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.
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..
This is a shame as those who enrolled are not getting any privacy here at all. Also remember Anthem and the big data breach? 
Exactly the company and vendor assistant you want doing this right?
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.
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
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.
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 the trade off for subsidies, you get your data traded and sold all over the place. 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? 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. People don’t work that way so we have a world of broken software models that people keep trying to force upon others.
“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..
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
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…
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”).
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.
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.
http://www.cmanet.org/news/detail/?article=anthem-blue-cross-begins-medical-chart
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.
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. 
everyone to believe in stats, no matter what they are. 
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. 
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.
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.
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 
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. 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. 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. 
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? 
r data to sell, nothing to do with cigarettes in reality. 
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. 
that when you checked in to your virtual world it was just that, virtual.
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. 
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? 
benefit? A lot of bots and the company that owns them and makes money from them…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 as we become what Dr. Gourley states, the techno slaves that only fill in where the bots can’t go. 
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? 
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?
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. 
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.