These scores are being sold to pharma and to insurance companies. Yesterday I read an article that just about made me choke, with an executive being quoted as saying “don’t waste your time on this patient, spend more time on this one as they show they are taking their medications”…again here we go again with flawed data. You can look at the link below to see an actual conversation I had with a pharmacist and how this works. They hate it as the executives from the EQuiPP program are constantly breathing down their backs as the pay for performance numbers are not improving fast enough, when in fact the data is not correct. Patients who pay cash are being classified in error as Outliers.
Patients Who Pay “Cash” When Filling Prescriptions Are Now Called “Outliers, Pharmacists Required to Fix Outliers as They Show Up As Non Medication Adherence Compliant With 5 Star Systems Full of Flawed Data…Do you not think these flawed scores will be used to deny or allow access? Better think on that one again. We know CMS is having a hard time today with many of their models with flawed data and in turn not improving care to the patient. Also, don’t confuse medication prediction scores with “actual” facts that PBMs use to see who’s filling their prescriptions. Those are actual transactions that have taken place where most of the predictions scoring is pure bullshit.
CMS Medicare Part D Program With Medication Therapy Management–Here Comes the Flawed Medication Adherence Prediction Scores, Make Sure Jane Doe Gets the “Cheap Meds”..All pharmacy benefit managers today are using some kind of prediction scoring and just take a look at the screenshot right off the Express Scripts page to the right here. Do you see open discrimination here? You should as they use 300 “secret” metrics created by some algorithm to give you a “secret” score that you can’t have or see. If the code were ever broken down so we could see the metrics here I’m sure you would see all kinds of queries related to race, etc. as you can already see one in the image for “income” and “age” if under 65 years old. You are being scored on many things you can’t change which is not fair.
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 PrivacyAll of this “scoring” costs lot of money and in healthcare today, we are paying for tons of predictive queries and software platforms that offer little or no ROI and this is a big one. We come right back to Excess Scoring of US Consumers and we get no benefit at all. Here’s some additional links below if you want to catch up on what’s going on today with all of this. Pretty much all of this goes back again to a division of Untied Healthcare, called Ingenix, which is now Optum Insights which created such “scoring” of patients as that’s what they do. In addition, you can find some shocking “Cronyism” political ties here that might help make more sense of what’s going on and who’s pocket all of this is feeding.
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
Express Scripts- New Program to Contact and Predict Patients Who May Not Be Taking Their Medicine Based On Ingenix Algorithms–We Want the Revenue Please Don’t StopAll in all, predictive medication scoring also helps pharma substantiate the high prices of their drugs as for years it’s been a media circus of “keep blaming the patient” for non perfect results. I learned that tidbit from a former executive and code writer at the NISS many years ago. Anyway, pay attention here is this is what your pharmacist does today for their performance metrics, dealing with the flawed data that comes down the line. Former President Jimmy Carter made a speech not too long ago about the US not being a democracy any more and how now is becoming more of a dictatorship and here’s one big example of how this works with using algorithms and flawed data created by coders and developers to control individuals in the US. BD
CAMP HILL, Pa.--(EON: Enhanced Online News)--Rite Aid Corporation (NYSE: RAD) announced today that pharmacists across its nearly 4,600 locations chainwide are now utilizing Pharmacy Quality Solutions’ (PQS) EQuIPP, an information management platform that provides access to performance data across key patient care quality metrics, including those focused on medication adherence and appropriate medication use. Rite Aid is the largest drugstore chain to provide EQuIPP access to all pharmacists.
“Value-based healthcare is here to stay and that’s why it’s important for Rite Aid to provide our pharmacists with the resources and tools they need to deliver improved health outcomes for their patients,” said Jocelyn Konrad, Rite Aid executive vice president of pharmacy. “Our pharmacists are committed to providing excellent care to their customers, and with EQuIPP, we’re empowering them to make an even greater difference in the health and wellbeing of their customers and succeed in today’s healthcare environment.”