Walgreens Signs Agreement With PBM OptumRX (United Heatlhcare) and Anthem Then Sues Express Scripts

The long and short of the OptumRX agreement is  to allow patients to be able to pick up and fill a prescription in a retail store versus mail order.  That in inself tells me that there’s folks who don’t care for mail order services?  In addition, Walgreens will be able to pick up more data to sell as well.  OptumRX does it’s share of prescription data selling as well.  We might see other types of arrangements surface as remember there are two Hedge Fund executives sitting on the board at Walgreens. 

Two Hedge Fund Executives Gain Board Seat Walgreens, Stock Buy Backs To Continue And Increase, As Well Cost Cutting With Products And Maybe Employees
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

Walgreens and United Healthcare have also ventured together on other projects, as in some areas pharmacists gain some P4P money with getting a customer to sign up for the YMCA.  I think there are some matching funds from CDC that come into play here too.  A short while back a pharmacist told me that they were told to only sign up patients with United Healthcare with the YMCA and that would make sense based on this agreement at the link below.

UnitedHealth, YMCA Expand Diabetes Prevention Program with P4P forWalgreens
UnitedHealthCare To Use Data Mining Algorithms On Claim Data To Look For Those At “Risk” of Developing Diabetes – Walgreensand the YMCA Benefit With Pay for Performance Dollars to Promote and Supply The Tools

Moving forward Anthem who’s suing Express Scripts wants a judgment that it could terminate its deal with Express Scripts, which goes to 2019, but the Anthem is not sure it would officially end the contract?  Below is where Walgreens was charged wtih over charging customers.  They all want one thing, money.  A couple years ago United and Anthem had a pretty big dispute going and Walgreens is at a disadvantage in the fact that they don’t own a pharmacy benefit manager so are they too going to put more United Healthcare eggs in the basket with OptumRX?

Walgreens Accused of Overcharging Customers-Algorithms-Drug Stores Have to Pay Penalties on Their Issues, Why Does Wall Street Skate When Their Killer Algorithms Attack?

If you have watched the news of late, then you may have noticed that United/Optum RX has figured out there’s big money in distributing drugs and pharmacy benefit managers of course make money with so called kick backs from the drug companies and their distributors.  You may not always get the lowest price but rather the drug that pays the PBM the best.  Here’s where OptumRX is now in the workman’s comp pharmacy benefit management business with this acquisition of a couple months ago.  Pay attention folks as the bigger conglomerates keep getting bigger and bigger and the more say they have, the less say we have.

United Healthcare Buys Helios Workman’s Comp PBM and Their Other Related Businesses

You can see here where OptumRX has already hurt some of the business in Florida with a big move to take some of their business.

Express Scripts To Lay Off 400 People Tampa As United Healthcare Moves Patients To Their Own Pharmacy Benefit Management Company-Subsidiary Watch

By the way, look at how Express Scripts “scores” you with predictive behavior algorithms with 300 metrics that mostly have nothing to do with taking prescriptions.  They all do this and I just happend to cover the Express Scripts portion as they brag about it on their website for anyone to see.

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

It was back in 2010 that Express Scripts started running medication adherence predictions with the use of Ingenix (United Healthcare) algorithms, so the scoring algorithms get intertwined all over the place for the sake of making money selling “scores” about all of us and with flawed data to boot.  The archived post on that one is below. 

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 Stop

Now with Walgreens working to buy Rite-Aid, they too are using the EQIPP Platform to “score” and take in a bunch of data on predictions.  The only problem with this program is that it searches out all kinds of financial data to check on you to find a credit card, or some other transaction to see if you filled a prescription, when, and a lot more.  Below are a couple links that goes into detail on why you should pay cash for prescriptions if you want to preserve “some” of your privacy.

Rite Aid Pharmacies are the Latest to Begin Used Flawed Data Provided by the EQuIPP Platform Relative to “Scoring” Patients for Predictive Medication Adherence–The “Outlier” Patients…
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…

Are you starting to see a pattern here, maybe?  If you don’t better dig in a look again as this is all about making money distributing drugs and not so much on saving costs as it’s always billed.  Why else would Anthem be suing Express Scripts?  In addition you also have FICO doing medication prediction scoress, so easy they say to do with mining data about you is all they need is your name and address and they can score anyone on with what they also call medication adherence scores…la te dah…tons more data about you to sell along with these “scores”.

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

Also as a side note, be aware that your voice is being scored for your behavior at the insurance call centers, most of them have these algos to score you and yes these behavior scores get sold too!

“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…

So out of this deal with OptumRX, as a patient you get convenience of going to a Walgreens store and both Walgreens and OptumRX benefit on getting more data and scores to sell about you, and those scores are top secret, just try and ask a pharmacist for your medication prediction adherence score sometimes?  BD


Unlike CVS, Walgreens doesn’t operate its own drug-benefits business. The deal with OptumRx will probably draw more customers into Walgreens stores, along with boosting drug sales, according to Ann Hynes, an analyst at Mizuho Securities. Express Scripts probably has the most to lose during the employer-benefits selling season, which begins next month, according to Hynes. The company has a similar arrangement with Walgreens, but still tends to push customers to get their drugs by mail.

UnitedHealth’s partnership with Walgreens starts on Jan. 1. Some members with drug coverage from OptumRx may lose the option of filling their prescriptions at pharmacies other than Walgreens under the deal, though that’s up to the employer or other entity that’s making the benefits decision. The deal will also give Walgreens pharmacists more access to information that will help them counsel patients who are on multiple drugs, aren’t getting refills or taking pills that shouldn’t be taken together, said Mark Thierer, chief executive officer of OptumRx.

http://www.bloomberg.com/news/articles/2016-03-17/unitedhealth-takes-on-cvs-express-scripts-with-walgreens-deal

United Healthcare Puts Their Quants To Work Again-Designs a Subsidiary to Compete Against Them and Sell Insurance With a New Set of Algorithms Named Harken

You read the title correctly as United adds yet one more subsidiary to their almost 400 subsidiary companies.  This is indeed marketing that will get more insureed inside one of their networks and of course they are competing with the other insurers as well.  The catch here is for the insured to visit one of the Harken facilities to experience no co-pays and I’m guessing these could be doctors on salary as so many across the nation are now averaging payments about 12% less than what Medicare pays.  This is in a test market area for righ now in Illinois and Georgia.image

Doctors In Network LeaveUnited Healthcare–Tired of Getting Paid At Rates 12% Less Than Medicare…

One might ask too, will there be United Healthcare coupons handed out as yet another way to get even more behavioral data about you as well. 

United Healthcare Finds Yet Another Way to Track You At the Grocery Store–Healthy Savings Card That Will Give You Discounts and Track What You Buy..
Health Insurance Companies Providing Charge Cards And/Or Coupons For Healthy Foods–More Data To Collect About You And Potentially Repackage and Sell For A Profit…

You can maybe guess that the revenue cycling for these offices could be handled by yet another United Subsidiary company, Optum 360.  That is an outsource company that goes into practices and hospitals, fires the existing folks and usually hired them back for less or lesser benefits, etc. 

Mayo Clinic is the Latest to Outsource Revenue Cycling to Optum 360, A UnitedHealthcare/Dignity Health Company Pursuing Hospital Contracts All Over the US For Profit…

It’s also worth the speculation of looking at another United Healthcare subsidiary, the MedExpress urgent care clinics that were purchased by United last year which I beleive there’s just under 200 of them now that blanket pretty well in a few states like West Virginai, Pennsylvania, so see if there’s thought of merging Harkin in with these subsidiaries. 

Optum (United Healthcare) Buys MedExpress Urgent Care Business- 141 Full Service Clinics In 11 States–Company Advertises They Are In the Market to Buy Your MD Practice, As A “Too Big To Fail Insurer” Moves Forward With More Acquisitions
OPTUM Clinics Holdings, New Subsidiary Incorporated In 2015 Raises Over 36 Million (Exchange of Shares) From Investors Unknown-Form D Used to Maintain Secrecy Of Who They Are For Now…

In addition the push to get even more consumer behavior data is also active with this model in Arizona to where the center revovles around a clinic and provides all kind of services, even to getting into the patient’s financial affairs with managing their money.  Again as I keep saying, United is a too big to fail insurer and it into all different types of businesses most are not aware of. 

And So It Starts With Funded Health Insurance Communities to Help the Poor and Obtain A Lot More Behavior Data to Mine and Sell ForUnited Healthcare From the Participants…

Here’s the bank services of the Optum Bank, ready to give out an HSA account and of course a MasterCard to empty it out as needed and at the same time be able to collect more behavioral data about you too. 

United Healthcare Owns a Bank-Optum Bank That Will Collect Your HSA Money, Give You a MasterCard to Empty It Out-Which Enables Even More Data Mining and Selling Transactions About You

United/Optum has grown by acquiring other companies.  In addition if you can’t afford care, there’s another option at Optum (which you have to pay for) with a “discount card” called Health Allies.  This company was founded by current CMS head, Andy Slavitt and the daughter of Senator Elizabeth Warren, Amelia Warren Tyagi in California when both of them got together at a “beach house” as it was quoted in an interview in California from knowing each other at the McKinsey Group.  We all know what “The Firm” (McKinsey) group is today, the “CEO school” basically as written about in the book called “The Firm: The Story of McKinsey and Its Secret Influence on American Business”.  

Being that Warren’s daughter now runs a company that is stated to compete with McKinsey, one could speculate if the agency had anything to do with the fact that a former United Healthcare Executive ended up running the NHS i the UK as well.  You can ponder that one if you like.  The company finds McKinsey-like people to run companies.  You can go here for the visual history on Health Allies and take a look.  I might guess both Warren’s daughter and Current CMS Head Andy Slavitt made a big haul here with United buying Health Allies and I think allowed Mr. Slavitt to go further and create the Ingenix subsidiary of United Healthcare, which has a huge history of not being honest with their math models and algorithms. 

With all the mergers and acquisitions today, I feel it’s important for consumers to be aware of who’s bottom line you are feeding with your healthcare today as United/Optum is pretty much just “hiding in plain site”  with all their subsidiaries and taking advantage of the fact that people don’t bother to look and read.  Here’s another example of the new Optum Clinical Labs subsidiary and we don’t know who jumped in to add the additional $32 million in funding here either.  With United’s current CEO now sitting on the board of Cargill, corporation, well one could speculate, was it one of the hedge funds that food company operates?  The investors in the new Optum Clinical Labs subsidiary was kept in secret with the SEC filing.

The scary thing here is one health insurance company forming a monopoly at HHS and CMS today and we are seeing lack of competition here and again too much power from one US corporation.  There have been and currently are several executives of United who serve over at the CAP (Center for American Progress) who is the think tank that writes healthcare policy for HHS today.  That is scary too as you imagewill also find folks like Dr. Zeke Emanuel and Jonathon Gruber over there as well as members, writing policy.  If you have ever read much of Zeke Emanuel’s books or articles, it’s hard to ignore the fact that he’s walking commercial for Optum and United Healthcare, been that way for a few years now.

Zeke Emanuel Joins Venture Capital Group–Will He Still Be Writing US Healthcare Policy at the CAP Think Tank?

So here we go again, just one more subsidiary to gain more market share and the United Healthcare/Optum Quants have been busy modeling yet one more choice to make things even more complicated for consumers?  Why?  Because it means big profits to keep consumers jumping through constantly changing models and algorithms to get their healthcare as United is very aware of the captive audience they have unfortunately. 

Don’t be confused as these models are not here to really give you better care, they are created in the name of profit and gaining bigger market share and like I said the quants have been busy as health insurers hired armies of them, just like the financial markets.  BD

Data Scientists/Quants in the Health Insurance Business–Modeling Beyond the Speed and Capabilities of Humans To Keep Up With The Affordable Care Act–Turning Into A World of Killer Algorithms That We All Hate..


UnitedHealthcare is facing competition this year in Atlanta and Chicago from a new name in health insurance — a carrier that’s actually one of its subsidiaries. For the first time, individual shoppers are buying coverage from Harken Health, a company with about 100 employees based at an office on the UnitedHealthcare corporate campus in Minnetonka.

Harken is being run as an independent entity, executives said, with a distinct approach to selling coverage. Subscribers receive unlimited access to primary care, without copays, if they visit a health center owned by Harken Health.

Rather than charge a premium, Harken Health says it collects a “membership fee.” The company’s clinics are called “health centers.” Beyond not charging copays at the centers, there’s also no “coinsurance” — a form of cost-sharing that Vanderheyden says just adds complexity. By simplifying payment, the centers don’t have to bother with all the paperwork and hassle to get paid by insurers, Vanderheyden said.

Harken sells a “bronze” quality plan with a $6,850 deductible to a 40-year-old in Chicago for $242 per month. UnitedHealthcare offers slightly lower deductibles and monthly costs of $255 and $269.

http://www.startribune.com/unitedhealthcare-launches-a-smaller-very-very-different-insurer/371824841/

United Healthcare Now Offering Employers Wearable Wellness Devices-UnitedHealthcareMotion–More Data To Mine And Sell With Related Risk Assessment Scoring Processes About You-Excess Scoring

Here we go again, the Big Brother push and of course could all these “motion” scores be combined and queried with medical claims and other information on hand at United?  Sure they could and we now would have an entire new bunch of risk assessment scores to imagesell about you for profit.  Just remember everything is not as it seems out there.  If you want one of these to improve your health, go buy one and use it on your own without having to send all your numbers to some server connected via Qualcomm.  The incentives here of over around $1000.00 a year are not worth a bunch of privacy.

So far this is for employers to offer to employees right now but watch the next pitch to have one of these on every Medicare Advantage insured patient they have.  Just behind IMS who had a big IPO last year, United is second in the dollar amounts they make selling medical data.  There’s no privacy statement with this device and there also appears to be yet another United fitness devices called TrioMotionFit.  If they don’t get you with one, the other one is there.  I have no doubt in this new low income United Healthcare community that soon all these folks will be hooked in as they want into every nook and cranny of one’s life, a big way to take advantage of the poor with mining all their data for sale. 

And So It Starts With Funded Health Insurance Communities to Help the Poor and Obtain A Lot More Behavior Data to Mine and Sell For United Healthcare From the Participants…

These folks at the Insurance community center are also going to be stuck with this little number:  UnitedHealthcare myMoney Connect, so if seeing a doctor at the low income housing commnity there’s all kinds of ways to be enticed to give up your data.   

How soon before they roll this out to their workers comp PBM subsidiary, Helios they just bought?  Good question maybe..

United Healthcare Buys Helios Workman’s Comp PBM and Their Other Related Businesses

Coming back on topic here, how soon will employees be getting “the stick” on this wellness program?  It’s not about making you healthier in the long run, it’s about collecting more data to sell and to score you with.  If you read the news, wearables are not what people want as we don’timage work that way and with all aspects of life wanting us to interact with “their” algorithms, we don’t have time for this on a daily basis.  The novelty with trying it usually wears off in about 2 months is what’s been published.  Do you even have a clue as to how much data employers need to give to insurance companies today in order to insure you?  It’s a lot of of course they go out and buy all kinds of data to score you as well, such as all your credit card transactions too.  Here’s one you never heard of that buys up all your credit card transactions, runs analytics to score you and sells those scores to insurers, banks, etc.

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

If that isn’t enough for you, check this link out below on how the drug stores and pharmacy benefit managers “score” you every time you fill a prescription on whether or not you will take your drugs.  This is a “prediction” and not actual data, so keep that in mind and IMS of course buys all of this data up as well as your insurer.

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

I call it Excess Scoring of US consumers as it continues to tag more and more and more risk assessment about us to some data base and it all gets sold for profit, so look at the data from these fitness devices and do you think it will be combined with other data, you bet it will and it will be scored and sold for big corporate profits.  The market now for consumer data selling is around $200 Billion a year. 

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..

This is really all about selling data and risk assessments and behavior change to get you to give it up so corporations can profit.  Wellness is all about education and healtheir lifestyles and having people “want” to take an interest and not force fed by dummying you down to a device that makes profits for corporate America as that’s what this is.   We really need a law to Index and License all data sellers, so we know who they are.  In case of errors and flaws with profiles created we have no way to even address correcting those errors.  With more machine learning, be ready for even more flawed scores about you to emerge. 

Index and License Data Sellers, Step One Needed for Any Consumer Privacy Efforts to Exist - Spurious Correlations and Flawed Data Risk Assessments Thrive To Erroneously Deny Access

I would say pass on this and get your own device that keeps everything “on the device” and doesn’t have a connection to send it somewhere as an alternative.  Watch for those coupons too from insurers, just another way to track what you eat as well.  This is a broken Big Brother model as again “people don’t work this way” and companies will do anything today to trick you into giving away you data, so they can profit.  BD 

Health Insurance Companies Providing Charge Cards And/Orcoupons For Healthy Foods–More Data To Collect About You And Potentially Repackage and Sell For A Profit…


LAS VEGAS (March 1, 2016) – UnitedHealthcare and Qualcomm Incorporated (NASDAQ: QCOM), through its wholly owned subsidiary Qualcomm Life, Inc., today announced UnitedHealthcare Motion™, a new wellness program that provides employees with wearable devices at no additional charge and enables them to earn up to $1,460 per year by meeting certain goals for the number of daily steps.

UnitedHealthcare Motion is being showcased for the first time at this year’s Healthcare Information and Management Systems Society Conference (HIMSS), the industry-leading health information technology conference. The UnitedHealthcare Motion app will be displayed at the Qualcomm Life booth (No. 6437) at HIMSS 2016.

The wellness program and related fitness trackers are being offered initially to companies with 101 to 300 employees with a fully insured health plan. Employees and their covered spouses receive custom-designed wearable devices that track the number of steps users take each day. Unlike other wearable devices that simply track the total number of steps, the UnitedHealthcare Motion devices tabulate the total number, frequency and intensity of the steps taken, providing a more accurate and comprehensive summary of the user’s daily activity.

The data is then sent to the UnitedHealthcare Motion app, which is powered with seamless and secure connectivity through Qualcomm Life’s 2net Mobile connectivity platform. Employees can earn Health Reimbursement Account credits that can total up to $1,460 per year, while employers can obtain premium savings based on program participants’ combined results.  

http://www.uhc.com/news-room/2016-news-release-archive/wearable-devices-wellness-program