Just when you think it can’t get any worse it does.  If you read here often enough then you know I am a privacy advocate and have had an informal campaign going for a few years on indexing and licensing data sellers, that take your data, without your permission or with a legal statement that you agree to that says they can that you don’t understand.  When you read this article, it says exactly what I have been talking about with “Excess Scoring” of consumers.  This is huge as your data gets used, queried and sold to supposedly create all these worthless rankings of doctors, care and services. Actually it’s been a very poplar post as more consumers are beginning to learn and understand the “secret” scoring that’s taking place for profit all over the US.  Now we have Algo Man Andy Slavitt head of CMS , a former Goldman Sachs banker wanting to make it easier to sell patient claim and other data for money.  Read the link below and links in that post to see exactly what’s going on. 

Excess Scoring of US Consumers, US Citizens-Scored into Oblivion By Proprietary Algorithms and Formulas, Never Duplicated or Tested for Accuracy-Profits of Big Business And A White House Executive Command To Continue the Abuse..

We all know Slavitt’s  Ingenix background and how he was sued all over the place for algos that don’t help care but rather just make money with little concern for doctors and patients.  A few months ago, another of the Ingenix lawsuits just finally settled up to where doctors were being shorted on out of network pay.  There were tons of lawsuits over the Ingenix algorithms. 

What this is talking about here is again selling and scoring your healthcare data and you don’t get to have a say in any of this.  If you have looked over the last few years we have the “useless” ranking of doctors and hospitals that CMS has been putting out.  Is this of any use?  Not really as narrow networks pretty much control what doctors and hospitals you can use and be covered, so why keep putting this “ranking” data out there?  It only serves to be a negative when folks see rankings of hospitals that they can’t go to as their are not in their network.  It doesn’t take a rocket scientist to figure that out.  The news media in looking for click bait keeps trying to put out doctor quality data and nobody cares anymore and for that matter might not want to even think about looking to see if the doctors they are limited to are not at the top of quality lists.  This is just another broken model that is pushed to the limit as government is drunk on stats and algos that do little or nothing for the average consumer.

Actually to quote Dr. Halamka, CIO  from Harvard Medical from a recent post of his, he has this to say in speaking about transitioning from Meaningful Use..

“There is only one part of the draft legislation that I think is truly unhelpful - creating a government sponsored rating system  for healthcare information technology.    I cannot think of another industry in which the government provides the “Yelp”-like function.”

This is in reference to the Senate HELP committee to draft legislation to change Meaningful Use, a model that broke a long time ago that has not been changed as we have a full on ONC division at HHS that’s totally over their heads and stuck on what to do and seems to focus on fairy tales like the perception of “information blocking”.  Things like this happen with people who have never written code and get all whacked out on what they “think” is out there.  I used to get that all the time when I wrote my simple EMR years ago with the doctors and their perceptions.  I’m not picking on doctors but the way anyone outside of engineering and programming views software versus the folks that write it perceives how the code works is off base quite a bit of the time.  I solved that by showing a few doctors what code looked like and what I had to do to facilitate a simple change in the software:)

Let me clarify something in all of this as well as I am not talking about big data in genomic research as that’s where big data belongs in scientific research and is needed there and that’s a science, but what I am talking about here is the awful ranking of doctors and use of patient data that gets used out of context to make money.  Selling patient data is all about that.  Sure we get some reports on trends and those are useful but that’s not where all of this is going at all. We also do need some quality reports to degree but this is going way past where it needs to be. As someone stated a while back, if you don’t monitor and keep Quants in check, they spin out of control and that’s exactly what we are seeing here with Slavitt at CMS, he’s a quant that spend time at Goldman and McKinsey who learned how to spin numbers for profit.

Actually having Senator Warren on this HELP committee could represent somewhat of a conflict of interest in my opinion as her family, and speaking of her daughter Amelia’s business in particular have had long term ties to United Healthcare as of course so does Andy Slavitt.  You can read about Amelia Warren at this Bloomberg link  and hear about the book she and her mother wrote that talks about solving the issues of the poor, and of course there’s been nothing new on that frontier either, but a lot of books sold of “All Your Worth”. 

The Bloomberg link talks about the company Amelia Warren co-founded with Andy Slavitt, Health Allies, a company that they sold to United Healthcare, which is nothing more than a card you pay $25.00 a month for to get discounts. You read that right, look it up on United Healthcare’s page.  In essence what it being said here is the relationships over the years and the fact that Amelia Warren founded a company that competes with McKinsey to find executives for big corporations.  I don’t exactly know why but every time I blog about the NHS leadership being someone from United Healthcare, I seem to get a lot of hits from Warren’s office reading it.  Case in point here is they all made a lot of money with and via United Healthcare so when you see a data selling proposal like this, one has to say hmmmmm. 

Anyway, in my opinion, the data selling here with this proposal is going way over the top on what’s needed for quality reporting on doctors and patient data.  Right now doctors are not happy and we sadly have quite a few that say “they can’t take it anymore” and quit.  400 doctors commit suicide every year.  We don’t need to make their lives even more miserable for the sake of selling data for stuffed reports, some out of context that will generate no ROI.  Actually I wrote a couple years ago about insurance companies driving themselves off a cliff with data.  They have so much of it today in trying to find some Pandora’s box of wisdom that they can’t even put out an accurate MD listing themselves as their quants keep changing the models of insurance policies based on cost numbers from doctors.

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..

In fact the complexities of insurers gets so bad with data, see the link below to where you have United Healthcare bidding and winning a contract to only find

out later the quants on the other side of United’s analytics bunch already knocked out all the doctors and there were none to go with this program.  See what I mean.
Howard County School Board in Maryland Rescinds United Healthcare Contract As Retirees Didn’t Want the Medicare Advantage Plan, No Providers Available..

The Secret Scoring of Doctors has been going on for quite a while and this is why you can’t keep your doctor as Obama promised.  We can talk more intelligently now instead of hanging that one on Obama and look at it for what it is.  We do have enough other items that we can blame Obama for, but this the work of Quants, who insurers have hired by groves that create this misery.  Here’s more on the Secret Scoring of America’s physicians and there’s also a link there to the World Privacy Forum about their outstanding report on “The Secret Scoring of America” and that’s very much worth a read.  If you look at the top of this page, go to the link and see the Privacy Forum Testimony at the Senate on Data Selling and Scoring from a couple years ago.  You’ll get to hear what’s being sold and scored about you and the fact that Congress is doing nothing about it. 

“The Secret Scoring of America’s Physicians” - Algorithmic Math Models For Insurance Network Contractual Exclusions, Relating to MDs Who See Medicare Advantage Patients..

In another industry, truck driving, the healthcare folks are spinning out of control over there too with wanting to get live real time readings on every driver’s blood pressure and sugar levels, etc.  That’s the work of some pilot the DOT is proposing and looking for drivers to volunteer.  Good luck as there’s a 100% turnover right now with long haul truck drivers not to mention a shortage, so let’s make their job even more miserable?  You can’t use technology in ways that don’t work the way that people do and that’s exactly what’s happening here.  I can’t think of any truck driver who would want to be hooked up real time monitoring of their vitals while driving a truck, the job is hard enough as it is. 

Remember how Bloomberg made everyone so miserable with thinking that his “Big Gulp” model was going to cut down kids drinking soft drinks with sugar?  It bombed as it was a bad model and “people don’t work that way” so with Andy Slavitt at CMS we have a lot of the same thought processes taking place, and he’ begins to become a liability rather than a help with healthcare numbers.  It’s all he knows, algos for profit and we have the extensive proof from the years of Ingenix, now called Optum Insights where he was the CEO. 

Selling doctors data is not the answer to providing better care.  Each hospital on their own has enough data to know what’s going on and reports such already to CMS.  Take ICD10, it has does nothing to improve patient care and only created a more complex billing system to where companies like Optum 360 stand to benefit and make more money.  It should have been delayed until ICD11 when SnoMed crosswalks are more mature. 

We issues too with some of the Silicon Valley technology perceptions and I wrote about that this week too.  You are being somewhat told that some of this technology is diagnostic when in fact it’s just another risk assessment, done to “score” you again, so again as consumers and doctors, we have this humongous ball and chain of risks tied to our ankles that not only denies access but also is a big contributing factor to accelerating inequality in the US as they are modeling it that way.  The folks with code or who pay for a lot of it have all the money.  By the way Optum Behavioral Health’s headquarters is right up there in Silicon Valley too. 

Silicon Valley Is At It Again Confusing the Public With Calling Risk Assessments a Form of A Diagnosis Tool…

So again maybe time to look at who’s running healthcare in this country?  In addition to Andy Slavitt and his Quant background we have HHS Burwell who was a former chief of staff for former US Secretary of the Treasury, Bob Rubin, so there’s the 6 degrees of Bob Rubin there, the person who succeeded in downing Glass Steagall during his tenure of office with the Clinton Administration.  Maybe this year at HIMSS as a keynote speaker we could hear about what her responsibilities were as Rubin’s chief of staff with the damage that was done.  He is by the way on the board of trustees of Mount Sinai-NYU Health as a side note. 

Again I see this as a total rip and a way to just sell more data for profit rather than providing any better care.  HHS and CMS have lost their way and are currently way off of where they should be in representing the government in healthcare.  Over the years United Healthcare has mentored many of the CMS models (a former CMS analyst told me that), and now they are beginning to break, just like the economic models in the US are doing.  This will do nothing except make money and not serve to improve the quality of healthcare.  As a matter of fact, myself and a banker had this conversation about 3 years ago and we both agreed that 50% of the analytics sold in the upcoming years would be totally useless and show zero ROI, so that’s exactly what this is, more data selling to make money and continue to trounce the dignity of the average US Consumer.  Here’s another area where HHS has poking their nose too, over at HUD, as they think they need your medical records before providing any help to you and have contracted with Lewis, another subsidiary of United Healthcare for this pilot. 

HHS and HUD Match Housing and Health Data - To Understand Needs of HUD Assisted Households-Study Contracted to Lewin Group - A Subsidiary of United Healthcare

Here’s one of the companies, Argus Analytics that buys all your credit card data and what a surprise to see the Consumer Financial Protection Bureau to be a customer of theirs as well.  See what I mean, it’s all about selling data for profit and this gets us no better care.  Be careful as well as the call centers of insurance companies are doing risk assessments on your voice to determine your current state of mind when you are on the phone with them as well. 

This is what the Algo Man, Slavitt running CMS sees as a future, a world of “scoring” consumers, using technology we have no access to and is pretty much just drunk on Algos, like the White House.  This is all Slavitt has ever known, so this data selling Senate Bill is just another extension of data for dollars and we lose again.  When it comes to privacy, we’re stuck there too as there’s a former United Healthcare lawyer that handles that at the ONC, she’s no help and has a long background of working to secure profits through her legal efforts as well.  Think the profit cards are stacked here, you might be right.  BD 

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..

Some medical data miners may soon be allowed to share and sell Medicare and private-sector medical-claims data, as well as analyses of that data, under proposed regulations the CMS issued Friday.
Quality improvement organizations and other “qualified entities” would be granted permission to perform data analytics work and share it with, or sell it to others, under an 86-page proposed rule that carries out a provision of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Dr. John Toussaint, CEO of the ThedaCare Center for Healthcare Value in Appleton, Wis., said the MACRA provision would allow organizations like the Wisconsin Health Information Organization to accept Medicare data and then publicly report the performance of physicians both on cost and quality. The information exchange, one of the original 13 qualified entities, is the all-payer claims database for the state.



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