Medical Quack

Covered California Insurance Participants to be Risk Assessed With Individual Scores To Be Sent to CMS By Anthem–Appears To Be No Opt Out For Privacy, Payback Time For the ACA Subsidies As Feds Get Your Scored Data

<p>When you read this article entirely, it’s like what in the heck is this now?  Seriously read the analytics that will be taking place and the company Anthem has contracted with of course is seeing some big dollar signs.  Your medical records are up for review and risk assessment from this third party company Inovalon, Inc. to conduct the “chart reviews”.  It’s supposed to run for a year on each patient.  That’s a lot of data and there won’t be an ROI on this at all and all those patients who’s medical records are “scored’ now will have the government involved in having a copy of such.  We are completely over scored in the US and this type of activity leads to greater inequality.  I don’t care what the purpose here is, once CMS has this data, what else will they do with it is the question as it won’t stop with just this study.  This is not going to stabilize premiums.  If you are going to do this, just set up an risk assessment pool.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/09/health-insurance-business-is-driving.html">Health Insurance Business Is Driving Itself Off a Cliff & Doesn’t Know When to Stop With Collecting, Analyzing and Processing Non Relevant Data With Little Or No Impact On Giving Good Care..</a></h5>  <p>This is a shame as those who enrolled are not getting any privacy here at all.  Also remember Anthem and the big data breach? <img align="right" src="http://lh6.ggpht.com/-4yKeXZOGJWY/U2hj_S1gpvI/AAAAAAABKL4/8L1D77wzoQY/image%25255B20%25255D.png?imgmax=800" style="float: right; display: inline" /> Exactly the company and vendor assistant you want doing this right?</p>  <p>Is it any wonder people aren’t taking care of their health, they’re too busy trying to stay under the radar.  Education works much better every time rather than another big data mine to help the insurance company.  They’ve buried themselves in analytics that don’t pay off over the years.</p>  <h5><a href="http://ducknetweb.blogspot.com/2015/02/anthem-data-breachcrooks-want-to-sell.html">Anthem Data Breach–Crooks Want to Sell Data Too–The Impact of the “Data Selling For Profit Epidemic” That Exists in the US With Scoring Consumers Removing Access and Human Dignity</a></h5>  <p>Besides the medical record audit you can probably also expect this proprietary medication adherence nonsense score to be added.  We are not talking normal adherence monitoring here, like seeing if someone filled a prescription, etc. we are talking 300 metrics that have nothing to do with taking medications.  If you are a male, you get dinged so flawed data with this portion of the audit as you can count on CMS wanting every tiny bit of data as they are suffering from what I call “Stat Rat Fever” after years of Untied Healthcare mentoring their models and sadly are headed in the same direction that hurt the VA in this effort. </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/06/medication-adherence-predictions-enter.html">Medication Adherence Predictions Enter the World of Quantitated Justifications For Things That Are Just Not True, Members of the Proprietary “Code Hosing” Clubs Out There Destroying Your Privacy</a></h5>  <p><strong>This is the trade off for subsidies, you get your data traded and sold all over the place.</strong>  They want the data to help manage you and your care and thus far outside of the obvious of what works, they are digging a data hole here of no return and this will be reflected for all to share in the cost of this expensive project.  Doctors are going to love this one as they are already are over loaded with red tape to make room for some data gathering folks, right? <strong>  The way this is set up is a complex accounting nightmare as you are dealing with people and trying to use linear analytics when the real world situation is non linear.</strong>  People don’t work that way so we have a world of broken software models that people keep trying to force upon others.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/05/people-dont-work-that-way-world-of.html">“People Don’t Work That Way” A World of Broken Software Models That Don’t Align To the Human Side,Too Much Push At Times With Only A Proof of Concept That Fails in the Real World..</a></h5>  <p>Again, none of this is related to actually giving and getting care, just a bunch of folks in DC that live in virtual worlds and hang on to every statistic they can get their hands on, broken models included.  Just one more way the government is putting a dollar sign on your head to predict how expensive your care could be and there will be plenty of error bars by the time the quants run through and create some wild ass models based on this.  BD  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/05/va-crisis-just-tip-of-iceberg-as-us.html">VA Crisis Just The Tip of the Iceberg As US Needs a Full On Healthcare Culture Change Everywhere To Get Back In Touch With the Real World of Patients…</a></h5>  <p>   <hr />In July, Anthem Blue Cross will begin chart reviews on enrollees who purchased Affordable Care Act (ACA)-compliant plans in either the individual and small group insurance markets (both on and off the exchange, known as “Covered California”).</p>  <p>The records requests are a result of the commercial risk adjustment program created by ACA Section 1343. The primary goal of the risk adjustment program is to spread the financial risk borne by payors more evenly in order to stabilize premiums and provide issuers the ability to offer a variety of plans to meet the needs of a diverse population. </p>  <p>During the risk adjustment audit, Anthem will review diagnosis code data obtained from the medical records of ACA-compliant individual and small group patients. This is not a typical audit on the physician practice; rather, Anthem is looking to identify conditions/illnesses that demonstrate patients who are at risk for being sicker or patients who are predicted to be healthier. This information will be utilized to determine a risk score, which is a measure of how costly an individual is anticipated to be, and will be reported to the Centers for Medicare and Medicaid Services. If at the end of the annual risk adjustment assessment, Plan A has a lower risk average score than Plan B, then Plan A has to issue a payment to Plan B. In a nutshell, the program is intended to prevent payors from cherry picking only healthy enrollees.</p>  <p><a href="http://www.cmanet.org/news/detail/?article=anthem-blue-cross-begins-medical-chart">http://www.cmanet.org/news/detail/?article=anthem-blue-cross-begins-medical-chart</a></p>

Covered California Insurance Participants to be Risk Assessed With Individual Scores To Be Sent to CMS By Anthem–Appears To Be No Opt Out For Privacy, Payback Time For the ACA Subsidies As Feds Get Your Scored Data

When you read this article entirely, it’s like what in the heck is this now? Seriously read the analytics that will be taking place and the...

Monday, June 29, 2015

Hospital News Rigging Now? UPMC and Local Paper In a Dispute Over What’s Covered in the News, Takes Paper Out of Hospital Gift Shops…

<p>Here we go again, and advertising from the Pittsburgh newspaper has also been cut, but the article states that has gone on for a few years with disputes over what has been covered in the news.  This doesn’t surprise me as “news rigging” is very much out there today.  You can read comments<img align="right" alt="image" border="0" height="202" src="http://lh3.googleusercontent.com/-7kMSQAlMh4E/VZAa_tmeGyI/AAAAAAABMaA/Ic-7i_PqWjA/image%25255B10%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="215" /> on Twitter about “knock off” news a well, where a bot perhaps takes a human journalists written article, re-rewrites it to avoid all plagiarism (the bot is this smart to to do this in a couple minutes) and off you go with a brand new knock off news article.  There’s always been disputes here and there over news articles but this one is to the point of being entirely ridiculous.</p>  <p>News agencies everywhere are facing tight budgets so it’s easy enough for UPMC to play the money card with cutting advertising.  That’s why we are seeing so much more news written by bots instead of humans, it’s a cost issue.  Hospitals of course are out looking for every dime they can get as well.  To make matters worse the labor situation at UPMC has raised a lot of eyebrows and for a while and I’m not sure if this is still the case but UPMC was the top profiting making hospital in the US.  That’s a big deal when the areas serviced are not wealthy neighborhoods in count.  You can read more on that topic below to where employees were really hit hard with a data breach, accounts were drained and so on.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/04/upmc-medical-center-workers-protesting.html">UPMC Medical Center Workers Protesting Low Wages While Investigation of Employee Data Breach Continues With Fake Tax Returns and Bank Accounts Drained..Double Whammy</a></h5>  <p>Circling back to the other side with automation that I mentioned above, it’s hard to get good news sometimes when everything out there starts looking the same.  I am really noticing that myself and I try hard to look for the Human written news out there and refrain from taking in a lot of bot news.  Anytime you read one of these studies with information from Medicare for example that are boring as heck, a bot probably wrote it.  That’s what bots do best, take a data base, spreadsheet container of information and write a story about the numbers and the authors program what impact they want where and so on.  The bots pretty much take care of the ridiculous stat news as well that we see constantly that have no statistical value even.  So next time you see these big headlines written about some Medicare data, you can pretty much figure you’ve been “bot fed” some news there. </p>  <p>UPMC is a great medical center for those who can afford it as I read.  The city I read finally put the bed the lawsuit they had filed against the hospital wanting to take back their non profit status.  We have that going on in California with Blue Shield insurance too, state says they will file and pay taxes due to excess levels of profits and cash stash reserves.  Who says non profits don’t make money, right?   Hospital inequality is also an issue people don’t want to discuss either in the US and I wrote about that a while back.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/03/hospital-inequality-yet-one-more.html">“Hospital Inequality” - Yet One More Growing Issue With Healthcare In the US..</a></h5>  <p>Here’s another link from the past on the “profit issue”.</p>  <h5><a href="http://ducknetweb.blogspot.com/2013/09/legal-battle-with-city-of-pittsburgh.html">Legal Battle With City of Pittsburgh and UPMC Medical Center Heating Up Again–Non Profit Hospital Pays No Property Taxes & Gets $200 Million Dollar Tax Break With $1 Billion in Excess Profits</a></h5>  <p>We have a lot of news rigging going on today and it’s bad as myself and others too complain you can’t figure out<img align="right" alt="image" border="0" height="195" src="http://lh3.googleusercontent.com/-UiHzGfJQ1gs/VZAbBSAM-2I/AAAAAAABMaI/ETWOnegiaqM/image%25255B9%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="257" /> what’s real and what’s click bait out there as well.  You have a lot of fake grass root campaigns so too many, consumers ignore almost all of them as we are worn down with healthcare in every corner of everything we do today.  We’re burned out on what to eat, what to say, how to do this and how to do that..complexities are wearing down the heart and soul of the US consumer and it’s modeled that way to occur.  Speaking for myself I’m running as fast as I can to stay away from most advertising with a few exceptions.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/04/news-rigging-has-arrived-astroturf-and.html">News Rigging Has Arrived! Astroturf and Manipulation of Media Messages-TED Video About “The Fake Grass Roots” Of Big Pharma and Other Campaigns That Fool and Fool Again…</a></h5>  <p>Bottom line is the hospital system is saying we don’t like your news coverage and we’re going to ban you from three gift shops and hurt some sales for you and “we’ll show you”…a bit juvenile is it not?  It is just one more example of the big institutions in the US telling the small fries what they can and cannot do.  If UPMC were a for profit they would probably be in the stock buy back business, like HCA Health in doing…7.7 Billion of them.  Hospitals have to finance those too so check your bill in the future:)  The UPMC battle seems to make national news every day and again the stark comparison of the clinical side to the business side of UPMC is startling when you read the news and it’s not all in that Pittsburgh Paper they have banned from gift shops either.  BD</p>  <h5><a href="http://ducknetweb.blogspot.com/2015/06/for-profit-hospitals-like-stock-buy.html">For Profit Hospitals Like Stock Buy Backs Too–HCA Buying Back $7.7 Billion Worth of Shares Over 3 Years…</a></h5>  <p>   <hr />Some UPMC hospitals are banning the Post-Gazette from sale in their gift shops, a move UPMC spokesman Paul Wood said was precipitated by “fairness issues” in the newspaper’s coverage of the health system.</p>  <p>At least three UPMC hospitals -- UPMC Shadyside, UPMC Mercy and Children’s Hospital of Pittsburgh of UPMC -- say they will no longer sell the newspaper.</p>  <p><a href="http://www.post-gazette.com/business/pittsburgh-company-news/2015/06/24/UPMC-hospitals-ban-sale-of-Post-Gazette-from-their-gift-shops/stories/201506240066">http://www.post-gazette.com/business/pittsburgh-company-news/2015/06/24/UPMC-hospitals-ban-sale-of-Post-Gazette-from-their-gift-shops/stories/201506240066</a></p>

Hospital News Rigging Now? UPMC and Local Paper In a Dispute Over What’s Covered in the News, Takes Paper Out of Hospital Gift Shops…

Here we go again, and advertising from the Pittsburgh newspaper has also been cut, but the article states that has gone on for a few years w...

Sunday, June 28, 2015

Operation “Perception-Deception” Into Full Swing in the US, With Killer Algorithms, Algo Fairies, Algo Duping, The Grays, and Of Course, Flags As Consumers Confuse Virtual World Values With the Real World…

<p>What a week it has been so far as well as last week as well.  It is worrisome as to what the American Public perceives today as a “real” value and it’s not their fault for the “Perception-Deception” mania that is filling the news waves and causing folks to create and follow fake grass root campaigns.  There’s so many of them anymore that you can’t tell the difference between fake and real.  I write about this quite often as to me being a former code writer, it’s as clear as day but others it is not.  Folks who know how write code and create math models know the power of manipulation behind it, and they can do good things or they can manipulate spurious correlations for profit.  We sit it every day.  I see it coming straight out of the White House sadly with this addiction our government has to being “Stat Rats” with a bad case of “Stat Rat Fever”.  It’s how big business has groomed<img align="right" alt="image" border="0" height="100" src="http://lh3.googleusercontent.com/-j3rtTEzBB3w/VYugWZUQWXI/AAAAAAABMZg/CNEaZqu9ydc/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="283" /> everyone to believe in stats, no matter what they are.  </p>  <p>First off I don’t have a problem with Climate Control and measure that need to come into play but I do have a problem seeing the White House predict numbers to make case that nobody can predict as they are shooting themselves in the foot and make themselves look less credible and that’s no way to get success from a campaign of such.  You can’t predict how many will die, get heart disease, asthma attacks and yet why do I see that?  This is the government who I expect more from, but here’s a link below from last year with the same type of “Stat Rat Fever” tone and it bugs me as Nobody can predict these numbers as much as they think they can.  One has to wonder are we back to the Gruber deal about calling the public stupid again?  Oh well…</p>  <h5><a href="http://ducknetweb.blogspot.com/2014/06/junk-science-appearing-everywhere-even.html">Junk Science Appearing Everywhere, Even The White House “PR Templated” Correspondence Creates Spurious Correlations…</a></h5>  <p>If you look around you are starting to see the folks caught up in “Stat Rat Fever” beginning to panic as they seem to be finding out there’s more to the real world than just meeting stat goals.  Some of these goals out there are just about impossible as they were built by people with “perceptions” on how they think things work, so a model gets built and in time it fails.  There’s no model that’s going to last forever either as they have to change with the times.  I don’t think our Congress gets this as the laws they pass they assume are to be permanent, but that’s not the case anymore.  As a matter of fact I have harped on this many times for them to restore the Office of Technology Assessment to get some help in understanding how this works.  They refuse to fund it and we live in the most complicated times ever and they continue to fool themselves and hurt us over and over due to once again “Perception-Deception”.  It’s everywhere.</p>  <h5><a href="http://ducknetweb.blogspot.com/2014/07/bill-to-restore-office-of-technology.html">Bill To Restore Office of Technology Assessment Was Defeated Again This Year As Congress Chooses to Remain In the Dark With Technology At A Time When Private Industry Is Doing Just the Opposite - “The Grays” Live On…</a></h5>  <p>Here’s a good book to read that helps explain what is real and what is not with how you get fooled over and over on the web.  If you scroll down to the bottom of this blog there’s what I call 4 essential videos that will help you make some sense of what’s going on out there.  We have a government that can’t even come to terms with the fact the the Affordable Care Act is largely run by the machines, even though they built it..scary indeed.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/06/virtual-unreality-maybe-good-read-after.html">“Virtual Unreality” - Maybe A Good Read After the Fake Facebook “Science” Report To Help You Figure Out What’s A Virtual Value and What’s A Real Value Out There</a></h5>  <p>Consumers are taking a real hosing today, and I call it “Code Hosing” as we have this obnoxious system of wanting to quantitate and score everything and everybody, but you know what, people don’t work that way.  Here’s a short clip from former Goldman Sachs Quant and author of a few books that tells you how models can cheat and behave badly.  He’s on our side if you will.  Video # 2 in the footer, is the full version documentary “The Quants of Wall Street” and they tell you the same thing about virtual values and the real world.  Mike Osinski is especially interesting to listen to in the video since he wrote the software that all banks used and abused for the mortgage scam.  “In software you can do something about anything and you end up in this virtual world but it’s the real world that counts, not living in a fantasy world of code”…</p>  <p><object height="244" width="425"><param name="movie" value="http://swf.tubechop.com/tubechop.swf?vurl=ed2FWNWwE3I&start=1700&end=1777&cid=6194999"></param><embed src="http://swf.tubechop.com/tubechop.swf?vurl=ed2FWNWwE3I&start=1700&end=1777&cid=6194999" type="application/x-shockwave-flash" allowfullscreen="true" width="425" height="244"></embed></object></p>  <p>Here’s a post I wrote over a year ago and republished it with a few updated edits, again to me it’s crystal clear on the failure of data mechanics logic with people.  We’re not algos being shifted through some stock exchange; however, that’s almost what the healthcare system is trying to to, “Stat Rat Fever”.  I’m all in for technologies that help in healthcare and breakthrough drugs, etc. but it’s not working that way for the American public.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/06/virtual-world-values-and-real-world-we.html">Virtual World Values and The Real World, We Have A Big Problem: People Can’t Tell the Difference Anymore as Perceptual Madness Grows to Further Accelerate Inequality…</a></h5>  <p>If you want more, there’s quite a few videos at the Attack of the Killer Algorithms page and you can book mark it and go back and watch when you have time as these are some people I learn from and they are smarter than me too.  Give it a chance and learn up as all the hope and prayers you may have, sadly to say won’t defy physics and the algorithms that are running the world.  Know what’s on the other side.  I can only put them out there and can’t change your perceptions but this is fact if you’re ready for it versus a fairy tale or some Algo Fairy stories.  We had enough of that with Kathleen Sebelius as head of HHS, so much that I created a name for it with the <a href="http://ducknetweb.blogspot.com/2014/04/secretary-sebelius-at-hhs-resigns-wrong.html">“Perception-Deception”..the Sebelius Syndrome</a> and it lives everywhere, at the SEC, Consumer Financial Protection Bureau and more.  </p>  <p><a href="http://www.ducknet.net/attack-of-the-killer-algorithms/">Attack of the Killer Algorithms (Videos)</a> </p>  <p>America is not America anymore as the horrific “scoring” of consumers that we experience is making everyone mad <img align="right" height="108" src="http://lh3.ggpht.com/-6HDDm04lOwA/Ts0zq-EuFHI/AAAAAAAA4d8/nMT-KL0JEDY/image_thumb%25255B12%25255D.png?imgmax=172" style="float: right; display: inline" width="232" />whether they know it or not but you don’t have opportunities like you used to.  Instead you have this huge number of “scores” that say “you can’t do that” or it’s your fault..”the score says”.   I know we have to have some qualifiers around but it’s gone way over the top and that’s what Quants will do when they get out of control.  If you have never been on the development or coding side of life, you’re always trying to make something better and you don’t take time as a developer to talk to the real world in your efforts you become completely detached from it.  I’ve seen it happen and experienced a little bit myself as it goes with the territory and people think they are better than you “because they can code”.  Everybody does not need to code and we have to not take advantage and code hose the consumers in this country who are doing something else in life.  </p>  <p><strong><u>It’s easier to keep fooling people than it is to convince them they have been fooled…words from Mark Twain</u></strong> and I think I can attest to that as I try my best to put the real world forward as I’ve live on two sides, in sales and marketing and as a coder so the two kick around in my brain and that’s what gives me a sense of what I call data mechanics logic.  I understand the coding process and then my brain switches over to think of how it will be used and marketed.  It hasn’t failed me yet.  Actually back in <a href="http://ducknetweb.blogspot.com/2009/02/kathleen-sebelius-kansas-governor-for.html">2009 I was scared half to death as when Sebelius and Deparle were brought in</a> I knew the accelerated coding and math models of insurers would run them over and they did, as both had big cases of “Perception-Deception”.  DeParle left early when things got tough and told us she has more fun with private equity and now sits on the board at CVS raking in a lot of money.  So here you go, Perception-Deception and choosing what you want may not always be the truth.  Again, hope and pray all you want, and there’s nothing wrong with that either, but don’t expect any of that to undo what the machines are doing algorithmically, it won’t happen.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/05/privacy-duping-of-america-intangible.html">Privacy Duping of America-The Intangible Threat Model Has Changed Significantly-Companies Hide The Code On the Web, $180 Billion Dollar A Year Business, Welcome to The Duperville World of Inequality..</a></h5>  <p>So now at the end we the perceptual madness of a flag.  It’s sad to see the likes of Wal-Mart getting involved here as it’s political.  They want attention and when you think back to the big CVS dupe, same thing. <strong> CVS jerks you around with or without cigarettes and nothing changed so the “symbols” are a distraction so the machines and new code continue to run</strong>.  It’s that simple so we may get rid of the Confederate flag but it’s down to <strong><u>“Perception-Deception”</u></strong> again and the Scoring of American with algorithmic processes that tag numbers on your head, denying you access with “secret scores” continues.  Look at how blatant Express Scripts is with their spurious correlations, made an infographic and proud of their spurious stuff as the public is fooled and they make money.  They all sell your data too and don’t care if it’s correct or not as bad data gets the same price as good data.  Here’s CVS announcing “we’re selling your secret scores” that of course you can’t have or see.  If you are not paying attention, you’re living in Duperville, sadly. <img align="right" alt="image" border="0" height="98" src="http://lh3.googleusercontent.com/-ZHaDVZmMiWg/VYugXgGaK9I/AAAAAAABMZo/DWyQzFu3BxI/image%25255B7%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="261" /></p>  <h5><a href="http://ducknetweb.blogspot.com/2015/04/cvs-to-share-more-medication-adherence.html">CVS to Share More Medication Adherence Love With New Contracts–Will Have More Data to Sell…</a></h5>  <p>Look on the web too with our government leaders just running around posting a lot of selfies, and what’s up with that?  I think they do a lot of that when they are overwhelmed and they too suffer Perception-Deception.  I just think they’re kind of nuts myself but again what it is in the virtual world values, a selfie, a flag..what are you doing with all these fake grass root campaigns that change nothing.  I know they are a good way to vent and relieve some frustration but in the long run, that’s about all we get from all of it.  </p>  <p>Anyway as I always try to do is encourage people to look at both sides and don’t be duped if you can avoid it.  It’s not a nice world out there and we get almost next to nothing with any support from the government these days.  They can’t create jobs here and can’t model what’s needed as again this disease of “Perception-Deception” lives on and nothing gets done.  We may rid the US of the Confederate flag, an object but when you look back at what was really accomplished…said to say it will once again be a lot “nothing”.  The country is just selling us down the river as they too suffer big from “Perception-Deception” and just can’t do a damn thing with the exception of maybe promoting more “Stat Rat Fever”, and that’s about all I see anyway.  BD  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/05/privacy-duping-of-america-intangible.html">Privacy Duping of America-The Intangible Threat Model Has Changed Significantly-Companies Hide The Code On the Web, $180 Billion Dollar A Year Business, Welcome to The Duperville World of Inequality..</a></h5>

Operation “Perception-Deception” Into Full Swing in the US, With Killer Algorithms, Algo Fairies, Algo Duping, The Grays, and Of Course, Flags As Consumers Confuse Virtual World Values With the Real World…

What a week it has been so far as well as last week as well. It is worrisome as to what the American Public perceives today as a “real” val...

Wednesday, June 24, 2015

Medication Adherence Predictions Enter the World of Quantitated Justifications For Things That Are Just Not True, Members of the Proprietary “Code Hosing” Clubs Out There Destroying Your Privacy

<p>This is just taking this a little too far and we know when you let Quants go wild, they will go, and go and go and quantitate and create spurious correlations and sell and market you on the fact they they have value and they do not.  If you read around the web enough there are many Quants and mathematicians that warn about this.  Go to the foot of this blog and watch the video from Charles Siefe, Mathematician and Journalist from NYU as he gives you the straight stuff. </p>  <p>Did you know that the data selling business is worth $180 billion a year?  It doesn’t matter to the data sellers as bad data gets the same money as good data and nobody does a “data sniff” and all they do is look at the “scored” outcomes.  We’re tire of being scored <a href="http://lab.express-scripts.com/insights/adherence/infographic-predicting-rx-nonadherence"><img align="right" alt="image" border="0" height="224" src="http://lh3.googleusercontent.com/-WTU_WavuGLg/VYjYaFce1MI/AAAAAAABMZA/DCNNtafnZm8/image%25255B8%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="352" /></a>into corners to where we can’t escape and get denied access at every turn.   </p>  <p>Focus in on the  <a href="http://lab.express-scripts.com/insights/adherence/infographic-predicting-rx-nonadherence">infographic here provided and marketed by Express Scripts</a> and look at what constitutes a bad nick with medication adherence.  <strong>I about fell off my chair reading this as it’s false.</strong>  Certainly monitoring and seeing if patients fill their prescriptions is part of watching for non compliance, but when you get a nick for being a male patient with a female doctor?  Give me a break!  <strong>Crap you get dinged if you have “children in the household” so come on this is way over the top beyond what would be considered normal monitoring and interventions, this is about making money.</strong>  </p>  <p>Oh but it gets better, read on and this is just the infographic and what they published. <strong>You can bet there’s some racial segmentation in there but again it’s all proprietary and we’ll never know.</strong>  Why should we trust these algorithms when we can’t verify for accuracy.  Gee I thought the bogus FICO was bad but this is really stretching it and I might add that Optum is doing the same thing, and all of this predicting occurs when you refill or fill a prescription.  Do they sell these scores, of course they do and make money.   FICO by the way says all they need is a name and address and they can score anyone on medication adherence…come on what kind of bridges are they selling here and what type of flawed data is reviewed.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/06/fico-medication-adherence-scoring.html">FICO Medication Adherence Scoring Should Be Banned As It’s Quantitated Justifications for Profit That Hurts US Consumers Using Proprietary Algorithms That Cannot Be Replicated For Accuracy or Audited</a></h5>  <p>Now I realize the value of data and how it can help us as I used to write software, but darn we’re over the edge with the extremes in trying to manage people to the inth degree of like what scientists use when looking for genomic targets in their research.  <strong>People have to be able to live and exist without unnecessary algorithmic scoring and we don’t have that in the US anymore.</strong>  We have been so duped into thinking any model or math formula is good for us and it’s not.  We have gone too far with all of this.  Certainly some monitoring and intervening when people don’t fill prescriptions, sure ask why but again to have what I see here as part of the 300 metrics used is insanity, especially when you see what some of the samples are.  Pretty soon very few will meet the parameters set forward as that’s how queries work when you keep refining them over and over.  </p>  <p>“Not using home delivery of drugs” a nick for medication compliance, and if that is not straight out marketing I don’t what is to get more business in the mail.  That has nothing to do with how people take their pills and where they get them<strong>.  I had a pharmacist talk to me recently, appalled at the idea of now getting lists of patients with 5 star ratings relative to medication adherence!</strong>  Of course the pharmacists are beat up to get more 5 stars to keep their reputation in tact.  So we are not about education now, but back to “scoring” again and quantitating something that not meant to be quantitated in this fashion.  Drug companies love this stuff as when drug sales are down they go pull a medication compliance study and blast it out there to blame consumers, you see it all the time.  </p>  <p align="left"><img align="left" alt="image" border="0" height="404" src="http://lh3.googleusercontent.com/-U0fHNHM3Vvo/VYjYc7peUgI/AAAAAAABMZI/N5v7HrnJd2c/image%25255B3%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: left; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="487" /></p>  <p> </p>  <p> </p>  <p> </p>  <p> </p>  <p> </p>  <p> </p>  <p> </p>  <p> </p>  <p> </p>  <p> </p>  <p> </p>  <p> </p>  <p> </p>  <p> </p>  <p> </p>  <p>The World Privacy Forum wrote a great report called “The Secret Scoring of America” as they don’t have this extreme in other countries and we stick out like a sore thumb with such models that are there for profit.  Heck the White House has cited this report many times, but that’s about all they get around to doing is “citing” it.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/04/world-privacy-forum-report-scoring-of.html">World Privacy Forum Report - The Scoring of America: How Secret Consumer Scores Threaten Your Privacy and Your Future - One Big Element that Fuels the Continued Attack of Killer Algorithms & Demise of the Middle Class Creating Profiteering And/Or Denial of Access</a></h5>  <p>As the models do become more extreme though, it is easier to see the duping effect as it gets to the point of being flat out nonsense and eventually wears at the “self worth” of people and makes them insecure to where they don’t know what common sense <img align="right" src="http://lh5.ggpht.com/-PC0UBew423k/U1iD1aE7lwI/AAAAAAABKCQ/AuyWjFk_CD8/image%25255B3%25255D.png?imgmax=800" style="float: right; display: inline" />is anymore.  That’s the danger of trusting proprietary algorithms and queries to where nobody else gets to verify for accuracy, no peers here, just money.</p>  <h5><a href="http://ducknetweb.blogspot.com/2015/03/its-time-to-look-at-some-of-proprietary.html">It’s Time To Look At Some of the Proprietary Code Running in the US–Too Many Companies and Banks Are Playing “Techno-God” Saying “Trust Me” With the Numbers and Stats…</a></h5>  <p>Look how doctors get scored to be fired, and their “scoring” is a big secret just like ours, you are not allowed to know or the game’s over.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/08/the-secret-scoring-of-americas.html">“The Secret Scoring of America’s Physicians” - Algorithmic Math Models For Insurance Network Contractual Exclusions, Relating to MDs Who See Medicare Advantage Patients..</a></h5>  <p>A few years ago a banker and I had this conversation and darn if it’s not true.</p>  <h5><a href="http://ducknetweb.blogspot.com/2013/02/half-of-analytics-investments-by.html">Half of Analytics Investments By Companies and Banks Will Be a Waste–What Do We Analyze with Big Data and Does It Have Value–Some Algo Fairies Would Do Better at Disneyland…</a></h5>  <p>Who knows the PBMS are probably buying your credit card data from Argus, just the banks and the insurers do to score you.  Read this link below and see how our own Consumer Protection Financial Bureau is buying that same data to create files on us.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/08/argus-analytics-produces-share-of.html">Argus Analytics Produces “Share of Credit Card” Data On Consumers - Digs Up The Dirt on Your Credit Card Behavior Patterns-US Consumer Protection Agency Is A Client-We Are Paying for Richard Cordray’s Slow Education Process</a></h5>  <p>Read about insurance companies using voice software to “score” your state of mind while you are on the phone with them, and yeah that’s a score to be sold too.</p>  <h5><a href="http://ducknetweb.blogspot.com/2014/05/this-call-may-be-recorded-for-quality.html">“This Call May Be Recorded for Quality Purposes”..Heck Not, Millions of Algorithms Have Been Turned Loose to Listen To and Analyze Your Voice When You Talk To Your Insurance Company As Algorithms Continue To Take Over the World…</a></h5>  <p>Again the US sticks out like a sore thumb as our inequality keeps growing while a little relief is being is taking place in other countries with data selling.  No other country “scores” the crap out of their citizens like the US and denies access.  Again look at the image at the top, even if you are just a “male” you get a nick on the scoring and that tells me that there’s more than likely all kinds of racial queries included here as well, but again it’s a secret scoring system and you do not get to see it or know how they do it.  This indeed does more harm than good and makes bit profits for the data sellers.  IMS is a huge healthcare data broker, making so much money they had an IPO last year and of course they buy all the PBM data and rework and repackage it for sale.</p>  <h5><a href="http://ducknetweb.blogspot.com/2014/01/need-any-more-proof-that-data-selling.html">Need Any More Proof That Data Selling is An Epidemic Out of Control IMS Health Files for an IPO And Holds 85% of the World’s Prescription Data</a></h5>  <p>There’s a good book coming out next year called “Weapons of Math Destruction” and Quant Cathy O’Neill is the author and you can watch one of her videos in the footer of this blog, she gets it.  She used to be a Quant at a Hedge fund and did financial models for a short while until she realized how too many bad models were being justified and hurting people.  So again, medication adherence scoring is as about as far out there as you can get with going way over the top with proprietary formulas that are there to sell and make money, nobody gets to verify any of this nonsense and consumers suffer.  And here’s CVS, look at this, ready to sell those secret scores about you to make money, at the link below.  BD</p>  <h5><a href="http://ducknetweb.blogspot.com/2015/04/cvs-to-share-more-medication-adherence.html">CVS to Share More Medication Adherence Love With New Contracts–Will Have More Data to Sell…</a></h5>

Medication Adherence Predictions Enter the World of Quantitated Justifications For Things That Are Just Not True, Members of the Proprietary “Code Hosing” Clubs Out There Destroying Your Privacy

This is just taking this a little too far and we know when you let Quants go wild, they will go, and go and go and quantitate and create spu...

Monday, June 22, 2015

CMS Chasing Wild Virtual Horses-A Big Distraction on the Hope of Finding Some “Algo Fairies” By Giving Entrepreneurs Access to Medicare Claims and Other Data…Marketing & Astro Turfing “The Sebelius Syndrome”..

<p>One thing I think that can safely be said is Andy Slavitt, a one time Goldman Sachs banker and United Healthcare Subsidiary CEO of Ingenix who tons of folks sued for flawed calculating algorithms on short payments on claims is trying to divert some attention from this fact.  It was interesting to watch this whole scenario as the name Ingenix got to be so bad out there that Untied had to change it to Optum.  It was well known all over that their anti fraud algorithms showed too many false positives and thus the the law suits.  So this looks to be an attention diversion<img align="right" alt="image" border="0" height="133" src="http://lh3.googleusercontent.com/-KnEbsu8fGQc/VYGDSamMUMI/AAAAAAABMYg/fq_fJVG4A0s/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="270" /> to wrap everyone up once again into the data bubble that this is going to create some big solutions, it’s not.  As a matter of fact it comes right back around to the fact that people can’t tell the difference between virtual world values and the real world and Untied for years has cashed in and profited on that.</p>  <h5><a href="http://ducknetweb.blogspot.com/2015/06/virtual-world-values-and-real-world-we.html">Virtual World Values and The Real World, We Have A Big Problem: People Can’t Tell the Difference Anymore as Perceptual Madness Grows to Further Accelerate Inequality…</a></h5>  <p>Now here we go again and sure come queries will reveal some new <strong><u>Stat Rat numbers</u></strong> but mostly this is a smoke screen to have folks jump in to the fake “hope” belief when in fact algorithms and numbers just execute as programmed.  Besides,<strong> <u><em><a href="http://ducknetweb.blogspot.com/2014/09/optum-labs-add-four-additional-data.html">Optum Labs</a></em></u></strong> has had a couple years running at this and look what they have produced?  Not much, some number crunches and that’s about it from all we have heard.  This latest effort in digging through claims is not going to save the world or probably even a scant amount of money, but again a good side show to keep those who don’t know the different in a loop of false hope.  Here’s a case that just settled recently.  Those were a good example of  Mr. Slavitt’s algorithms at work when employed at United.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/05/medical-society-of-new-york-wins-down.html">Medical Society of New York Wins Down Coding Algorithm Case Against United Healthcare, Short Paying Doctors Again–Killer Algorithms For Big Profits Live Everywhere…</a></h5>  <p>Right now many of CMS models are failing and there’s been a number of years of United mentoring CMS and HHS on their models and this I have been told from former Medicare employees that this went on for years.  We do I guess, need to keep the <strong><em><u><a href="http://ducknetweb.blogspot.com/2014/04/secretary-sebelius-at-hhs-resigns-wrong.html">“Sebelius Syndrome”</a></u></em></strong> alive for fake numbers for profit to keep rolling as that’s what’s going on in healthcare and otherwise.  </p>  <p>Take at look at the SEC as well.  What do you have there, a lawyer who’s totally lost in the world of technology<img align="right" alt="image" border="0" height="115" src="http://lh3.googleusercontent.com/-B9sWEibuOTQ/VYGDTBMDuPI/AAAAAAABMYo/_ud2IHIzukY/image%25255B7%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="236" /> and can’t find enough or adequate verbiage to regulate as she doesn’t get what’s really going on, so the SEC too suffers from the <a href="http://ducknetweb.blogspot.com/2014/04/secretary-sebelius-at-hhs-resigns-wrong.html"><strong><em>Sebelius Syndrome</em></strong></a> of behavioral perceptions that are just not true but technology allows such perceptions to be built, marketed and rigged by the news. </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/04/news-rigging-has-arrived-astroturf-and.html">News Rigging Has Arrived! Astroturf and Manipulation of Media Messages-TED Video About “The Fake Grass Roots” Of Big Pharma and Other Campaigns That Fool and Fool Again…</a></h5>  <p>Look at the game played yesterday with “news rigging” on how insurers just played around with the talk of one buying another, nothing solid but they were able to play on the fact that Humana who is actually for sale to grab the jugular of the stock bots and the madness pursued as insurance companies found a dirt cheap way with the chat to increase the price of their stock in a day.  The trading bots that read the news don’t know the difference and it was total game.  </p>  <p>Again, Andy Slavitt I believe has a real need to divert things from his past as he had so many lawsuits and with his roots in banking, well what does that leave your to think what his future is running Medicare?  Trust him, not in a New York minute to be honest in my opinion as his meddling and algorithms formulas from the past speak loud and clear, just like models used by banks. <strong><u> To understand how this works, scroll down and watch the Quant documentary in the footer of this blog as it talks bank models but the same math models with a little variation are running healthcare as well.</u></strong>  Mr. Slavitt does healthcare by the algorithms, not by the person or care they get, history shows it.  We just have another <strong>data goose chase here</strong> that will end up with queries that may be interesting here and there, but more so ones that will eventually lead these entrepreneurs to make money.  </p>  <p>I have no problem with good data creating good solutions but this is not one you can hang your hat on at all, it’s just more of what you could call some fake grass root campaigns and the public once again is being lead on to believe there’s more use to this than there really is.  We just see CMS going right down the same path that got the VA into trouble, a world of Stat Rat Fever to where nobody is doing data sniffs at all, just acting on queries.   I wrote about that observation a while back.  BD    </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/05/va-crisis-just-tip-of-iceberg-as-us.html">VA Crisis Just The Tip of the Iceberg As US Needs a Full On Healthcare Culture Change Everywhere To Get Back In Touch With the Real World of Patients…</a></h5>  <p>   <hr />For the first time, the Centers for Medicare & Medicaid Services will allow innovators and entrepreneurs to access Medicare claims and other <a href="http://www.healthcareitnews.com/directory/centers-medicare-medicaid-services-cms">CMS</a>data, Acting Administrator Andy Slavitt announced Tuesday at Health Datapalooza in Washington.</p>  <p>These entrepreneurs will be allowed to conduct approved research aimed at developing tools and technologies to improve care and benefit consumers, say CMS officials. The data will be deidentified, but will be connected with specific providers. CMS will begin accepting innovator research requests in September 2015.</p>  <p><a href="http://www.healthcareitnews.com/news/cms-gives-it-entrepreneurs-access-medicare-data">http://www.healthcareitnews.com/news/cms-gives-it-entrepreneurs-access-medicare-data</a></p>

CMS Chasing Wild Virtual Horses-A Big Distraction on the Hope of Finding Some “Algo Fairies” By Giving Entrepreneurs Access to Medicare Claims and Other Data…Marketing & Astro Turfing “The Sebelius Syndrome”..

One thing I think that can safely be said is Andy Slavitt, a one time Goldman Sachs banker and United Healthcare Subsidiary CEO of Ingenix w...

Wednesday, June 17, 2015

CVS Buys Independent Pharmacy, Picks Up A Slew of 7000 Ready Made Prescription Customers With Data To Mine and Sell…

<p>For the independent pharmacy, generic drug costs have gone up  as high as 30 percent and the pharmacy cannot price match big chain drug stores as regulations do not permit that to happen.   In reading this article further the pharmacy said they break even on 17% of the prescriptions and over 7 percent were done at a loss.  This same story is repeating itself all across the country with independent pharmacies as the price of a drug goes up in a day or two but the insurance reimbursement stays the same.  That’s a huge problem to say the least and even with an appeal, retroactive reimbursements are like almost zero.  <p>This pharmacy has been around since 1966 and the owner said it was time to sell out as he too as a pharmacist,<a href="http://monitorpharmacy.com/about-us-2/"><img align="right" alt="image" border="0" height="104" src="http://lh3.googleusercontent.com/-54Nqk2XIIeo/VX4PbRRX7LI/AAAAAAABMXI/HILMjMK9JSs/image%25255B14%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="300"></a> just like doctors are buried in red tape and can’t keep up with all the complexities demanded from the profiteering health insurance companies.  The new CVS store down the street when it opens has an immediate 7000 customers that need prescriptions, sounds like a marketing plan to me.  I just wonder if Walgreens was in there bidding for this too.  It’s so competitive.  As a matter of fact in some areas of the country people are upset over where CVS is moving in like a bull dozer and wants a “specific” location, can’t be a block away or down the street as their stats show exactly where they need to be for foot traffic I assume. <h5><a href="http://ducknetweb.blogspot.com/2015/06/communities-and-cities-rebelling.html">Communities and Cities Rebelling Against Chosen Locations of New CVS Stores Across the US…</a></h5> <p>Smaller independent pharmacies have been actually struggling for years but now it’s much worse.  When you look at what’s going on with Pharmacy Benefit Management, and look at this from United for an example, they can easily put a pharmacy out of business or dump out of network with a few algorithms.  <h5><a href="http://ducknetweb.blogspot.com/2013/03/walgreens-enters-contract-and.html">Walgreens Enters Contract and Investment With Amerisource Bergen for Drug Purchases and Distribution, Using Global Interests to Flex Pricing Muscles–independent Pharmacies Concerned</a></h5> <p><strong>Independent pharmacies are already being hit over the head with “medication compliance” scoring.  Yes this is the over use and abuse of the “Scoring of America” here thinking that taking medications can be completely quantified and it can’t</strong>.  Some pharmacists are already getting lists of patients that have 5 star ratings next to their names and the job of the pharmacists are to “change behavior” more so than filling prescriptions. <img align="right" alt="image" border="0" height="126" src="http://lh3.googleusercontent.com/--Tuq57mXyKc/VX4PcIer2iI/AAAAAAABMXQ/ZWMongoQIC8/image%25255B7%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; margin: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="187"> We all appreciate and want the advice of pharmacists and they do a good job of it over all but to have to resort to having a starred system is ridiculous and we have non other to thank than CMS for their virtual beliefs that 5 star rating systems work everywhere.  <strong>I don’t have an issue with reminders to take medications, etc. but it’s the God awful data mining and money making “scoring” that’s the issue.</strong>  Myself I can use Outlook if I need reminders, etc. but the apps out there go beyond such and mine and take your data for the most part.  <p>CMS has been mentored way too long by United Healthcare for their models in thinking that “scoring” is the way to solve all issues.  It’s not, but it is a huge way for them and others to create these scores and sell them for money.  That’s what’s really going on here.<strong><u>  You can read about the money making FICO medication “scoring” in the fact that they tout that all they need is a name and an address to score anyone.</u></strong>  So where are they getting their data?  We don’t know exactly as its proprietary and they take in stuff from data brokers, social web sites and more I understand to create these money making scores.  <strong><em>Here’s more on the FICO Medication adherence scoring (which is a big secret that you can’t know about or get those numbers) and also keep in mind Optum is doing the same thing and has been for years (subsidiary of United Healthcare) as they tie all this data mining software right into the drug store and pharmacy benefit management systems.</em></strong>  <h5><a href="http://ducknetweb.blogspot.com/2014/06/fico-medication-adherence-scoring.html">FICO Medication Adherence Scoring Should Be Banned As It’s Quantitated Justifications for Profit That Hurts US Consumers Using Proprietary Algorithms That Cannot Be Replicated For Accuracy or Audited</a></h5> <p>Then of course there’s big old IMS, the huge healthcare data broker making money hand over fist and last year they filed for an IPO and bought up some other data broker companies who buy and sell healthcare data.   The problem here is that your independent pharmacy has little or no interest in selling your data, but the big chains do and both CVS and Walgreens each make 1 to 2 billion a year selling your data.  <h5><a href="http://ducknetweb.blogspot.com/2014/01/need-any-more-proof-that-data-selling.html">Need Any More Proof That Data Selling is An Epidemic Out of Control IMS Health Files for an IPO And Holds 85% of the World’s Prescription Data</a></h5> <p>I think we should all start demanding to know what our funky data flawed medication adherence score is, don’t you?  I’m already on a list in error of people that take blood thinners and get calls and it makes me mad as I have never prescribed any or taken any, so there goes the absolute crap quality of these so called “medication adherence” scores.  It’s all about making money. <h5><a href="http://ducknetweb.blogspot.com/2012/03/independent-pharmacies-not-able-to.html">independent Pharmacies Not Able to Compete with Big Chains and Fear Going Out of Business–They Don’t Have Same High Levels of Data To Sell to Profit- Attack of the Killer Algorithms Chapter 23</a></h5> <p>These folks are dead serious about the money on this and you can read the link below and former head of Medicare,<img align="right" alt="image" border="0" height="134" src="http://lh3.googleusercontent.com/-YH1ePn3zAi0/VX4PdI7C_UI/AAAAAAABMXY/4uffYfiDqm8/image%25255B10%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; margin: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="187"> Nancy DeParle sits on the CVS board making money.  She was also the chief in charge of creating the Affordable Care Act and boy did she blow it in many area, but she doesn’t care now and a couple years ago did this great interview after leaving the White House where she said “private equity is more fun”…great stuff, right? <h5><a href="http://ducknetweb.blogspot.com/2015/04/cvs-to-share-more-medication-adherence.html">CVS to Share More Medication Adherence Love With New Contracts–Will Have More Data to Sell…</a></h5> <p>As a matter of fact, CVS couldn’t decide where the best e-commerce (which is really data mining algorithms) could be created so they opened not one, not two but three centers to reach into the brains of data scientists and coders alike to get the best code and user interface to entice you to give them more data, both in selling prescription services and other items.  You can read more about that the link below.  They also just bought Omnicare, the company that was in trouble for many years for over dosing seniors with medications with home infusions.  Omnicare and J&J paid big fines on that end of the stick.  <h5><a href="http://ducknetweb.blogspot.com/2014/11/cvs-to-open-new-e-commerce-technology.html">CVS to Open New E-Commerce Technology Centers in Boston, New York and Palo Alto– Need “New Code” to Make Bigger Profits While They And Others Continue to Destroy “US Consumer Dignity” With the Exploitations…</a></h5> <p>Having this income from the data was so important to their profits that when Apple Pay came out, they opted out as they would lose the capability to capture all of it.  So there you go… <h5><a href="http://ducknetweb.blogspot.com/2014/10/cvs-and-rite-aid-to-stop-using-apple.html">CVS and Rite Aid To Stop Using Apple Pay and “Yes” It Circles Right Back To Corporations and Banks Making Money Selling And Collecting Data and Offering Ad Exposure..What Else?</a></h5> <p>Also worth noting if you live in rural areas CVS can smack you with some higher co-pays too if you are part of their Care-Mark PBM too if you go to Walgreens or Wal-Mart to fill your prescription.  It’s their stupid “smoking” thing which has been all marketing.  If in a rural area and Wal-Mart as an example is the game in town to fill prescriptions, you take a hit for that.  It’s not as bad in city area but this is pretty stupid over all and just hurts consumers, just because of where they live.  You will drive to not get hit with a bigger co-pay in rural areas.  That’s the penalty for CVS not having you<img align="right" alt="image" border="0" height="121" src="http://lh3.googleusercontent.com/-zwFRYwvKdUU/VX4Pdzrwu1I/AAAAAAABMXg/5ng7ucB9xns/image%25255B13%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; margin: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="187">r data to sell, nothing to do with cigarettes in reality.  <h5><a href="http://ducknetweb.blogspot.com/2014/10/cvs-to-charge-consumers-higher-co-pays.html">CVS To Charge Consumers Higher Co-Pays With Prescriptions Filled at Drug Stores That Still Sell Tobacco Products–Killer Algorithms Attacking Once Again To Make Sure CVS Gets the Prescription Revenue And Your Data To Score And Sell</a></h5> <p><strong>So we say good bye to another good neighborhood friend here, the independent pharmacy who’s being ramrodded out business due to the complexities and corporate algorithmic processes related to data selling and making profits.</strong>  In addition, the employees from the Independent Drug Stores also now have the CVS Wellness program to deal with, and there’s a lawsuit working on that end as well.  Hope they do ok as it won’t be the same as now instead of employees they become “human capital” property of CVS for the pleasure of working there.   BD  <h5><a href="http://ducknetweb.blogspot.com/2014/03/cvs-faces-lawsuit-filed-by-employee.html">CVS Faces Lawsuit Filed By Employee Over Privacy Violations And Charging a $600 Fine For Non Participation In Wellness Program - The Term “Human Capital” Should Absolutely Be Abolished As Well Anymore..</a></h5> <p> <hr> Come July, though, Hagen and thousands of other area customers won't be picking up prescriptions from the nearly 50-year-old family-owned pharmacy. <p>After being approached by national chains for years, Michael and Tammy Bouckaert decided to sell the pharmacy side of their business to the new CVS Pharmacy being built a mile east at Midland Road and Euclid Avenue. <p>Pointing to stiff competition from several national pharmacy chains that now surround his business and changes to health insurance regulations that make it tough for independent pharmacies to turn a profit on prescription drugs, Michael Bouckaert said it was time to take the deal. <p>On July 11, files from the estimated 7,000 pharmacy customers are to be transferred to the new CVS Pharmacy. If customers don't change their preferred pharmacy with their healthcare providers, all prescriptions will automatically go to the new CVS, Bouckaert said. <p><a href="http://www.mlive.com/news/bay-city/index.ssf/2015/06/monitor_pharmacy_closing_after.html">http://www.mlive.com/news/bay-city/index.ssf/2015/06/monitor_pharmacy_closing_after.html</a></p>

CVS Buys Independent Pharmacy, Picks Up A Slew of 7000 Ready Made Prescription Customers With Data To Mine and Sell…

For the independent pharmacy, generic drug costs have gone up as high as 30 percent and the pharmacy cannot price match big chain drug stor...

Sunday, June 14, 2015

For Profit Hospitals Like Stock Buy Backs Too–HCA Buying Back $7.7 Billion Worth of Shares Over 3 Years…

<p>I talk a bit about stock buy backs, why?  Because as a consumer or a patient, we pay for them.  Insurance companies, all the majors on the S&P 500 are all doing stock buy backs with United leading the pack and also shoving out some dividends.  Why do they do this? <img align="right" alt="image" border="0" height="118" src="http://lh3.googleusercontent.com/-HaxHQXd-cRo/VXp1PkhnlWI/AAAAAAABMWs/7Pk1HQitRYE/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="212" /> To increase the price of their stock and to embellish their CEOs with more money, plain and simple.   With health insurers the trade off is something like this, you get narrow networks and they get more money to finance their stock buy backs.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/12/insurance-carrier-stock-buy-backs.html">Insurance Carrier Stock Buy Backs Continue to Rise While Consumers Are Finding It Harder to Afford Some Policies and Care With Dealing With High Deductibles And Narrow Networks…</a></h5>  <p>It was just recently reported in a study that HCA has the highest mark up rates of hospital systems in the US, well look at the money they need to finance those stock buy backs as the two kind of go hand in hand.  On top of that HCA just bought a bit physicians group, Pacific Partners Management Services, Inc. in the Silicon Valley area, Santa Clara and terms of the transaction were not disclosed.  In addition HCA and Humana are battling out a contract and as you know Humana is up on the sale chopping block currently so keep your eyes open on that story.  Humana does some stock buy backs too but nowhere near what the bigger insurers do.</p>  <h5><a href="http://ducknetweb.blogspot.com/2015/06/with-humana-up-for-sale-whats-impact-of.html">With Humana Up For Sale, What’s the Impact of the Medicare Risk Assessment Re-Run for Said Medicare Fraud? It’s a Big Potential Monetary Exposure For Humana and Other Insurers…</a></h5>  <p>I don’t know, maybe in addition to other questions asked when being admitted, maybe we need to start asking for profit hospitals “what part of our bills go to finance stock buy backs”…you think?  HCA also wants to be in the urgent care business too.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/10/hca-holdings-buys-carenow-urgent-care.html">HCA Holdings Buys CareNow Urgent Care Centers in Dallas Fort Worth Area of Texas</a></h5>  <h5><a href="http://ducknetweb.blogspot.com/2011/06/hca-to-pay-145-billion-to-take-over.html">HCA To Pay $1.45 Billion To Take Over Ownership of Seven Hospitals, and 13 Ambulatory Centers In Denver</a></h5>  <p>Also remember this big IPO?  I don’t know if their IPO still holds the top spot or not but this was a couple years ago this took place.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2011/03/hca-hospital-corporation-of-america.html">HCA (Hospital Corporation of America) Pulls Off the Largest Private Equity Firm Offering IPO in US History of $3.8 Billion</a></h5>  <p>So hold on to your hats and know that HCA will be doing what they need to do to keep the costs rising, have to finance those expensive stock buy backs.  BD  </p>  <p>   <hr />According to the firm’s calculations, HCA could drive roughly 9 percent earnings upside via share repurchases by the end of 2017; the company has a three-year capital spending plan of $7.7 billion in place.</p>  <p>HCA Holdings, Inc. operates hospitals. The Company operates acute care hospitals, outpatient facilities, clinics and other patient care delivery settings. HCA operates hospitals in the United States and the United Kingdom.</p>  <p><a href="http://www.streetreport.co/technical-insights-on-hca-holdings-inc-nysehca/16046/">http://www.streetreport.co/technical-insights-on-hca-holdings-inc-nysehca/16046/</a></p>

For Profit Hospitals Like Stock Buy Backs Too–HCA Buying Back $7.7 Billion Worth of Shares Over 3 Years…

I talk a bit about stock buy backs, why? Because as a consumer or a patient, we pay for them. Insurance companies, all the majors on the S...

Thursday, June 11, 2015

Virtual World Values and The Real World, We Have A Big Problem: People Can’t Tell the Difference Anymore as Perceptual Madness Grows to Further Accelerate Inequality…

<p>This is a republished blog post from March of 2014 and someone asked me to run it again, so here it is with a couple updates in the body and a few new links…</p>  <h3><em>This unwelcomed phenomena that exists today…”The Grays”…. </em></h3>  <p>Well somebody had to say it and sure we are experiencing the return of virtual reality which there’s nothing wrong with it for gaming or viewing let’s say a movie or just a more vivid experience.  When virtual reality first came out, well it was pretty definitive as everyone knew the game plan.  You check in and become someone you want to be in a virtual world and play around, have some fun, meet some other virtual people and hopefully when you are done you return back to your normal “real world” self.  Some people really got into and a few even got into a little trouble a few years back with getting confused but those were kind of isolated cases.  Again everyone understood<img align="right" height="187" src="http://lh4.ggpht.com/-plljo-PUd4Q/UV2UCf3JAXI/AAAAAAABGWU/TJC27hEzgmA/image%25255B7%25255D.png?imgmax=800" style="float: right; display: inline" width="226" /> that when you checked in to your virtual world it was just that, virtual.</p>  <p>Well let’s move forward a few years and look at where things have gone.  Technology is moving via leaps and bounds and just two years ago we didn’t have what we have today.  Two years ago some of the technologies we have out there today were not even thought of yet.  There’s more elements out there today with virtual reality to mix with and unfortunately it’s getting folks confused with where values are.  I have made the comments that if I had to choose between being connected to Facebook or using a Bill Gates toilet, well the real world tells me I need a toilet first if you will:)  </p>  <p><strong>We see stock values way over inflated on what we place on virtual technologies.  When you take social networks, for the most part, what do you have?  You have a bunch of apps that connect you to something or someone and it’s all code, data and queries stored on servers.</strong>  <u>No tangibles here to speak</u> of other than the cost of the hardware and yet we see stocks go way out of line here.  Sure there’s value but not to the levels of what we are seeing.  Come on, huge stock price values and IPOs on data and apps sitting on servers somewhere?  They are intangibles and they are out of balance with the values placed on the “real world”.  We need both, and boy am I seeing some very confused folks out there any more.  </p>  <p>Data has value, no doubt but you are marketed as well and and your value as a human compared to an algorithm, well it’s not very good.  With complexities today and marketing, watch people on a dating site.  It’s like going into a store with way too many decisions and then you are given more opportunities for some “click bait” to view even more and the site makes money as you move through a series of pages through ad exposure.  You have some very smart mathematicians that know how to work you and keep you coming back.  In other words don’t find your match, just keep coming back as the site will entertain you and keep you convinced that you need it.   This is another form of the “gray” areas as meeting someone online is hard enough as you meet them a fraction at a time.  So add on all the other money making noise and they got you.  </p>  <p><strong><em>It was kind of funny today that I read an article that <a href="http://www.govexec.com/excellence/promising-practices/2014/03/google-running-study-figure-out-how-people-work/81505/?oref=eig-homepage-morefromGEMG">Google is doing to do a study “to learn how people work”</a> so is that ironic?</em></strong>  <em>They seem to hire quite of them and after how many years in business they don’t know how people work?</em>  I read another article that said employees at Google can’t separate their work from their personal lives..hmmm..a little gray here too?  It’s kind of funny they need a study as we all kind of know, and self included you have to shut it for a few hours, days, etc. to get your feet totally back in the real world.  </p>  <p>Heck even last year the Algorithms were not educated enough at Google and said I was a real duck and suspended me as the machines did not<img align="right" alt="image" border="0" height="187" src="http://lh3.googleusercontent.com/-wr87ehTXEeQ/VXe49nheanI/AAAAAAABMWU/7CGV7oDwn6Q/image%25255B2%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="158" /> recognize it as a surname, that worked everywhere else in the world and I had to deal with the virtual Google Plus world and substantiate that I was “real”.  In the virtual world I could not exist there without a “machine compliant” name.  See how the virtual world messed with me and next time it could be something serious like a credit report or background virtual issue, as flawed data is on the rise due to the current data selling epidemic we have.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2013/01/im-sorry-your-google-plus-name-does-not.html">“I’m Sorry Your Google Plus Name Does Not Comply With Google “Names Policies”…Barbara “Duck Algorithm” & Was Using My Real Name All Along…Killer Algorithms Chapter 52 </a></h5>  <p>I keep talking about one topic over and over too and that is <strong><a href="http://ducknetweb.blogspot.ch/2014/05/people-dont-work-that-way-world-of.html"><em>“people don’t work that way”</em></a></strong> and I reference that when I keep reading about how developers and companies in the mHealth business can’t hook the consumers.  There’s a few reason besides just not wanting to be involved and that includes the data selling aspect as we all pretty much know it’s double sword and there’s the danger of some of your information getting out there and being used out of context.  You know with data and what  ever context you decide to apply, you can make a person look like a hero or a zero, only the query monster knows for sure.  Here’s a short clip with Quant Emanuel Derman<em> </em><a href="http://ducknetweb.blogspot.ch/2014/05/people-dont-work-that-way-world-of.html"><em>“People don’t work that way”…</em></a>where I borrowed the wisdom and the phrase from…</p>  <p><object height="244" width="425"><param name="movie" value="http://swf.tubechop.com/tubechop.swf?vurl=ed2FWNWwE3I&start=1700&end=1777&cid=6194999"></param><embed src="http://swf.tubechop.com/tubechop.swf?vurl=ed2FWNWwE3I&start=1700&end=1777&cid=6194999" type="application/x-shockwave-flash" allowfullscreen="true" width="425" height="244"></embed></object></p>  <p>This strangeness has even spread to TED, and if this happens I’m done with TED:)  It’s an X-Prize (AI X-Prize) to do a Ted presentation with artificial intelligence.  I agree again with Larry Ellison (more below) who’s business is technology that people are more interested in people.  Sure the virtuals are not going away but with what I see and the gray areas growing, do we need to create bigger gray areas.<strong>  So what’s next, quantified virtual worlds?  </strong></p>  <p><strong>I have never seen a time when people jump all over statistics like magpies.  I’m not saying they are all bad by any means, but anymore it’s like the peanut gallery that jumps up and rolls off numbers over and over.</strong>  A Los Angeles Time writer recently commented on that too saying “consumer are drowning in data” and we are.  I see it and get tired of it, so add on a bunch of magpie type repeats and it’s like “gosh how do I get away from some of this”:)  I like to read studies and statistics but I don’t want to be drowning in them with maximum doses in my face all the time.  Some of the studies and articles are just pure bunk too.  We end up with way too much quantitated justifications for things that are not true, usually because someone is trying to sell something.  Now I’m not saying it’s all bunk because it is not but it gets mixed in with the good stuff, and duped you are.  </p>  <p><strong>Here we go again with the “gray” areas that constitute a lot of confusion with folks not knowing where’s the real and virtual worlds, and where you draw the line?</strong>   If you like this clip below then venture down to the footer and watch the entire video #1, it’s one of the best out there to make this point.  What did I read and is that credible?  A question that’s worth a mention today before you suck in everything as some is good and some is marketing.  </p>  <p><object height="244" width="425"><param name="movie" value="http://swf.tubechop.com/tubechop.swf?vurl=qiQwZ6inbOM&start=54&end=450&cid=1746342"></param><embed src="http://swf.tubechop.com/tubechop.swf?vurl=qiQwZ6inbOM&start=54&end=450&cid=1746342" type="application/x-shockwave-flash" allowfullscreen="true" width="425" height="244"></embed></object></p>  <p>Press releases though are usually a good spot to place statistics and that’s respectable as you can link what the “sell” aspect is with the studies or stats mentioned, but when we get these wild statistic news stories that are not attached, what is their point you do have to wonder?  </p>  <p>Larry Ellison gave some really good feedback, kind off the cuff in his lecture given at his HCM conference.  He’s very disturbed with kids that are just spending their time on video games, so we go back to the virtual worlds again.  Go to the end at the Q and A for his “personal” comments at the link below.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/02/larry-ellison-ceo-oracle-hcm.html">Larry Ellison, CEO Oracle, HCM Conference Keynote–”Be Careful About Virtual Relationships With Artificially Intelligent Pieces of Software That’s Smarter Than You“, It’s Really All About People”–Algo Duping and the Killer Algorithms Living Amongst Us…(Update) Video </a></h5>  <p>He’s says there’s a virtual ball instead of a real ball with games and everyone gets to be LeBron with virtual reality.  Kids are confused he says, everyone thinks they are LeBron. <strong>If your game playing or life is more fun in the virtual world, it’s a danger.  Virtual relationships..again we go back to dating sites.  The impact of technology on children right now he says is both fabulous and terrible.  </strong></p>  <p>In the end Ellison says, we are really more interested in people even with our interest in technology and I think he’s right on that and there’s a bit of rub as some of that is being lost with the pace we have with technology today.  <img align="right" src="http://lh5.ggpht.com/-mXWH8dtMMiw/UwEwzh492nI/AAAAAAABJZM/1EgzRg3Ln00/image%25255B3%25255D.png?imgmax=800" style="float: right; display: inline" />We can’t slow technology down but we can control the rate at which we absorb it personally.  We can’t control though how it evolves around us and it confuses people.  What’s real and what’s virtual?   </p>  <p>Again go hang around a dating site and you see all these areas to click and read and look at pictures and then are presented with more, or <strong>there’s little amusements there to ask a person to upload more pictures, and that will keep you busy if you want to appease all of the requests:)</strong>  The sites can keep you very busy and you can lose your focus as why you are there.  The funniest one was a site that sends you a flow sheet to visualize it for you, again the interactions until you move off the site and meet someone in person, it’s all virtual.  I sit there and kind of laugh at some of that as if want to know me better, then talk rather than give me some kind of virtual busy work to do:)  It’s how you get sucked in.  If a person loaded up fake pictures, then they’ll probably load up some more fake pictures for you:) </p>  <p>The movie HER, and really all you need to see is the trailer and you can get the message on how this guy substituted a real relationship with a virtual one that made him happy, so there we go with some of those “gray” areas.  This is worth embedding the trailer here again to make the point.  Sometimes folks don’t even realize they are just living for this bit of attention on the web and then lose touch with what’s real out there. </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/01/movie-her-good-example-on-how-folks.html">Movie “HER”– Good Example On How Folks Can’t Separate And/Or Unite The Virtual With The Real World, Billionaires Are Made Out of Those Who Know How to Keep These Areas “Gray” With Creating and Maintaining The Addictive Code That Does It…</a></h5>  <p>If you go back a few months you can also read where Bill Gates said <a href="http://www.dailymail.co.uk/news/article-2486084/The-internet-NOT-save-world-Bill-Gates-rubbishes-Zuckerbergs-joke-claim-online-access-priority-developing-world.html">“the internet will not save the world”</a> so again maturity here with technology and where it can really benefit.<strong>  Both Bill Gates and Larry Ellison were the early pioneers and understand “data mechanics” better than anyone else out there</strong> and again have the maturity to see beyond the end of their nose by all means and we should listen to both of them.  </p>  <p>So again virtual reality has it’s place but when the lines get gray that help you determine where the virtual worlds leave off and where the real world kicks back in, it gets pretty fuzzy out there.  I run into people all the time with what I call weird or strange perceptions as they carry some of this over into the real world and there are companies that profit richly from it, so be careful.</p>  <div id="scid:5737277B-5D6D-4f48-ABFC-DD9C333F4C5D:30d9ca11-51d4-43d4-a003-91321b60999d" class="wlWriterSmartContent" style="float: none; padding-bottom: 0px; padding-top: 0px; padding-left: 0px; margin: 0px; display: inline; padding-right: 0px"><embed type="application/x-shockwave-flash" height="252" width="448" src="http://www.youtube.com/v/WzV6mXIOVl4?hd=1" wmode="transparent" />    <div style="font-size: 0.8em; width: 448px; clear: both">HER Movie</div> </div>  <p>And here’s one more clip..Mike Osinski “<strong>with software you can do something about everything”</strong> but you have to live in the real world and he knows a bit about virtual worlds as he wrote the software all the banks used for the mortgage scam that banks used improperly and drug so many of us into a virtual world.  The big refinance was all mastered and created in a “virtual world”.  So keep that thought if you will.  </p>  <p><strong>The whole country was sucked into that virtual world</strong> where banks did real stock transactions where the sales and models were not representative of the real world, <strong>(I’d call it virtual risk at this point)</strong> but hopefully we are little smarter now.  If you like the clip then go down to the footer and watch video #2, the Quants of Wall Street to learn more about how that virtual world functioned.  As Larry Ellison said on his HCM talk, we though we were Lebron.  This video was made about 3 years ago, so not new knowledge here at all.  </p>  <p><object height="244" width="425"><param name="movie" value="http://swf.tubechop.com/tubechop.swf?vurl=ed2FWNWwE3I&start=2810&end=2845&cid=1746075"></param><embed src="http://swf.tubechop.com/tubechop.swf?vurl=ed2FWNWwE3I&start=2810&end=2845&cid=1746075" type="application/x-shockwave-flash" allowfullscreen="true" width="425" height="244"></embed></object></p>  <p>So with all the tech insanity we seem to be experiencing of late, well time to keep it in check and allow consumers time to digest some of it and not “dummy down” folks for profit either.  </p>  <p><a href="http://ducknetweb.blogspot.com/2014/03/algorithms-that-exploit-sean-gourley.html">This video from Dr. Sean Gourley, physicist and CEO of QUID</a> might make you think a little bit.  He tells us last year 51% of the traffic on the internet were bots, the rest humans.  Last year it's up to 61% bots and the rest humans, so what's going on here.  He uses a chart to show the human value with the value of the bot, and it's doing better than human value. </p>  <p>Dr.  Gourley states we do need algorithms to manage the complex world, but who's algorithms are they, and will I benefit one could ask as well.  We know in this process that bot are going to get more access for sure and the human access looks like it will dwarf that.  So again trying to look and dig deep, there's some good questions or things to think about here for sure.  </p>  <p><strong>So who's going to be the biggest benefactor here?  Is the next number going to be stating 71% of the internet is bots and the rest humans, so what is the real function to connect Facebook with drones?</strong>  Who’s going to really <img align="right" height="179" src="http://lh4.ggpht.com/-B-_a6SK1KrI/UlbXy3uyhsI/AAAAAAABIFg/EPVwNpRgkAo/image%25255B7%25255D.png?imgmax=800" style="float: right; display: inline" width="122" />benefit?  A lot of bots and the company that owns them and makes money from them…<strong>bots are worth about $100 and humans are worth zero and are basically tech slaves.  Sure some folks will get internet connectivity and that’s not a bad thing but at a cost and it will support the growing world of bots and their profitability not the humans</strong> as we become what Dr. Gourley states, the techno slaves that only fill in where the bots can’t go.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/02/generation-like-relentless-marketing-of.html">“Generation Like”, the Relentless Marketing of Teenagers Online and The Money It Makes, “Fake Like Farms” and The Money Generated There As Well..(Videos)</a></h5>  <p>Anyway I hope I made the point here about the growing “gray” areas we have with virtual technologies and be aware as you might accidentally find yourself subscribing to the virtual values and losing some of your own “real world values”.  All those new folks getting access will be able to be LeBron too.  The essay below is great and worth reading, be a skeptic when you need to be and you might ask is it real or is it virtual sometimes to help keep your balance, I do it:)  I want to be aware and cognizant of when thing venture out of the virtual world and have impact on what’s going on in my real world, the one that really counts.    Talking with quants and mathematicians who design and model a lot of the virtual worlds out there can be big help to learn.  Read the publication below as well.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2013/10/on-being-data-skeptic-modelers-have.html">“On Being a Data skeptic- Modelers Have A Bigger Responsibility Now Than Ever Before”–A Must Read Essay, Start “Sniffing the Data”…</a></h5>  <p>If this has generated some interest, then dive in for the full on education on the <a href="http://www.ducknet.net/attack-of-the-killer-algorithms/">Attack of the Killer Algorithms videos</a> at the link below.  It’s computer code and math models that over stepped lines of efficiencies we all want and have turned into “qualifiers” that will score you out of opportunities in the US, this is what’s happened to the middle class, we’re mathematically “scored” into corners with data unknown (and who knows how accurate)and we can’t escape the spreadsheets and data bases that limit our access any longer.  BD  </p>      <h5><a href="http://ducknetweb.blogspot.com/2015/05/privacy-duping-of-america-intangible.html">Privacy Duping of America-The Intangible Threat Model Has Changed Significantly-Companies Hide The Code On the Web, $180 Billion Dollar A Year Business, Welcome to The Duperville World of Inequality..</a></h5>

Virtual World Values and The Real World, We Have A Big Problem: People Can’t Tell the Difference Anymore as Perceptual Madness Grows to Further Accelerate Inequality…

This is a republished blog post from March of 2014 and someone asked me to run it again, so here it is with a couple updates in the body and...

Tuesday, June 09, 2015

Walgreens, No Time For Charity, Moves Truckloads of Closed Store Inventory to Landfill, Mayor of Wyoming Town Upset As New Products Perfectly Usable Were Trashed

<p>We all know how big business has to focus on stock buy backs, acquisitions, etc. today so donating perfectly good products that have been inventory to charity is just too much for a big corporation to deal with.  Instead, items like toilet paper, canned goods, toys, and much <img align="right" alt="image" border="0" height="132" src="http://lh3.googleusercontent.com/-UrCuOEVNyiA/VXMrR4K--BI/AAAAAAABMV8/yd77XV-tqlE/image%25255B7%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="222" />more were just hauled off by the truckload to a local landfill.  Not only is this a waste for not allowing such to to go charity, why put perfectly good new products in a landfill?  The story says an insurance company made that decision as God forbid someone would use some new toilet paper and file a lawsuit over it being defective from a closed store?  Is that the reasoning here? </p>  <p>By the time the mayor found out what was going on, trucks were already on their way to the landfill.  We have a little buzzword here called “decommissioned” that seems to allow this to happen, so the store was “scored” as decommissioned and thus so the inventory was now waste.  I talk about the scoring of America and the Killer Algorithms all the time here at the Medical Quack and you can see by the interpretation of the word “decommission” it totally relieved Walgreens of having to even think about donating to the poor and legally allowed the company to pretty much say “we’re in this for money” we don’t care about the poor, you think?  In other recent Walgreens news, a few days ago they spun off a home infusion subsidiary.  Remember too the record $8 billion dollar bond sale last year to raise money to complete the acquisition of Boots.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/05/walgreens-spins-off-home-drug-infusion.html">Walgreens Spins Off Home Drug Infusion Company–Option Care Bought by Private Equity Firm Madison Dearborn Partners..Option One Formerly Walgreens Infusion Services Subsidiary</a></h5>  <p><script type="text/javascript" src="http://www.kaltura.com/p/557781/sp/55778100/embedIframeJs/uiconf_id/25650542/partner_id/557781"></script><object allowfullscreen="true" allownetworking="all" allowscriptaccess="always" data="http://www.kaltura.com/index.php/kwidget/wid/0_snvdy8c0/uiconf_id/25650542" height="300" id="kaltura_player_1433609816" name="kaltura_player_1433609816" type="application/x-shockwave-flash" width="480"><param name="allowScriptAccess" value="always" /><param name="allowNetworking" value="all" /><param name="allowFullScreen" value="true" /><param name="bgcolor" value="#000000" /><param name="movie" value="http://www.kaltura.com/index.php/kwidget/wid/0_snvdy8c0/uiconf_id/25650542" /><param name="flashVars" value="" /><a href="http://corp.kaltura.com">video platform</a><a href="http://corp.kaltura.com/video_platform/video_management">video management</a><a href="http://corp.kaltura.com/solutions/video_solution">video solutions</a><a href="http://corp.kaltura.com/video_platform/video_publishing">video player</a></object></p>  <p>The company also has a couple new members sitting on their board from Hedge Funds, so you could possibly see a link there as far as a focus in making money only.  When stock buy backs come around, it seems everything else seems to be affected.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/09/two-hedge-fund-executives-gain-board.html">Two Hedge Fund Executives Gain Board Seat Walgreens, Stock Buy Backs To Continue And Increase, As Well Cost Cutting With Products And Maybe Employees</a></h5>  <p>Last year Walgreens closed a long time facility in Flagstaff, Arizona.</p>  <h5><a href="http://ducknetweb.blogspot.com/2014/07/walgreens-closing-distribution-center.html">Walgreens Closing Distribution Center in Flagstaff Arizona - 345 Jobs Lost While Senator Durbin of Illinois States They Are Turning Their Backs On the US Should They Move Their Headquarters Outside the US</a></h5>  <p>But let’s bottom this thing out and get to the real reasons…Walgreens makes between 1-2 billion a year selling our personal data, so guess what, if the products were donated, they wouldn’t get any data to sell.  I’ve covered theirs and other data selling efforts quite a bit.</p>  <h5><a href="http://ducknetweb.blogspot.com/2013/10/walgreens-cashing-in-big-in-data.html">Walgreens Cashing in Big In the Data Selling Epidemic Arena–Incentives Connected to Apps and Devices That Sell, Re-Query and Re-Sell Our Data And Data Profiles</a></h5>  <p><a href="http://www.localnews8.com/news/walgreens-sends-truckloads-of-inventory-to-dump/33425922">http://www.localnews8.com/news/walgreens-sends-truckloads-of-inventory-to-dump/33425922</a></p>

Walgreens, No Time For Charity, Moves Truckloads of Closed Store Inventory to Landfill, Mayor of Wyoming Town Upset As New Products Perfectly Usable Were Trashed

We all know how big business has to focus on stock buy backs, acquisitions, etc. today so donating perfectly good products that have been in...

Saturday, June 06, 2015

Communities and Cities Rebelling Against Chosen Locations of New CVS Stores Across the US…

<p>I read one article and of course this is something that always occurs with new zoning<img align="right" alt="image" border="0" height="116" src="http://lh3.googleusercontent.com/-Q0w7pB9hRWw/VXMhsqAkrHI/AAAAAAABMVs/DciU9PAROYE/image%25255B2%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; margin: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="187" /> and changing the landscape in the US, but darn there sure seemed to be quite a few communities not happy about where CVS plans to either open new stores or is working to secure locations.  This is not just an east coast thing as it’s happening in California too.  So what’s the deal here?</p>  <p>They are taking over a lot of areas where “favorite” restaurants exist and shoving them out, that seems to be the reason for most of this.  Here’s the story on Chula Vista, California…two restaurants that people love, being shoved out.</p>  <p>Here’s the link to the story in California…</p>  <p><a href="http://www.10news.com/news/south-bay-residents-upset-about-plan-to-close-to-2-restaurants-to-open-new-cvs-pharmacy">CVS and Chula Vista, CA</a></p>  <p>And here’s a few more…</p>  <p><a href="http://www.newhavenindependent.org/index.php/archives/entry/westville_north_cvs_showdown/">CVS and New Haven, CT</a></p>  <p><a href="http://patch.com/massachusetts/framingham/downtown-framingham-cvs-closing-0">CVS and Framingham, MA</a></p>  <p><a href="http://www.metrowestdailynews.com/article/20150604/NEWS/150607640">CVS and Hopkinton, MA</a></p>  <p>It’s not that CVS is putting in a new store, it seems to be a matter of where and people’s favorite businesses are being the sacrificed lambs.  In southern California we have both them and Walgreens on street corners like gas stations used to be.  BD      </p>

Communities and Cities Rebelling Against Chosen Locations of New CVS Stores Across the US…

I read one article and of course this is something that always occurs with new zoning and changing the landscape in the US, but darn there ...

Saturday, June 06, 2015

With Humana Up For Sale, What’s the Impact of the Medicare Risk Assessment Re-Run for Said Medicare Fraud? It’s a Big Potential Monetary Exposure For Humana and Other Insurers…

<p>If you are not aware of the Medicare Advantage Re-Run of the Risk Assessment model, I’ll give you a link where you can read up.  At risk would be the two largest Medicare Advantage Insurers, Humana and United Healthcare.  This issue has been spurred by the number of lawsuits that have been filed and ones that keep coming from Whistle Blowers.  In short the Whistle Blowers are stating that insurers inflated the risk factors with patients so payments would be larger.  In reading what’s been on the web here, it was an automated process “an algorithm” that was used to model and diagnose patients with more chronic diseases so again the payout would be higher.  CMS auditors found this on their own and there has not been a ton of coverage on it but it’s out there.  </p>  <p>So far we have never seen Medicare run such a process in an effort to recoup money that is “said fraud” from insurers but<img align="right" alt="image" border="0" height="136" src="http://lh3.googleusercontent.com/-mgjGBkYmCIk/VW__PZuyoUI/AAAAAAABMVU/DznQu0CqIRI/image%25255B2%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; margin: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="187" /> it’s a hefty number of around $70 billion and this occurred over a five year period.  That’s a lot of money so when you read about a small doctor somewhere doing a million in fraud, it’s small peanuts by comparison.  With Humana up for sale, one has to wonder what would be written into an acquisition to cover this if CMS lowers the boom and does re-run the risk factors.   Again last I read the agency intends to re-run the assessments but you never know what could change.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/03/cms-to-rerun-medicare-advantage-risk.html">CMS to Rerun the Medicare Advantage Risk Scores–Dating Back to 2008 To Catch the Automated Risk Fiddlers of Said Insurer Fraud Amounting to Around $70 Billion–Be Ready For It…</a></h5>  <p>Here’s another back article as well that goes into more detail on how CMS found the “risk fiddler” insurers, of course the lawsuits also pushed this along.  Insurers over the years have hired a lot more Quants to model their businesses and policies and there’s some former bank and hedge fund and high frequency quants probably mixed in the bunch who know how to whittle profits down to the penny mark.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/08/cms-discovers-that-insurers-offering.html">CMS Discovers That Insurers Offering Medicare Advantage “Really Know How To Sharp Shoot A Model With Adjusting Risk For Profit”, A Common Everyday Occurrence in Financial Markets…</a></h5>  <p><strong>In the financial world you don’t change the portfolio to squirrel around with risk to attain profit, you just change the math.  In the insurance world you don’t squirrel around with the policy, you just change the math, same thing and put people through absolute misery to do this.</strong></p>  <p><em>“<a href="http://www.kaiserhealthnews.org/Stories/2014/August/07/Medicare-advantage-plans-exaggerate-diseases-to-make-money-says-study.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+khn+%28All+Kaiser+Health+News%29">Medicare pays the Advantage health plans</a> higher rates for sicker patients and less for healthy people using a complex formula called a “risk score.” But the HHS study spells out several ways health plans have inflated those scores, from reporting surprisingly high levels of medical conditions such as alcohol or drug dependence to billing for an inordinately high number of patients with complications of diabetes.”</em></p>  <p><em>“CMS will sweep diagnoses submitted for a prior payment year as of the deadline. MA Organizations should look to the monthly payment letter to determine when adjustments will be applied to payments.”</em></p>  <p>Not too long ago Humana lost a big contract to United Healthcare in Wisconsin.  It’s almost gets scary at times inviting United to the table to bid but not a lot of choice.  I did several posts in the past to where United would sue if they didn’t get a contract and this went all the way to suing the DOD to get the west coast Tri-Care contract.  We never heard anything else other than the fact that Untied sued and then a couple months later DOD announces United received the contract for the west coast region.  The Tri-Care bids when they were sent out and announced brought about some interesting changes with insurers as the awards were not done on a solid basis.  You can read the back links below from a few years ago and see how the bigger guys even then had a lot of pressure on the smaller insurers.  In addition to the Medicare Advantage customers, there’s also the Tri-Care Contract in the south which I think has a couple more years to run.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2010/05/healthnet-will-keep-tri-care-north.html">HealthNet Will Keep the Tri-Care North Contract – GOA Investigated the Original Award to Aetna</a></h5>  <h5><a href="http://ducknetweb.blogspot.com/2009/07/health-net-and-humana-file-protests.html">Health Net and Humana File Protests over Military Healthcare Awards to UnitedHealthcare and Aetna</a></h5>  <h5><a href="http://ducknetweb.blogspot.com/2011/02/humana-keeps-tricare-in-south-and-back.html">Humana Keeps Tricare In The South And Back in May of 2010 HealthNet Was Able to Keep the Northeast-Both Companies Filed Appeals</a></h5>  <p>In the northeast, Aetna originally took the contract away from Health Net, a much smaller company and then later Health Net got the contract back as Aetna cheated.  In the interim though with having to move forward, United came in and swept up all the licenses for Connecticut, New York and New Jersey policies and after that occurred, those folks who had Health Net, actually are under written by United and not Health Net.  I think today I still see Health Net policies in the northeast and again those are really just Health Net managing polices owned by United Healthcare. </p>  <h5><a href="http://ducknetweb.blogspot.com/2010/11/healthnet-in-connecticut-to-lay-off-750.html">HealthNet in Connecticut to Lay Off 750 Employees as United Healthcare Takes Over Membership In the Northeast</a></h5>  <h5><a href="http://ducknetweb.blogspot.com/2011/02/unitedhealth-group-sued-class-action.html">UnitedHealth Group Sued-Class Action Lawsuit Relative to Purchase of HealthNet in Northeast-Post Auditing With Demands For Providers to Repay Reimbursements</a></h5>  <p>Here’s some more lawsuit actions with United and the Tri-Care contracts, see what I mean about suing? </p>  <h5><a href="http://ducknetweb.blogspot.com/2011/06/update-unitedhealthcare-sues-department.html">Update: UnitedHealthcare Sues Department of Defense Over Tri-Care Contracts–They Said They Would Do This – Is This A Case Of My Algorithms Are Better Than Yours?</a></h5>  <h5><a href="http://ducknetweb.blogspot.com/2011/06/unitedhealth-loses-tri-care-protest.html">UnitedHealth Loses Tri-Care Protest Again With Contract Awarded to Humana in the South-Now Protesting Contracts Awarded In Both the South and the Western States</a></h5>  <p>So moving forward what would an acquisition require?  Who’s going to accept the liability of the Humana portion of the CMS Money Grab if they do in fact re-run the risk assessments?  <strong>That’s a good question and again is CMS still have it on their agenda.</strong>  Let’s look at another angle too and that is how much of a hit could Humana take?  Of course United is going to take a hit and at one time talked about putting money aside for the CMS Medicare Advantage re-run.  So let’s explore Goldman, who is putting the Humana sale together for a moment.  What if they take this <img align="right" src="http://lh6.ggpht.com/-6VfPfsMlP2s/VPppHHVXgSI/AAAAAAABMFU/hojbfbnGAH8/image%25255B3%25255D.png?imgmax=800" style="float: right; display: inline" />CMS re-run financial obligations of the acquisitions out of the deal so another insurer could buy Humana?  Well where are all those Humana Medicare Advantage Insured going to go?  Something to think about as if the CMS exposure to the Money Grab rerun is removed, who’s going to pay?  The insured, like it or not are attached to those business models.  </p>  <p>In speaking out loud, you could have a CMS re-run of United coming in and buying up all those licenses if left out of the acquisition deal, like they did with Health Net at a cheap cost back in 2009 and taking over a ton of insured policies.  When United bought the Health Net licenses, over 750 jobs were gone as they were not part of that deal.   I would not put it past them if the opportunity arrived and then look at the market share they would have on Medicare Advantage?  So with Andy Slavitt, a former United Healthcare Executive at CMS calling the shots, what’s he going to do.  Would this in fact create a wind fall for United if the CMS re-run is not in the deal for another insurer to acquire Humana and they decide to jump in and buy licenses?  It would be a windfall for his former employer.  </p>  <p>Again I am speaking out loud here and looking at insurer business trends as they have evolved and as deals today are put together.  Keep your eyes open on this deal as it won’t be a simple one I don’t think.  Meanwhile Humana has just sold off a company, Concentra, they bought just a few years ago and this raises some cash.  My original post on the acquisition is below. </p>  <h5><a href="http://ducknetweb.blogspot.com/2010/12/humana-acquires-concentra-inc-privately.html">Humana Acquires Concentra Inc.- A Privately Held Healthcare Company in Texas</a></h5>  <p>There’s been a couple of other Humana issues which I think they have weathered over the last couple of years too.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2013/04/law-firm-states-they-will-no-longer.html">Law Firm States They Will No Longer Work With Political Intelligence Firms After Senator Grassley Questions and After Humana Fired Them - Wellpoint Evaluating Their Relationship</a></h5>  <h5><a href="http://ducknetweb.blogspot.com/2013/04/humana-fires-its-lobbying-firm-over.html">Humana Fires It’s Lobbying Firm Over Possible Insider Trading Violation</a></h5>  <p>So this should prove to be very interesting to see how this all comes about as like everything else, it’s complicated.  One more item to think about as well, and that is financing stock buy backs…health insurers have some pretty healthy ones out there and part of your premium payments finance this as well.  BD </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/12/insurance-carrier-stock-buy-backs.html">Insurance Carrier stock Buy Backs Continue to Rise While Consumers Are Finding It Harder to Afford Some Policies and Care With Dealing With High Deductibles And Narrow Networks…</a></h5>  <p>   <hr />“It was pretty well-known that Humana has been up for sale for the last couple of quarters,” said Vishnu Lekraj, Chicago-based senior research analyst at Morningstar Inc.</p>  <p>Valued at $32.01 billion as of Wednesday, a sale of the Louisville, Kentucky-based health insurer would have only a modest impact on the group health care market, given that 7.5 million of its 14.2 million enrollees were in Medicare and Medicare Advantage products, as of March 31, Mr. Lekraj said.</p>  <p><a href="http://www.businessinsurance.com/article/20150603/NEWS03/150609923/humana-would-be-attractive-takeover-target-for-aetna-cigna?tags=%7C285%7C307%7C329">http://www.businessinsurance.com/article/20150603/NEWS03/150609923/humana-would-be-attractive-takeover-target-for-aetna-cigna?tags=%7C285%7C307%7C329</a></p>

With Humana Up For Sale, What’s the Impact of the Medicare Risk Assessment Re-Run for Said Medicare Fraud? It’s a Big Potential Monetary Exposure For Humana and Other Insurers…

If you are not aware of the Medicare Advantage Re-Run of the Risk Assessment model, I’ll give you a link where you can read up. At risk wou...

Thursday, June 04, 2015

Subscribe to: Comments ( Atom )

Covered California Insurance Participants to be Risk Assessed With Individual Scores To Be Sent to CMS By Anthem–Appears To Be No Opt Out For Privacy, Payback Time For the ACA Subsidies As Feds Get Your Scored Data

Hospital News Rigging Now? UPMC and Local Paper In a Dispute Over What’s Covered in the News, Takes Paper Out of Hospital Gift Shops…

Operation “Perception-Deception” Into Full Swing in the US, With Killer Algorithms, Algo Fairies, Algo Duping, The Grays, and Of Course, Flags As Consumers Confuse Virtual World Values With the Real World…

Medication Adherence Predictions Enter the World of Quantitated Justifications For Things That Are Just Not True, Members of the Proprietary “Code Hosing” Clubs Out There Destroying Your Privacy

CMS Chasing Wild Virtual Horses-A Big Distraction on the Hope of Finding Some “Algo Fairies” By Giving Entrepreneurs Access to Medicare Claims and Other Data…Marketing & Astro Turfing “The Sebelius Syndrome”..

CVS Buys Independent Pharmacy, Picks Up A Slew of 7000 Ready Made Prescription Customers With Data To Mine and Sell…

For Profit Hospitals Like Stock Buy Backs Too–HCA Buying Back $7.7 Billion Worth of Shares Over 3 Years…

Virtual World Values and The Real World, We Have A Big Problem: People Can’t Tell the Difference Anymore as Perceptual Madness Grows to Further Accelerate Inequality…

Walgreens, No Time For Charity, Moves Truckloads of Closed Store Inventory to Landfill, Mayor of Wyoming Town Upset As New Products Perfectly Usable Were Trashed

Communities and Cities Rebelling Against Chosen Locations of New CVS Stores Across the US…

With Humana Up For Sale, What’s the Impact of the Medicare Risk Assessment Re-Run for Said Medicare Fraud? It’s a Big Potential Monetary Exposure For Humana and Other Insurers…

Privacy Campaign

Blog Archive