device tax it may have been a good plan a few years ago but not now as things change so “deadheads” would be wise to see this and quit hanging on to what doesn’t work. Sometimes going back in time to look at the past can offer some good insight but most of it today is futile as it doesn’t apply.
This topic was also chapter 17 of my Attack of the Killer Algorithms series which depicts how math and formulas “get you” when you least expect it and it is due to flawed data or folks using unethical algorithms and formulas for profit. Instead of the Occupy movement as we see it, “Occupy Algorithms” for goodness sakes and let’s get some accurate queries and data out there instead of some of the ones designed for “desired” results. We end up with something along this line:
”Hey dude let’s crunch some numbers and see if we can come up with some analytics to sell”
Actually if more economists would collaborate with more mathematicians I think we might have a little better forecasting going on as many economists sometimes get those “flawed” reports and rely on antiquated methodologies of math too, so bump head guys and see what collaboration might do. How much is that algorithm in the window? Even going up the ladder from healthcare this lives and I urge everyone to watch this documentary at the link below about the Quants on Wall Street…hello…wake up…as you actually get to hear them talk about the fiction they create outside the real world and economies are built on this, not good when it comes to inequality as it keeps it going and again in DC we go back to a distraction of more abortion talk..ho hum. You can also find this video on the links page where I have over forty chapters on how algorithms have teeth and bite you, everyday event that you may not be aware of, again flawed data or formulas for profits without ethics for most of it.
Don’t get me wrong as far as the data is concerned as I am great fan of research and studies that create cures and treatments but we live with this other element out there that is for profit only and really is not helping even though you will see some very well crafted marketing studies they create to support their queries and algorithms that are junk. I had the NISS write to me and they agree about all the junk out there and “liked” the Killer Algorithm series and I have no clue why but nobody else seems to write about this as I guess we are more Algo Duped than we could imagine.
Sure it is hard to tell the difference but there are smart people out there, a smarter than me that can help with some of this before garbage runs a muck in the press. A lot of those folks don’t have a clue, mostly because they have never written code and they to cover some of this but there's been many news articles out there about journalists 
know a little bit of code to help them report better, and I agree any education with how things work today is great. I didn’t write those article though so don’t chew me up on that account and I do understand the quotas and grading procedures that journalism goes through at times with ratings and getting that best OMG story out there so more readers go to websites and are exposed to advertisements so they can stay in business as advertising pays the bills.
So if you don’t think that we need funding for the NIH and FDA, read this article in the link below as this was a full blown effort to help keep funding at the NIH and a way to bring some private industry partnerships in to keep it going. Those biotech companies that we are depending on to create cures and treatments will go away if everyone keeps sinking money into the next gaming format we have out there. Where’s our heads at times and sure games are ok and we need some entertainment but look at where we put our priorities, entertaining ourselves first it appears instead of the betterment of the world and fighting diseases and finding cures. New game ventures are funded right and left and science is left at the end of the line. Look at this headline though even the NFL which is our entertainment has gotten wind of this and made their contribution.
Look at this company making millions in profit with
mining data and his whole operation doesn’t even come under any federal laws, he writes algorithms, queries and studies and goes to town. In time as a consumer you might have to be chasing down some of the data sold here and fix it and this is just one example. This company and others who sell data should be licensed and pay an excise tax as they are the ones who benefit and we just run around for free and fix their erroneous information which a lot of times is created with non credible data mixed with credible data. It’s fine to crunch numbers and predict on geographic and demographic data as we get smarter but when you bring it down to the individual level and score with this, we have a problem of flawed data as it’s not all credible.
So want more money for research, go where the money’s at to where the data sellers get their data for nothing and profits for free…billions in profit and they should not object as the employees of all the entities may need some of this research for treatment or a cure someday, so no reason for anyone to balk at the idea when we have billionaires doing their share by all means. It’s a way of giving back that makes sense. I have to pay an excise tax every time I buy a tire to drive to a “lesser” paying job these days. If we don’t find the money then the NIH and the FDA cannot service the US citizens in a way that works toward the betterment of the country where all benefit. It’s time corporate America kicks in their share in the form of an excise tax as they make billions doing it and consumers just chase their data for them for free as we are under the Attack of the Killer Algorithms being guilty until we prove our innocence with data today…kind of sucks…but the digital illiterate lawmakers have stood by to just let it happen. Link below..some idle thoughts of mine dating back to August of 2009…yup too far ahead of my time:)
The NIH and FDA need money to serve so let’s get it done and use the resources we have and get the greedy folks out there to give back via such a tax as they won’t do it on their own and let’s ensure we can work towards having a world of credible data and get rid of some of the junk out there and move forward.
In closing, Francis Collins at the NIH and Dr. Margaret Hamburg at the FDA see what you think as a potential solution to a solid method of contributions that would be collected quarterly and help keep the agencies in business with the resources they both need.
Someone has to introduce some creative thinking here as it certainly is not getting out of the 70s in Washington any time soon and I hope the “default” topic of women's health and abortions can be put away for good so we can move forward as it does little but deprive and basically publicizes even more how out of touch and the lack of digital literacy we have making laws. BD
Adding to the spooky-Kabuki atmosphere was the claim by Mary Woolley, President of Research!America that if sequestration goes into effect, entire industries, including biotech, would “die here” and/or go overseas. One might expect such catastrophizing from an organization that embeds an exclamation point in its name, but still, it’s just plain nuts.
http://mdd.blogs.medicaldevicedaily.com/2012/09/20/heresy-and-theater-of-the-absurd-the-nih-budget-discussion/
With current economic conditions crowd funding is growing pretty strongly in the areas of healthcare as people don’t have the money and insurance is not covering some procedures such as this one. 
He cannot get a heart transplant due to his age and doctors have recommended a mechanical heart that would keep him alive for a few years but he would also need to stay near the battery that runs it. He has now found a stem cell treatment that could prove more effective and at 75 years of age would you want to try a stem cell treatment or go through open heart surgery and deal with the device? There are trials around I on this blog I have included posts about the same or similar types of procedures and right here in California Cedar Sinai has a clinical trial doing stem cell injections with the heart.
The stem cell procedure is available in the Bahamas and they are hoping to raise 35k via the GoFundMe website. Doctors would extract stem cells from his blood, send the cells to Israel and then reinject the cells back into his heart to bring it back to 40% capacity. Again, this really shows the US with a healthcare system that needs to be fixed. Its makes you ask is this the future of healthcare having to raise money with Crowd Funding on major procedures and treatments when other charities or options are not available? When you visit the website there are many other people doing the same. It shows where corporations are NOT people when it comes to healthcare and the fact that REAL caring people are still out there, just sad that corporate America for the most part is not on the same track. We seem to keep things out of reach here in the US and and tax the wrong entities whereby taxing data sellers could create funding for both the upkeep of the US IT system and at the same time give additional funding to healthcare. BD
The reason?
A failing heart that currently functions at just 18% of its optimal capacity. Despite a six-way bypass surgery and other operations over the past several years, if Gail doesn’t act soon he won’t live long.
Doctors recently recommended he get a mechanical heart transplant, which would require he remain near a battery most of the time and most likely keep him alive for a maximum of just a few years. At 75 years old, Gail says doctors told him he’s ineligible for an regular heart transplant.
The Cogdills are hoping to raise $35,000 through the website GoFundMe to help them travel to Nassau, Bahamas, next month and pay for the procedure. The plan is for doctors there to extract stem cells from his blood, send them to Israel for treatment then reinsert the strengthened cells into his heart to bring the organ back up to about 40% capacity.
http://mashable.com/2012/09/21/ex-nfl-star-heart-gofundme/?utm_source=twitterfeed&utm_medium=twitter&utm_campaign=Feed%3A+Mashable+%28Mashable%29
Here’s the trailer and one of the opening comments is “the industry doesn’t want to stop making money”, an irrational system. We have a disease management system. You can see Dr. Don Berwick features here as well talking about
the faulty care. The system does not want to change. “What can we do to get your productivity up” you hear the one doctor say and she says “I want to take care of patients and not worry about my productivity’. I just watched the trailer and it looks good as far as addressing and making issues known. Screenings are coming to many theaters and television will also offer it on demand and it is for sale on ITunes. The movie touts a way out and to save the Healthcare of the US. I can’t see it from the trailer but will have to watch the full movie:)
In all fairness though we can’t overlook the fact of so many companies in healthcare traded on the open market and that affects care and the price we pay as well. We have all seen the drug stories and stock prices and heard the denial of care stories from insurers as they report to shareholders so again that adds to it and makes the battle a bit more difficult at times. BD
ESCAPE FIRE: The Fight to Rescue American Healthcare tackles one of the most pressing issues of our time: how can we save our badly broken healthcare system? American healthcare costs are rising so rapidly that they could reach $4.2 trillion annually, roughly 20% of our gross domestic product, within ten years. We spend $300 billion a year on pharmaceutical drugs - almost as much as the rest of the world combined. We pay more, yet our health outcomes are worse. About 65% of Americans are overweight and almost 75% of healthcare costs are spent on preventable diseases that are the major causes of disability and death in our society.
It’s not surprising that healthcare tops many Americans' concerns and is at the center of a political firestorm in our nation's Capitol.
But the current battle over cost and access does not ultimately address the root of the problem: we have a disease-care system, not a healthcare system.
ESCAPE FIRE examines the powerful forces maintaining the status quo, a medical industry designed for quick fixes rather than prevention, for profit-driven care rather than patient-driven care. After decades of resistance, a movement to bring innovative high-touch, low-cost methods of prevention and healing into our high-tech, costly system is finally gaining ground. This film follows dramatic human stories as well as leaders fighting to transform healthcare at the highest levels of medicine, industry, government, and even the US military. ESCAPE FIRE is about a way out, about saving the health of a nation.
The film is being directed and produced by Matthew Heineman and Susan Froemke. With a team at HBO, the filmmakers collaborated for two years on the groundbreaking, Emmy-nominated HBO series, THE ALZHEIMER’S PROJECT, which aired in May 2009.
https://vimeo.com/27450676#signin
What was interesting was to hear how they do ok in the US
, and why shouldn’t drug companies as we pay more here and somewhat subsidize others, but he stated in their own home country of Germany that the generic competition was becoming a much issue there. It’s a bit of a catch 22 as many can’t afford the more expensive drugs who need them and then the corporation says they need the money for R and D, so I guess we go back to the NIH for more funding again. Even big corporations are not so much worried about credit ratings being at the absolute top and I guess with plenty of cash the company doesn’t have to worry.
Above are a couple examples of what is happening in India with generic drugs and it wouldn’t be too much of a surprise to see other countries doing something of the same. BD
Speaking at the Boston College Chief Executives' Club, Marijn Dekkers said there was "tremendous pressure" on drug makers to lower prices.
"The danger of pushing the prices of prescription drugs down, down, down is that at some point the business model of developing these drugs will lose its attractiveness," he said.
Drug companies are also facing increasing pressure from generic competition as they lose patent protection on some of their biggest selling products.
On Monday, Bayer said an Indian patents appeals board rejected its petition to block the entry of a generic version of its cancer drug Nexavar.
http://www.reuters.com/article/2012/09/19/us-bayer-dekkers-idUSBRE88I1HR20120919?feedType=RSS&feedName=healthNews&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+reuters/healthNews+%28Reuters+Health+News%29&utm_content=Google+Reader
Well it hit a member of Congress which goes to show that all
Congressmen are not rich, just one huge batch of them are. The article states he was treated for bi-polar mental illness and shoot I think 3/4 of the folks in DC have some huge bi-polar tendencies, and whenever I see all the filibusters, that pops into my head. The house is listed for $2.5 million so I assume it’s good sized house. He hopes to return to work soon and perhaps he can make a case for medical bills when he returns to work on the problems and issues.
We shall see if the rest welcome him back or what occurs when he returns as he certainly is the poster child in DC on healthcare right now. BD
“Like millions of Americans, Congressman Jackson and Mrs. Jackson are grappling with soaring healthcare costs and are selling their residence to help defray costs of their obligations,” Jackson’s chief of staff Rick Bryant said in a statement. “The Congressman would like to personally thank everyone who has offered prayers on behalf of his family.
Jackson recently took a leave of absence from Congress to get treatment at the Mayo Clinic for bipolar disorder. Though Jackson Jr. is reported to be back in D.C recovering at home, he has yet to return to work on the Hill.
“Jesse Jackson is seeking medical help for a mental illness and I hope that he comes back in full health and he’s been a very productive member of the Congress of the United States and I hope that he returns,” Hoyer said.
http://www.politico.com/news/stories/0912/81391.html
This was in the news today about InterSystems who has had a big interest in healthcare and has software for the financial business as well. 
You can read the entire article at the link but I thought this was interesting to see some of the history on how the highly successful VA system came about. The company is in the data base business and functions quite well outside the US with many clients. In addition the CEO/founder Phillip Ragon also has a foundation to where they made a $100 million dollar contribution to Massachusetts General Hospital and you can read about their research work relative to the HIV virus below.
The organization, like the Gates Foundation is committed to finding a vaccine for AIDS/HIV. With the VA medical records system they integrated 130 platforms, and boy would that be a headache by today’s standards due to the complexities that exist today. Mr. Ragon has a physics degree from MIT and created the data base business in 1978. At present the business is focused on the HIE information exchange area of Health IT. It’s kind of interesting on how the article talks about his battles with Microsoft which were not over software at all, it was real estate. For someone who got started early in the Health IT business the rewards are there and he generously gives back. BD
widely used in the health-care market space,” said Lynne Dunbrack, program director of connected health strategies at market research company IDC Health Insights, in a phone call from its Framingham, Massachusetts, headquarters. “Their customers continually praise them for their development team and their support staff.” In 1994, Ragon acquired the health-care database division of struggling Digital Equipment Corp., a purchase that almost doubled annual sales to $33 million. In 2003, the company created an electronic health-record database for the U.S. Department of Veterans Affairs, integrating 130 different platforms being used throughout the VA system.
The result was so successful for the VA that Ragon was called to testify before a Senate committee researching electronic health records in 2006.
http://www.bloomberg.com/news/2012-09-18/hidden-u-s-software-billionaire-ragon-surfaces-in-boston.html
You can read the press release below and certainly this can be a good thing to study outcomes with treatments and be able to determine toxic behaviors in drugs before they are prescribed. 
We already have black box warnings and a ton of warnings on side effect we hear already. In addition with data as such available they are looking to potentially avoid some of these areas if possible during drug development. In addition to such data bases of information it is also interesting to see what is being done with stem cells to also speed up the process of creating new drugs with again finding adverse reactions with cells being studied and using sequencing technologies together.
[PRESSWIRE] Cambridge, MA, USA - 19.02.2012 -- GGA Software Services LLC, the leading provider of outsourced scientific informatics services to the life sciences industry, announced that it has been selected to provide data curation services to nine global pharmaceutical companies that are participating in a pan-European collaboration to develop in silico tools for predicting the toxicity of drug candidates.
This project, known as eTOX, is part of the European Innovative Medicines Initiative (IMI), a public-private partnership between the European Union and the European Federation of Pharmaceutical Industries and Associations (EFPIA). After a rigorous selection procedure in which several companies worldwide were evaluated, nine of the pharmaceutical companies in the project decided to use GGA as their subcontractor to curate more than 5,000 legacy toxicity reports for inclusion into a joint database.
Richard Golob, President and CEO of GGA Software Services, said, “GGA’s scientific domain expertise and data curation capabilities are an excellent match with the curation needs for the eTOX Project, and we are pleased that we will serve as the curation partner for nine global pharmaceutical companies participating in the eTOX Project.” The following companies have decided to contract with GGA for curation services: AstraZeneca, Bayer Pharma, Boehringer Ingelheim, GlaxoSmithKline, H. Lundbeck, Novartis, Sanofi-Aventis, Servier, and UCB Pharma.
The primary focus for the data curation effort is systemic toxicity studies (1 to 4 week repeated dose studies in rodents, dogs, and other non-rodents), but the data curation effort has been extended to longer studies, as well as to pharmacokinetic/toxicokinetic studies and in vivo safety pharmacology.
“The overall goal of the eTOX Project is to develop in silico predictive systems for organ and in vivo toxicity and thereby help improve the drug development process and reduce animal use, and the project’s backbone is the database of preclinical toxicity data that GGA will help us curate”, according to Francois Pognan, eTOX Project Leader and Executive Director of Biochemical, Analytical, and Translational Safety at Novartis Institutes for BioMedical Research. He said, “The eTOX Project emerged from the understanding that the pharmaceutical industry has not used efficiently the wealth of preclinical toxicity data generated in studies, and that a database bringing together curated data from previously unpublished, legacy preclinical toxicity studies would provide the basis for powerful data mining to build predictive tools.”
Pognan said, “The eTOX database will likely become one of the largest repositories for high-quality repeat dose toxicity data.” He continued, “This project will be the first time in pharmaco-toxicological research that unused or poorly used, highly relevant preclinical drug safety data will be combined to improve the quality of drug candidates and the processes for their development.”
GGA will receive the archived studies in batches from the nine pharmaceutical companies over the next three years, and will extract the data according to a specified format and use a rigorous quality control process to ensure high data quality. These pharmaceutical companies selected GGA among the possible data curation partners for the eTOX Project on the basis of capacity, quality, data security, reliability, and cost. According to Golob, “We understand the importance of building a high-quality database in ensuring the construction and validation of effective predictive toxicity models, and we appreciate the opportunity to participate in this important initiative.”
About GGA Software Services LLC
GGA Software Services is a leading provider of outsourced scientific informatics services to the life sciences industry. Headquartered in Cambridge, Massachusetts, with a 400-person development center in St. Petersburg, Russia, and with teams in Finland and Switzerland, GGA offers broad capabilities in scientific software engineering, algorithm development, and data curation, especially in cheminformatics, bioinformatics, and development informatics. Global pharmaceutical, medical device, and scientific instrumentation companies rely on GGA to provide ongoing scientific informatics services, including support, maintenance, and QA services, to enhance their internal resources. Since 1994, GGA has successfully served as an extended workbench for its clients, allowing them to both achieve their critical objectives and optimize their scientific informatics budget.
Well right now you could maybe see this 22k robot working in a
drug factory maybe? We know how automated the processes are but putting bottles in boxes for shipping maybe? It would depend on the factory. When you watch the video you can see where that could make sense. Baxter is the name of the Robot.
There’s no programming for the Robot and it looks like a macro picks up what it needs to be done with being trained from a non technical employee. It doesn’t even need a cage and senses when humans get in it’s work space. Software updates give the robot new functions. You have to love the face or screen with the eyes. BD
off a conveyor belt, so long as they don't weigh more than five to 10 pounds. The two-armed robot has a computer-screen face with animated eyes, stands at about 3 feet, and is priced at $22,000. It is designed to do such tasks as loading and unloading, sorting and tending of other machinery, jobs typically done by people.
Most industrial robots are larger, one-armed machines whose tasks include lifting heavy objects, cutting metal or welding. Those machines typically cost hundreds of thousands of dollars.
Baxter is designed so that workers can "teach" it to do tasks, the company said. For instance, a worker could guide the robot's arms to an object. Cameras embedded in the wrists would then determine how to grasp the object. The robot nods when instructions are clear; a puzzled look appears on its computer-screen face when they aren't.
http://online.wsj.com/article/SB10000872396390443720204578004441732584574.html
This is a great talk and Bill Gates talks about how it all works 
together, sometimes it’s the government, sometimes its interests with commercial companies, and sometimes it’s invented. He talks about the free market and where demands can be met. He found out in some countries nothing was being done for the poor. Vaccines for the poor countries were not available he found and the Foundation needed incentives to get the pharmaceutical companies involved. They funded research and helped governments outside the United States. Warren Buffet’s gift helped a lot.
He says his work as a philanthropist is the most interesting job he has ever had. This is great to see a lot of media work with both Bill and Melinda Gates speaking out and encouraging others to work in the same direction as their Foundation.
There’s also a longer version link below with a full introduction and a question and answer session here if you have a little more time. There’s some great humor in the long version as well as Warren Buffet was the first choice to speak at the Forum:) He says the US needed to re-dedicate ourselves when it comes to education. Technology talk, yes there’s more jobs are going to be available that we can’t catch up to educate enough to be ready to fill them. BD
Ok did you get all of that in the title? Are you confused maybe? All the big actions with insurers seems to take place in the subsidiary companies and this has been going on for a while. Now Health Care Service Corporation is listed here as the 4th largest health insurance company in the US. It just all depends how you slice and dice who owns who and where the contracts and dollars go. We have more of these confusing algorithms here and details of ownership that make it murky.
Blue of Montana doesn’t have a lot of reserves and with joining forces with this other Blue subsidiary/conglomeration they can have access to additional funds to improve their technology. There was no price listed. This move will help them compete with United Healthcare in the state who is eating their lunch over contracts and algorithmic pricing.
You can read below and see yet another big Blue Cross subsidiary, Western States Insurance, is being bought by Payne Financial Corporation
, so are the Blues selling off subsidiaries for a purpose, like money? Will folks in Montana and in some of the other areas know who they are insured by in time? Who owns who <grin>. Refer to the first line above about contracts being a bitch:) At least in this case the parties are known and there’s no lawsuits. Interestingly enough the Western States website has a page to where they solicit and focus on acquisitions too. BD
From the Payne Website:
“Focused on the Inland Northwest, Payne Financial Group is a large, full service, independent insurance agency, specializing in personal 
insurance, business insurance, employee benefits and surety bonds. We understand the importance of risk management and asset protection. We start by covering the basics and then fine tune with additional layers protecting the niche or specialized needs you may have”.
Also of note, Healthcare Service Corporation also owns a stake in the Blue Cross Blue Shield Venture Capital company that is managed by a company names Sandbox and just moved to San Francisco to set up yet one more incubator so perhaps some additional interest there for the Blues of Montana being purchased. BD
Blue Cross said it will become part of Health Care Service Corp., a coalition of Blue Cross/Blue Shield plans in Texas, Illinois, Oklahoma and New Mexico. The company, headquartered in Chicago, has more than 13 million customers.
“With just $128 million of reserves (for Blue Cross of Montana), it makes it very difficult for us to come up with that kind of money.”
For example, HCSC already is developing and using mobile applications, whereby customers or providers use their smart phones, computer tablets or other mobile devices to interact with the insurer, Frank said.
Also on Monday, a major subsidiary of Blue Cross – Western States Insurance – announced it will be purchased by the Payne Financial Group. Both firms are headquartered in Missoula.
http://mtstandard.com/news/state-and-regional/blue-cross-joins-coalition---health-insurance-co-becomes/article_970cb742-0169-11e2-a0bc-001a4bcf887a.html
It was just in June of this year the company announced a 20 percent lay off as costs were growing. Complete was one of the
front runners out there in sequencing and since 2008 the competition has increased immensely. At that time as well they announced they had hired a financial advisor and were looking at potentially selling the company so it looks like it was mission accomplished.
From the BGI website:
”With a goal toward excellence, high efficiency, and accuracy, BGI has successfully completed a large number of projects. These include sequencing 1% of the human genome for the International Human Genome Project, contributing 10% to the International Human HapMap Project, the first Asian diploid genome, 1000 genomes project, human Gut Metagenome, , being a key player in the Sino-British Chicken Genome Project, and completely sequencing the rice genome, the silkworm genome, the potato genome, carrying out research to combat SARS and, most recently decoding the genome of Germany deadly E.coli.”
Less than two years after going public, Mountain View DNA-sequencing startup Complete Genomics agreed to an acquisition offer from
a Chinese company Monday that values the firm at about one-third of the valuation received in its initial public offering.
Complete Genomics, which has sought to offer full DNA sequencing for less than $1,000 apiece, announced it has agreed to sell the company to BGI-Shenzhen for $3.15 a share in cash, for a total of about $117.6 million.
The expense has been an obstacle for researchers who are trying to decode patterns that correspond to maladies known to have genetic roots. Driving down the cost -- the central mission of Complete Genomics' technology and business model -- has been critical to performing large studies.
BGI works in the same field, and hopes that the acquisition -- which it plans to perform through a U.S. subsidiary -- will allow Complete Genomics to continue its mission.
http://www.mercurynews.com/business/ci_21562899/chinese-company-agrees-buy-mountain-view-dna-sequencing
Who isn’t starting some kind in incubator or innovation center today and good that partnerships as such are building. Last October J and J 
announced their Life Sciences Innovation Center which was said to have opened the first quarter of this year so it may already be on the move. J and J had a pharmaceutical R and D facility here already and refurbished part of the buildings to house the innovation center, Janssen Labs. The innovation center will occupy about 35,000 square feet.
There was not any additional information yet on the other locations but San Francisco of course is where biotech and code come together with many technologies when it comes to sequencing and software. BD
NEW BRUNSWICK, N.J. — Johnson & Johnson says it will set up four regional “innovation centers” in life sciences hotspots around the world to speed up early research.
The New Brunswick, N.J., health care giant wants to increase collaboration and investment across its businesses: prescription drugs, consumer health products and medical devices and diagnostic equipment.
The centers will be Boston, London, China and California, with that one including campuses in San Diego and San Francisco. They’re expected to begin operating in the coming months.
http://www.washingtonpost.com/business/johnson-and-johnson-starting-4-hubs-in-hotspots-for-more-collaborations-on-early-research/2012/09/18/54dacdee-01b1-11e2-bbf0-e33b4ee2f0e8_story.html
You do have to say one thing about Nuance, they seem to almost own the world of speech recognition as I seem to remember posting several articles when they purchase another company. The phonetag solution I
would guess is one of the features with mobile phones would be a hot ticket. Voice to text is huge now. I have it on my Windows phone and it seem everyone is working on accuracy and it will get there as Ditech also has Voice Quality Assurance with their designed algorithms . Recently Nuance also launched their competitor for Siri as well so I am guessing these two technologies might be working together?
One NASDAQ-listed firm buying another as voice and language
solutions provider Nuance this morning announced that it has agreed to acquire 
San Jose, California-based Ditech Networks (Ditech) for $1.45 per share in cash, representing a total value of approximately $22.5 million.
That purchase price is net of Ditech’s cash as of the signing date, and is almost exactly the company’s market capitalization at the last market close.
The transaction is expected to close late in 2012.
Nuance says it was particularly interested in getting its hands on Ditech’s Voice Quality Assurance (VQA) technology and PhoneTag voicemail-to-text services, which it will use to enhance its own portfolio of mobile and enterprise voice offerings.
More specifically, Ditech’s PhoneTag service will boost Nuance’s Dragon Voice to Text Services business by adding customers and ‘complementary technologies’.
http://thenextweb.com/insider/2012/09/18/nuance-buys-nasdaq-listed-voice-technology-firm-ditech-1-45-per-share-22-5m/
I think this has been in the works and development for a while as 
back in the 2009 the company announced peer to peer sharing where providers could share records and I am guessing this was in the prior client/server version and of course since that time eClinicalWorks has their web based program so it makes sense to expand sharing even further.
You can see from the image that there are over 10k physicians currently connected and as I understand here the new network will even enable doctors who are not user of the eClinicalWorks software also connect. The network uses an open architecture built from the Direct or NHIN network. That was one of the smartest standards and sharing capabilities that has come along in a while. You do not need the CONNECT protocol to connect to the NHIN and many have developed their own interfaces such as this one. When you stop and think about it, what do we do today, email and the NHIN network with an interface handles it nicely. Again the beauty of this is that any doctor can connect, regardless of whether they use eClinical or another medical records system. BD
Here’s a video that explains a little bit more on how it works.
Even HealthVault set up for the Direct project back in February of 2009 and again there are many more that wrote their interface to the Direct program. BD
This peer-to-peer network will support national standards or networks and will be Nationwide Health Information Network (NHIN) Direct compatible, making interoperability affordable. Members that Join The Network are able to:
This open network can be accessed via www.jointhenetwork.com or www.p2popen.co
http://www.heraldonline.com/2012/09/17/4267839/eclinicalworks-launches-join-the.html
Once again we have “big” headlines here again about how hospitals and doctors bill Medicare. Sure there are absolute fraud cases and better use of analytics can certainly help identify patterns and bring those to light for investigation but overall that’s a small portion of the process. Again with HHS using their new software to identify patterns this should help with those cases. Now we get to the battle of the algorithms again with codes and what is actually being done at hospitals and doctor’s offices. 
You can read the entire article in it’s entirety and see some good points made. You do have to also remember there are the “consultants” that work with hospitals to show them areas to where they can increase revenue and save money. Many times too the consultants will quote some type of percentage figure with their sales pitch on how much additional revenue they are missing out on. This article misses the input there completely and whether or not they are right or wrong they exist and an entire industry exists because of this factor. I don’t know where the author got their information but he/she quoted that a medical records company is also touting higher reimbursement with using their system which is kind of unusual unless there’s a big focus on revenue cycling and that may be a separate module for purchase. I wrote about it back in October of 2011.
anymore about billing because most of the times there’s no good guy/bad guy here, just interpretations. One doctor says due to his medical records system he spends more time evaluating patient care and thus so does that deserve more money? You would have to be living under a rock not to realize the additional data that doctors review today compared to the past and they do spend more time and do a better job, but again the antiquate compensation systems sometimes look at these situations as upcoding, when in fact it may not be. In the news last year we had Prime for one example with one billing code and with automated coding how did this happen? Oh we go back to the queries and coders again, it is what it is when automated. Actually the companies that are set up to “just bill” that are fraudulent end up being better codes than doctors and hospitals as that’s their only focus as they don’t see patients and just work numbers.
Sometimes again how much money are you chasing and what would be the return, zero of there’s no fraud or mistakes so unless one is at least chasing a million or so in suspected fraud, does it make sense to chase everything out there? Somewhere along the line someone needs to make some kind of a business decision and it might be to check the 3rd party consultants to see what they are selling too. When you go back through a little history here we had the United/Ingenix cases too where for 15 years doctors we short paid with the use of data base that low balled the customary fees, so this 
certainly brought an awareness around as well with looking around by doctors and hospitals to make sure they are not short paid or missing money. The algorithms and the lawsuits that followed set the stage here. As time moves forward, many forget about this and how algorithmic formulas were used to short payments and make profits for the corporate insurer. We don’t want that again. It is also worth nothing that United has ton of analytics subsidiaries that work out there today and they are hiring folks to analytics at a rocket speed. So again who set the stage for all of this? United also owns a bank and the other day a question popped into my head in wondering how many “quants” might work there.
If you read the news then you know that doctors and hospitals are being cut right and left too with contracts from insurers so when the money goes down in some areas it’s a matter of survival to replace income and if there are “legal and “document” billing codes with Medicare, well you get the picture, and again I’m not talking about the absolute “fraud” cases as those with insurers or Medicare should be investigated and brought to justice.
Then we also have this, the re-admissions algorithms which is not more than just swapping money back and forth, although there are some great strides made here with improvements as we study data, but the cut and dry algorithmic formulas are just a showing of the lack of using analytics properly in my opinion as when this plays out in the news today, we have these “bad guy” OMG headlines stating doctors and hospitals are doing nothing about this which is not true. The analytics used by insurers are not without fault or do the job 100% either. On these fines for re-admissions you find some of the best healthcare facilities in the US, so what’s that tell you? An algorithms is not complete answer. Like I keep saying, folks are algo duped.
Basically it’s crap journalism for ratings on some of this and the naïve public thinking that some algorithms are going to be 100% of this solution…you have to give that a chuckle as we have so much “Algo Duping” going on today. It’s the intelligence you get from studying the data and not a black and white algo that makes the difference. You can see this in the $3 million dollar carrot program that Heritage has going, they think an algorithms is going to be the answer…information will help but look at the site too on how they go about it, looks a gaming website. Again the information is valuable but no black and white algorithm for a solution and again naïve beliefs here at work and former HHS secretary Leavitt is all in it so again has he been duped too? Just talk to folks who write code about the logic and sense behind a lot of this and you will see much different side than what you are sold via media.
profits like HCA, certainly it would call for a look at their coding to ensure everything is done correctly. If everything is systematic and legal then it open doors for others, but it depends on how they are going to interpret the algorithms and formulas an someone has to make a decision on the “value of time” with added Health IT complexities in care if the hospitals and doctors are worth the money if you want to get down a real simple question.
Don Berwick was right with his assessment of the system, you pay more when folks do more and charge the piece and that’s you get and now stories are in the news about “stents” that may not have been needed and that area for sure should be looked at as now we have gone beyond just billing here and have safety and patient care involved.
So before you get all enraged about this article and thinking doctors and hospitals are thieves, take another look as you may have been Algo Duped here. More time spent, the higher the code and it’s always been this way with a HPI and several other components that enter into a patients chart as they document the work. I think now Medicare has to take a look at their side of this and somewhere along the line see what they are chasing too and go after those where it makes sense with fraud and where upcoding beyond the normal office visit code 99213 and other codes still appear to be legal to bill as when the additional time is spent and also I hear doctors say too it does take more time today as I can cure the young patients but with the older population they get more treatments with chronic disease care than cures so does this earn them a 99214? Sound like it’s a big question to ask as all the consultants will tell you the documentation needed to use it so the bill goes through, its what they do. BD
Medical groups say the shift to higher codes reflects the fact that seniors have gotten older and sicker, requiring more complex care. “I rarely have a person who comes to me for a cold,” said Brantley B. Pace, who has practiced family medicine for more than a half-century in Monticello, Miss., and whose bills were among the highest in the sample of claims.
Although patients at individual practices such as Pace’s may be older and sicker, many health-care experts say the age and health of Medicare beneficiaries as a group has not changed, and research supports that contention.
Doctors, hospital emergency rooms and many other providers are paid by Medicare based on a series of billing codes that are designed to reflect the complexity of the treatments delivered and the time required. For doctor visits, the lowest code, which pays about $20, is for minimal problems requiring a few minutes’ time. The highest code, which pays about $140, is for more serious cases that typically require
40 minutes of face-to-face contact.
Many doctors and hospitals say that computerized medical records encourage the move to higher codes because the software makes it easier for providers to quickly create documentation for charges. One electronic medical records company predicts on its Web site that its product will result in an increase of one coding level for each patient visit, potentially adding $225,000 in new revenue in a year.
Thomas Weida, a family physician in Hershey, Pa., said that as a result of his switch to electronic records, he typically spends an additional five minutes with patients reviewing their medical information and prescribing treatments. That alone could justify higher billing codes in many instances, said Weida, a medical coding expert for the American Academy of Family Physicians.
http://www.washingtonpost.com/national/health-science/doctors-others-billing-medicare-at-higher-rates/2012/09/15/27047458-f2fa-11e1-adc6-87dfa8eff430_story_2.html
Details at the link below..thank you.
If you find something there that helped you
and you want to say thanks..here’s the tip jar…
Any contributions are always appreciated!
Math–This Could be a Subject for Michael Moore to Explore and Document In a Movie
Screenings Too–Killer Algorithms Part 12–Medical Billing Codes Style
Assessing Consumer Credit Scores–Attack of the Killer Algorithms Chapter 21 With Flawed Data
Duping” Society Combined With A World of Rogue Algorithms & Flawed Data Continues In Markets As Seen With Knight Capital This Week-Attack of the Killer Algorithms Chapter 36
Study Fraud With EHR Technologies, Namely Medical Records/Billing Software Used by Hospitals– HHS And SEC Continue Getting Their Non-Algorithmic Fannies Kicked–Attack of the Killer Algorithms Chapter 46
SilverScript Senior Drug Program Sanctioned by Medicare Until the Payment And Billing Algorithms are Cleaned Up-Killer Algorithms Chapter 53
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