CVS Joins Walgreens With No DNA Box on the Shelf – But What About the Marketing to Consumers on Tests?

<p>I have written here about the<strong> various plans to market “genetic benefits”</strong> here with most of the recent announcements.  Granted if a doctor believes a test should be done prior to writing a prescription, then we follow the advice of the doctor, but from what I have seen in recent articles here the plan of action got a little crowded here and has the potential of confusing both consumers and physicians, and it’s not just a matter of a “box on the shelf”, that is the minimal part of the issue.  Perhaps the FDA feels that this availability would encourage more consumers to delve into getting their DNA tests?  Also, you have to remember this is not an inexpensive proposition with individuals finding it difficult today just to be able to afford normal medications prescribed.<a href="http://lh3.ggpht.com/_v3zjJigoAPE/S_QgKirEb_I/AAAAAAAAeIE/bxC1VNaO644/s1600-h/image3.png"><img align="right" alt="image" border="0" height="123" src="http://lh3.ggpht.com/_v3zjJigoAPE/S_QgLNxibzI/AAAAAAAAeII/3fFNKDqX2OE/image_thumb1.png?imgmax=800" style="border-right-width: 0px; display: inline; border-top-width: 0px; border-bottom-width: 0px; margin-left: 0px; border-left-width: 0px; margin-right: 0px" title="image" width="136" /></a> </p> <h4><a href="http://ducknetweb.blogspot.com/2010/05/walgreens-changed-their-minds-on.html"><font size="2">Walgreens Changed Their Minds on Selling Home Genomic Test Due to FDA Inquiry – What Is The Big Deal?</font></a></h4> <p><strong>My opinion here on the topic is that the doctors were somewhat being left out of the solution with the pharmacies more or less taking charge here with tests and certainly there’s both side of the coin.</strong>  If a patient is going to be prescribed a medication that is questionable on whether or not the drug would work, then the test might just be the right thing to do, but to mass market and encourage all to have tests because “they are available” could lead to further confusion.  We also have to keep sight of the fact that we now bring payers into the picture and risk management as far as cost.  Granted in time things may flow in this direction but processes and standards need to be established before we jump in feet first.  Medco outlined their plans recently.</p> <h4><a href="http://ducknetweb.blogspot.com/2010/05/medco-also-entering-into-field-of.html"><font size="2">Medco Also Entering Into the Field of “Genetic Benefit Management” With Making New Tests Available</font></a></h4> <p>Online if an individual wants to have their DNA tests done, they can do it and the only difference between the box on the shelf and signing up online is the box being available for purchase instead of the company mailing one out, thus again I don’t see the box on the shelf being an issue, but rather the marketing side of all of this as the cost is still $200-$300 for a standard run, whether or not the box is mailed or if were bought off the shelf.  Maybe the visibility of being on the shelf is too much at this point, none of us know about that since it has not been done.  </p> <p><strong>There’s definitely money here to be made with encouraging employers to pay for such tests with plans where employer provided insurance comes into play,</strong> and we need to remember privacy issues here too and everything as it is today we still need to worry about the “evil twin payer” getting a hold of the information and possibly using it to “score” a patient, whether it is done officially or off the records.  It’s like hearing a comment in court where the judge says “strike that from the record” but the fact that it was still heard and/or seen doesn’t change.<strong>  Even with not being official and not able to be used officially or legally in an evaluation, such information could ultimately lead to looking for loopholes in other areas to “score” and assess risk.  We have seen that in a couple recent court cases, so to be legally correct, best bet would not to have the information available to see at all.  </strong></p> <p>I don’t think we or the sequencing business has matured enough to jump into the mass marketing here and <strong>you can’t ignore the fact that marketing does occur today as it is all around us, healthcare included, just look at how hospitals market for a simple example and it doesn’t stop there</strong>.  Who would have ever thought a few years ago that hospitals would have to market like we are seeing today, and some of it is a bit redundant to a degree too.  <a href="http://lh3.ggpht.com/_v3zjJigoAPE/S_QgLblRA7I/AAAAAAAAeIM/JibXOad07c0/s1600-h/image8.png"><img align="right" alt="image" border="0" height="111" src="http://lh4.ggpht.com/_v3zjJigoAPE/S_QgL7a8dhI/AAAAAAAAeIQ/tKom48gxnm8/image_thumb4.png?imgmax=800" style="border-right-width: 0px; display: inline; border-top-width: 0px; border-bottom-width: 0px; margin-left: 0px; border-left-width: 0px; margin-right: 0px" title="image" width="186" /></a> </p> <h4><a href="http://ducknetweb.blogspot.com/2010/05/pharmacy-benefit-managers-striking.html"><font size="2">Pharmacy Benefit Managers Striking Alliances with Genomic Test Companies – A New Left Hook in Shaping Portions of Healthcare Reform With Genetic Benefit Managers?</font></a></h4> <p>It does get confusing today, what is marketing and what is a good decision and is the pressure from marketing pushing a decision that maybe doesn’t need to be present?  There’s a lot to think about there and companies need to show some area of responsibility when it comes to better patient care and see both sides and <strong>not just focus on how much money it will bring to the bottom line, in other words balance.</strong>  When everything is only profit driven, consumers will not follow and trust corporate marketing plans as eventually it comes out in the water as to what the full circle plan is.  </p> <p>As I have suggested before, it’s a good idea to read what those who have been sequenced have to say about their results and what impact is has or has not had on their lives, here’s a couple links:</p> <h6><a href="http://ducknetweb.blogspot.com/2009/01/steven-pinker-harvard-professor-of.html"><font size="2">Steven Pinkerton, Harvard Professor of Psychology talks about his genome, what he found out, what he learned, and how the psychological interpretations are somewhat still up for discussion</font></a></h6> <h6><a href="http://ducknetweb.blogspot.com/2009/06/charlie-rose-personalized-medicine-with.html"><font size="2">Charlie Rose - Personalized Medicine with Steven Pinker, Anne Wojcicki, George Church and Linda Avey</font></a></h6> <h6><a href="http://ducknetweb.blogspot.com/2009/01/burden-of-knowing-genetic-sequencing.html"><font size="2">The Burden of Knowing – Genetic Sequencing and what you might find out</font></a></h6> <p>You can search around my blog too as there are more if you want to listen to some who have gone through the process so you kind of know up front what to expect and what decision processes it may present.  BD  </p> <blockquote> <p><a href="http://www.chicagotribune.com/topic/economy-business-finance/cvs-corp.-ORCRP004225.topic">CVS</a> Caremark Corp. is joining rival <a href="http://www.chicagotribune.com/topic/economy-business-finance/consumer-goods-industries/walgreen-co.-ORCRP017359.topic">Walgreen Co.</a> in shelving plans to sell personal genetic testing kits following federal regulatory scrutiny of the supplier of the product.</p> <p>Deerfield-based Walgreens reversed its decision to carry Pathway Genomics' test kits Thursday, the day before they were scheduled to hit the shelves of 6,000 of its drugstores. CVS confirmed Tuesday that it will hold off on its plans to begin selling the kits in August.</p> <p>Buyers of the kit send a sample of saliva to a Pathway laboratory by mail and receive a genetic health report online. The tests claim to assess the risk of dozens of health conditions, including Alzheimer's disease, breast cancer and <a href="http://www.chicagotribune.com/topic/health/physical-conditions/obesity-HEDAI0000057.topic">obesity</a>. </p> <p>Some scientists are concerned that consumers will misuse or misunderstand the results.</p> </blockquote> <p><a href="http://www.chicagotribune.com/business/ct-biz-0519-cvs-genetics-kit-20100518,0,4928942.story">Genetic testing kits: CVS delays sales of genetic testing kits - chicagotribune.com</a></p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:580c2276-0185-4380-abfb-76cc7e4172bf" class="wlWriterEditableSmartContent">Technorati Tags: <a href="http://www.example.com/healthcare" rel="tag">healthcare</a>, <a href="http://www.example.com/drugs" rel="tag">drugs</a>, <a href="http://www.example.com/pharma" rel="tag">pharma</a>, <a href="http://www.example.com/personalized+medicine" rel="tag">personalized medicine</a>, <a href="http://www.example.com/pharmacy+benefit+managers" rel="tag">pharmacy benefit managers</a>, <a href="http://www.example.com/PBM" rel="tag">PBM</a>, <a href="http://www.example.com/patients" rel="tag">patients</a>, <a href="http://www.example.com/High+Frequency+Healthcare" rel="tag">High Frequency Healthcare</a>, <a href="http://www.example.com/Congress" rel="tag">Congress</a>, <a href="http://www.example.com/CVS" rel="tag">CVS</a>, <a href="http://www.example.com/Walgreens" rel="tag">Walgreens</a>, <a href="http://www.example.com/DNA" rel="tag">DNA</a></div>

CVS Joins Walgreens With No DNA Box on the Shelf – But What About the Marketing to Consumers on Tests?

I have written here about the various plans to market “genetic benefits” here with most of the recent announcements.  Granted if a doctor ...

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Pharmaceutical Wholesalers Inc. File Legal Complaint Against OptumRx “Aligning Its Interests” with the Big Three Drug Distributors in US, Thus Acting as an Agent of the Government With Accreditation Processes

<p>This is a pretty interesting lawsuit and it includes named invidituals at HHS and CMS as well as participants.  You can view all the defendants included in the <a href="https://www.law360.com/cases/581cff6a5270e84d59000001">filing here.</a>   Being we are at the end of the Obama administration, the named directors Burwell and Slavitt in this case involvement once out of office may or may not still be included, but OptumRX portion looks like it won’t go away.</p> <p>This is basically collusion with the government giving exceptional regulation controls to OptumRX on <a href="https://lh3.googleusercontent.com/-nTq7yCVQmIU/WDHZppI5bzI/AAAAAAABM2o/Di60u0eZQ1Y/s1600-h/image%25255B3%25255D.png"><img align="right" alt="image" border="0" height="126" src="https://lh3.googleusercontent.com/-lTdcxFwJdc8/WDHZqc4qZgI/AAAAAAABM2s/C4HFa3C1W-Q/image_thumb%25255B1%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="240"></a>the accredited distribution of drugs distribution of drugs in the US with basically setting up shop with only the 3 major distributors, and thus so it is making it harder for the secondary or smaller drug distributors to function and operate.  We know what less competition probably means, even higher prices at the drug store.  </p> <p>The lawsuit also points out that United Healthcare is a Medicare Part D insurer and with that fact it appears to be an “agent of the government” will also having the OptumRX subsidiary, the PBM manager having the authority to use the accrediting program called VAWD to basically let other smaller drug distributors in the game.  It would seem to make more sense to have pharmacies be accredited than distributors since they are the ones selling the drugs. </p> <p>OptumRX might be working to drive independent pharmacies out of business to and convert those customers to their mail order pharmacy or to Walgreens, their preferred pharmacy partner.  Recently there was a big partnership created there as well to allow higher profits via Walgreens.</p> <h5><a href="http://ducknetweb.blogspot.com/2016/03/walgreens-signs-agreement-with-pbm.html">Walgreens Signs Agreement With PBM OptumRX (United Heatlhcare) and Anthem Then Sues Express Scripts</a></h5> <p>The fear is that secondary drug distributors will be pushed out of business.  Effective October 1st, all prescription claims not not filled via a VAWD distributor could be denied.  There’s a long list of VAWD credited distributors.  Wholesalers in most states are already subject to inspection by state and/or federal regulators to ensure compliance so what’s the action with OptumRX to act as a 3rd party regulator of sorts?  All pharmacies who fill prescriptions are required to sign a contract with Optum, which I have read in some instances includes the pharmacists not being able to offer a cheaper cash price to the customer as they would be in violation of the contract.  </p> <p>Here’s an interesting tidbit on how OptumRX makes a ton of money from diabetes test strips, take notice of this and the <a href="http://www.pharmacychoice.com/news/article.cfm?Article_ID=1608884">entire article can be read here.</a>  Look at how this winds around with insurer United making big deals on test strips, but does this savings get passed on to the consumers, apparently not. </p> <p><em>“Tackling OTC supplies was the logical next step for OptumRX. OptumRX has a booming mail-order pharmacy business and diabetic test strips play a big role in their profitability. They champion one brand, Roche’s Accu-Chek, and by pooling their purchasing power get manufacturers to compete against each they secure steep discounts. To put this in real world terms: from a retail pharmacy, these <strong>test strips cost about $90 per 50 test strips to the consumer</strong> and is then adjudicated with<strong> insurance companies for about $95</strong>. However, with their steep discounts, it is <strong>estimated that OptumRX pays only about $10 per box of 50 test strip</strong>s because <strong>Roche only charges Medicare about $5 for that same box</strong>. </em></p> <p><em>This means that<strong> OptumRX stands to make up to $85 in gross profit per box, per month</strong>; multiplied by the diabetic population of their 65 million members, OptumRX is playing with real numbers. It sheds a lot of light onto American’s high insurance premiums and the resources they can call on to fight the legal action brought against their new bold policies in court.”</em></p> <p>If noting else, when you look at the big money that the OptumRX subsidiary of United is making, the paragraphs above shed some light on how this is happening and it’s all done with algorithmic business models with a series of algorithms for distributors and drug stores to jump through.  </p> <h5><a href="http://ducknetweb.blogspot.com/2016/04/united-healthcare-reports-1st-quarter.html">United Healthcare Reports 1st Quarter-OptumRX (Pharmacy Benefit Manager) Produces More Revenue Than Its Health Insurance Groups</a></h5> <p>Again states have regulations but now OptumRX in fact is becoming a 3PL regulation enforcer via the government on some of this?  I have read that OptumRX is giving folks some extended time to become VAWD certified before cancelling payments here and there, and wholesalers must already comply with the Drug Supply Chain Security Act (DSCSA) which requires the FDA to issue regulations regarding wholesale distributor and third-party logistics provider licensure.</p> <p>So basically smaller distributors who provide better drug prices might be edged out completely.  So again with more certification policies and adherence, is this going to fix any</p> <p> </p> <p>thing other than to allow OptumRX to charge more a the drug store counter and really accomplishe much?  Here’s the lawsuit on the “clawbacks” that are taking place when you arrive to get your prescription at the drug store with the OptumRX algorithms “front running” the script cost via the pharmacy software networks in place all over the US before you can physically even get there to fill your prescription too. </p> <h5><a href="http://ducknetweb.blogspot.com/2016/10/cigna-united-healthcare-face-class_16.html">Cigna & United Healthcare Face Class Action Suits-PBM Over Charging Customers for Prescriptions, OptumRX Pharmacy Benefit Management Software-“Front Running” Consumers With Killer Algorithms at the Drug Store</a></h5> <p>I’ve often said it would be of real interest to have a video of a pharmacist filling a prescription via the software of the pharmacy benefit management systems in place at pharmacies today so the public can see what the process is for the pharmacist just to get you your bottle of pills, and maybe involving a call or two to the dreaded PBM pharmacy tech.  <p>Don’t forget that Optum 360 is now taking care of all your Quest Diagnositics lab bills too as their outsourcer.  Pay attention to the “too big to fail” health insurer, United with close to 300 subsidiaires that do all kinds of things out there outside of just insurance.  BD <h5><a href="http://ducknetweb.blogspot.com/2016/09/quants-of-optum-carve-out-new.html">Quants of Optum Carve Out New Outsourced Billing Deal with Quest Labs, Will Also Serve to Enhance The Scoring & Data Selling Business Conducted by Both Companies via Powerful Subsidiaries</a></h5> <p>They’re buying up your doctors too, another reason you can’t keep your doctor as they own and manage physicians groups all over the US today.  </p> <h5><a href="http://ducknetweb.blogspot.com/2016/08/optumcare-doctors-to-get-allscripts.html">OptumCare Doctors to Get Allscripts Medical Records EHR–Optum Continues to Buy More Practices and Manage More Doctors Through Independent Physician Associations, Many of Which They Own</a></h5> <p>By thew way, if you have never seen how the automated prescription services work, take a look at this…complete audit trails that also feed <a href="http://ducknetweb.blogspot.com/2015/06/medication-adherence-predictions-enter.html">medication compliance software data systems.</a>  That is yet another topic for conversation with flawed data using metrics about us that are flawed.  BD  </p> <p><iframe height="315" src="https://www.youtube.com/embed/SfXoQWnpIb4" frameborder="0" width="560" allowfullscreen></iframe></p> <p> <hr> WASHINGTON (Legal Newsline) - A not-for-profit trade association that represents independently-owned pharmaceutical wholesalers is suing a pharmacy benefit manager and the federal government over a new accreditation policy, arguing it violates various state and federal laws. The Association of Independent Pharmaceutical Wholesalers Inc., based in Pine Brook, N.J., filed its complaint in the U.S. District Court for the District of Columbia Nov. 4. </p> <p>The named defendants include OptumRx Inc., based in Irvine, Calif.; the U.S. Department of Health and Human Services; Sylvia Burwell, secretary of the DHHS; the Centers for Medicare and Medicaid Services; and Andrew Slavitt, acting administrator of the CMS.</p> <p>“OptumRx’s business relationships with the Big Three have resulted in the implementation of bad faith policies designed to steer market share away from the Secondary Wholesale Market and toward the Big Three,” AIPW alleges. </p> <p>For instance, AIPW claims OptumRx, in August, informed its participating pharmacies that effective Oct. 1, participating pharmacies were required to purchase all medications being dispensed to OptumRx members from a VAWD. VAWD, an accreditation offered by the National Association Boards of Pharmacy, essentially eliminates the secondary wholesale market, AIPW argues.</p> <p>“Plaintiff’s members have already been informed by their pharmacy customers that the pharmacies will cease ordering medications and supplies from Plaintiff’s members due to OptumRx’s VAWD-Accreditation Policy,” the association alleges. “This is because the pharmacy customers face PBM audits from OptumRx, whereby OptumRx actively threatens to ‘recoup’ 100 percent of funds paid to the pharmacy arising from the purchase of drugs from wholesalers such as Plaintiff’s members that are not VAWD accredited.”</p> <p><a href="http://legalnewsline.com/stories/511045586-pharmaceutical-wholesale-group-says-accreditation-policy-will-irreparably-damage-the-nation-s-prescription-drug-delivery-system" title="http://legalnewsline.com/stories/511045586-pharmaceutical-wholesale-group-says-accreditation-policy-will-irreparably-damage-the-nation-s-prescription-drug-delivery-system">http://legalnewsline.com/stories/511045586-pharmaceutical-wholesale-group-says-accreditation-policy-will-irreparably-damage-the-nation-s-prescription-drug-delivery-system</a></p>

Pharmaceutical Wholesalers Inc. File Legal Complaint Against OptumRx “Aligning Its Interests” with the Big Three Drug Distributors in US, Thus Acting as an Agent of the Government With Accreditation Processes

This is a pretty interesting lawsuit and it includes named invidituals at HHS and CMS as well as participants.  You can view all the defenda...

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CVS Caremark Announces First 13 Drugs to be Incorporated Into Their “Genetic Benefit Management Service”

<p>Generation Health has put together a "Best Test" laboratory network to manage testing costs for payers. The firm has also developed data and analytics to review gaps in care among patients, and outreach programs addressing communications between patients, physicians and pharmacists.  This is a focus toward employers and is cost related, so I guess now we can add on genetic testing benefit managers to work with pharmacy benefit managers.</p> <h4><a href="http://ducknetweb.blogspot.com/2009/11/cvs-caremark-launching-collaborating.html"><font size="2">CVS Caremark Launching Collaborating with Generation Health To Launch Program to Predict Patient Response for a Dozen Drugs With Genetic Testing</font></a></h4> <p><em>“This is the first announcement of this type I have seen.  Generation Health bills itself as a genetic benefit management company.  It seems </em><a href="http://lh5.ggpht.com/_v3zjJigoAPE/SwiTmCxUi7I/AAAAAAAAbEQ/i5T0BQ4TnNg/s1600-h/image%5B3%5D.png"><em><img align="right" alt="image" border="0" height="87" src="http://lh6.ggpht.com/_v3zjJigoAPE/SwiTnM8ZnUI/AAAAAAAAbEU/5kE-T4hPlDE/image_thumb%5B1%5D.png?imgmax=800" title="image" width="153" /></em></a><em>interesting that GINA has just become effective with new provisions that prevent family history to be used as it relates back to potential discrimination in hereditary areas and now we have a company wanting to jump in and help patients manage clinical and genetic testing through a pharmacy benefit manager.</em> “ </p> <p>As noted before, the box will not be available on the shelf.  With the announcement of these first 3 drugs they will council on whether or not the particular drugs will work.  As I understand this is being generated via the employer benefit manager with health insurance benefits.  BD  </p> <h4><a href="http://ducknetweb.blogspot.com/2010/05/cvs-joins-walgreens-with-no-dna-box-on.html"><font size="2">CVS Joins Walgreens With No DNA Box on the Shelf – But What About the Marketing to Consumers on Tests?</font></a></h4> <blockquote> <p>NEW YORK (GenomeWeb News) – CVS Caremark and Generation Health today announced the 13 drug therapies that will be included in the initial offering of their <strong>integrated Genetic Benefit Management service.</strong></p> <p>The firms said that they are offering the industry's first <strong>Best Test Genetics Network,</strong> which coordinates pharmacogenomic testing for members of CVS Caremark's network. </p> <p>The drugs that have been selected thus far include six drugs dispensed generally through <strong>PBM services:</strong> Nolvadex (tamoxifen), Plavix (clopidogrel), Tabloid (thioguanine), Tegretol (carbamazepine), and Ziagen (abacavir). </p> <p>It also includes seven drugs dispensed through <strong>CVS Caremark's specialty pharmacy business:</strong> Pegasys (peginterferon alfa-2a), Copegus (ribavirin), Gleevec (imatinib mesylate), Tasigna (nilotinib), Sprycel (dasatinib), Tarceva (erlotinib), and Tykerb (lapatinib).</p> <p>Through its PGx testing program, CVS Caremark hopes to manage costs and improve healthcare outcomes through its more than 7,000 CVS pharmacy and Longs Drugs stores; its PBM, mail order, and specialty pharmacy arm Caremark Pharmacy Services; its retail-based health clinic subsidiary MinuteClinic; and its online pharmacy, CVS.com. The PBM division, Caremark Pharmacy Services, provides services to more than 2,000 health plans.</p> </blockquote> <p><a href="http://www.genomeweb.com/dxpgx/cvs-caremark-generation-health-select-13-drugs-pgx-alliance">CVS Caremark, Generation Health Select 13 Drugs for PGx Alliance | GenomeWeb Daily News | DxPGx | GenomeWeb</a></p> <p></p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:2189ec2a-3b27-4a04-8e66-8b3b341081a0" class="wlWriterEditableSmartContent">Technorati Tags: <a href="http://www.example.com/CVS" rel="tag">CVS</a>, <a href="http://www.example.com/pharmacogenomics" rel="tag">pharmacogenomics</a>, <a href="http://www.example.com/healthcare" rel="tag">healthcare</a>, <a href="http://www.example.com/pharmacy+benefit+manager" rel="tag">pharmacy benefit manager</a>, <a href="http://www.example.com/Drugs" rel="tag">Drugs</a>, <a href="http://www.example.com/warfarin" rel="tag">warfarin</a>, <a href="http://www.example.com/Oncology" rel="tag">Oncology</a>, <a href="http://www.example.com/cardiovascular+disease" rel="tag">cardiovascular disease</a>, <a href="http://www.example.com/HIV" rel="tag">HIV</a>, <a href="http://www.example.com/genetic+testing" rel="tag">genetic testing</a></div>

CVS Caremark Announces First 13 Drugs to be Incorporated Into Their “Genetic Benefit Management Service”

Generation Health has put together a "Best Test" laboratory network to manage testing costs for payers. The firm has also develope...

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Algorithmic Health Insurance Subsidy Calculations in California Need Some Mathematical Adjustments - Models Used In the Real World Don’t Always Play Out As Created With a “Proof of Concept”As Designed…Real People Don’t Work That Way

<p>Here’s a video with a couple that explains what they are looking at with the “cut off points” if you will on what the cost is going to be.  When you look at the jump with just a $1.00 difference with income, the cost jump is huge and they used the Covered California calculator to help them make decisions.  There’s already been<img align="right" src="http://lh3.ggpht.com/-q1ZlYU3i__8/UnXCngdfnNI/AAAAAAABIbk/HRJc-_5HyMI/image%25255B9%25255D.png?imgmax=800" style="float: right; display: inline" /> some of this in the news to where consumers now are having to make decisions based on “flawed models” out there that were perhaps set up to benefit insurers with keeping in line with the “risk assessments” designed but again the way it plays out with the algorithmic formulas it can be insane for those on the edge of the next income bracket.  A couple weeks ago I made the post about the “damn algorithms” with Obamacare and in one day it has over 5000 hits, which unheard of for the most part for my blog with the crowd numbers I reach…so it was read well…it is the algorithms causing all of the discrepancies and again we go back to the models as the formulas are written to work and run on servers 24/7, based on the design of the model.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/02/those-damn-killer-algorithms-keep.html">Those Damn “Killer Algorithms” Keep Screwing Up Obamacare, One more Delay Added for Small Businesses, Static Text Laws and Digital Technology Crossing Hairs, We Continue To Endure the Constant Rise And Fall Of The Machines… </a></h5> <p>Sure you can read the stories all day long on the politics side of it and sure that plays in there a little bit but what do we as consumers have to “really” deal with..the models running on the website so really no matter what politicians say or promise, until anything gets changed with a model, the machines are running the show.  It is all about the continuous rise and fall of the machines here as the models are being tested again and again and are much harder to build today for sure than the days when Medicare Advantage models were built years ago.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/01/obamacare-for-2014-how-in-world-are-all.html">Obamacare for 2014, How In the World Are All Those Algorithms Going To Play Together, World of Complex IT Infrastructures That Are Attached To Almost Every Law On the Books Might Pose Some Issues To Recently Generated House Bills…</a></h5> <p>When you go back in time the 3000 plus pages of the Affordable Care Act was written, the verbiage was of course gone over by stacks of lawyers etc. to ensure everything was legal, but again the code running on servers (as modeled and written by interpreting verbiage in the law) runs hog ass wild.  That was a tough job and if you go back in time, the folks in charge of this area like Nancy DeParle and Steve Larsen got out of it and went back to private industry for more money when the going got tough as again it’s a daunting project.  We’ll have more and more of this I seem to believe until we get some “digital centric” laws out there to where the technologies are spelled out and named in some of these processes.  Again that’s not a perfect science for sure but at least it would make lawmakers look at what runs all of the complexities with IT infrastructures instead of what we have now, a blue lagoon of models and algorithms that are not working all the way around.  </p> <p><iframe style="height: 273px; width: 476px" height="315" src="//www.youtube.com/embed/TK94K0h9_4w?list=UUosNuCC96Oicg_3CqBCfuRg" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe></p> <p>When Congress gets stuck with complexities they like us have emotional outbursts that get attention like the <a href="http://ducknetweb.blogspot.com/2013/09/jon-stewart-discusses-little-paper.html">“fake” filibuster to where Ted Cruz decided to read Dr. Seus</a> which didn’t accomplish much and I’ll say it again, Congress really needs to restore that Office of Technology Assessment to help them and that’s’ a non partisan statement, they all need it.  I can’t figure out for the life of me why they run from or don’t consider such as we are living in the most complex times ever so hey do like everyone else does, research and get some cold hard data going to help make better found laws. </p> <p>So just watch the video and see where the “starch” dividing lines play in here…and yes to adjust this requires bringing a bunch of new “query monsters”, quants and a few others to see if this model can be adjusted to work better with humans.  If you watch Video #2 below in the footer about the Quants of Wall Street you will hear some former financial folks talk and basically come flat out and tell you “people don’t work that way”…pretty good worlds of wisdom from a current financial professor who used to be part of writing the black box code for Goldman Sachs?  You think?  Here’s a clip from it as a preview…</p> <object height="344" width="425"><param name="movie" value="http://swf.tubechop.com/tubechop.swf?vurl=ed2FWNWwE3I&start=1710&end=1778&cid=2251847"></param><embed src="http://swf.tubechop.com/tubechop.swf?vurl=ed2FWNWwE3I&start=1710&end=1778&cid=2251847" type="application/x-shockwave-flash" allowfullscreen="true" width="425" height="344"></embed></object> <p>The model of insurance subsidiaries for many in California is broken.  BD  </p> <hr />Dawn and Nick LaPolla of Fair Oaks are solidly middle class, and they aren’t uninsured. <p>Yet their required switch to a new health insurance plan under federal changes puts them at a financial crossroads. </p> <p>If they earn less than $94,200 a year, the family of four’s preferred plan through the California health exchange would cost about $750 a month. But if they make even slightly more, they’ll pay about $1,040. That’s because they would exceed the threshold to qualify for federal subsidies. Their current high-deductible plan, which expires in two months, costs $573 a month.</p> <p>A 58-year-old earning $46,000 a year and living in Bakersfield would pay about $5,075 a year, or 11 percent of his pay, for the most-affordable plan. If he made $45,000 a year, he would pay $2,570, or 5.7 percent of his income, for the same plan.</p> <p>A household of three, ages 16, 45 and 46, earning $80,000 and living in San Jose would pay $8,928 a year, or more than 11 percent of their income, for one of the cheapest policies. At $75,000 a year, the cost would drop to $4,512, or 6 percent of their income.</p> <p>“We created this law because people had to to choose between paying the mortgage and paying for health insurance so they didn’t go bankrupt from medical bills,” Court said. “Now some of them need to make new choices: Should they work or cut back in the labor force to get the subsidies?” </p> <p> <a href="http://www.fresnobee.com/2014/03/08/3810084/in-california-middle-class-feels.html#storylink=cpy">http://www.fresnobee.com/2014/03/08/3810084/in-california-middle-class-feels.html#storylink=cpy</a></p>

Algorithmic Health Insurance Subsidy Calculations in California Need Some Mathematical Adjustments - Models Used In the Real World Don’t Always Play Out As Created With a “Proof of Concept”As Designed…Real People Don’t Work That Way

Here’s a video with a couple that explains what they are looking at with the “cut off points” if you will on what the cost is going to be.  ...

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Walgreens Changed Their Minds on Selling Home Genomic Test Due to FDA Inquiry – What Is The Big Deal?

<p> Pathway Genomics and a few others have been doing this on the web for a while now and you will have consumers getting confused thinking that the over the counter price is a bargain, well they still have to register online and go through the normal processes, with the only difference being they don’t have to wait for the<a href="http://lh4.ggpht.com/_v3zjJigoAPE/S-umVxPxowI/AAAAAAAAd-s/sCXA4KItVkA/s1600-h/image%5B3%5D.png"><img align="right" alt="image" border="0" height="123" src="http://lh6.ggpht.com/_v3zjJigoAPE/S-umWV-1_HI/AAAAAAAAd-w/wIsPdWmC_1Y/image_thumb%5B1%5D.png?imgmax=800" style="border-bottom: 0px; border-left: 0px; display: inline; margin-left: 0px; border-top: 0px; margin-right: 0px; border-right: 0px" title="image" width="240" /></a> mail to bring the kit!</p> <p><a href="http://ducknetweb.blogspot.com/2010/05/walgreens-stores-to-offer-genetic.html">Walgreens Stores To Offer Genetic Testing From Pathway Genomics Over the Counter</a> </p> <p>If someone has not noticed, we are an aging society here in the US and <strong>those over 65 of age are not going to jump on this anytime too soon either.</strong>  I do agree there needs to be interaction with their physician to help interpret and understand what the results mean, and <strong>for that matter more doctors could learn a bit more about it as well.</strong>  For a good point of reference, it helps to read about what the first participants who had their genome sequenced had to say:</p> <h4><font size="2"><a href="http://ducknetweb.blogspot.com/2009/01/steven-pinker-harvard-professor-of.html">Steven Pinkerton, Harvard Professor of Psychology talks about his genome, what he found out, what he learned, and how the psychological interpretations are somewhat still up for discussion</a></font></h4> <p><u>Here’s a couple of statements from Steven Pinkerton:</u></p> <p><em>“The two biggest pieces of news I got about my disease risks were a <strong>12.6 percent chance of getting </strong></em><a href="http://health.nytimes.com/health/guides/disease/prostate-cancer/overview.html?inline=nyt-classifier"><strong><em>prostate cancer</em></strong></a><em><strong> before I turn 80 compared with the average risk for white men of 17.8 percent, </strong>and a<strong> 26.8 percent chance of getting </strong></em><a href="http://health.nytimes.com/health/guides/disease/type-2-diabetes/overview.html?inline=nyt-classifier"><strong><em>Type 2 diabetes</em></strong></a><em><strong> compared with the average risk of 21.9 percent.</strong> Most of the other outcomes involved even smaller departures from the norm. For a blessedly average person like me, it is completely unclear what to do with these odds. A one-in-four chance of developing </em><a href="http://health.nytimes.com/health/guides/disease/diabetes/overview.html?inline=nyt-classifier"><em>diabetes</em></a><em> should make any prudent person watch his weight and other risk factors. But then so should a one-in-five chance.”</em></p> <p><em>I also have genes that are nothing to brag about (like average </em><a href="http://health.nytimes.com/health/guides/test/mental-status-tests/overview.html?inline=nyt-classifier"><em>memory</em></a><em> performance and lower efficiency at learning from errors), ones whose meanings are a bit baffling (like a gene that gives me “typical odds” for having red hair, which I don’t have), and ones whose predictions are flat-out wrong (like a high risk of </em><a href="http://health.nytimes.com/health/guides/symptoms/hair-loss/overview.html?inline=nyt-classifier"><em>baldness</em></a><em>).</em></p> <p align="center"><em>____________________</em></p> <p>CVS is in the market too with genomics in a little different way and have their program going and their plan is for analysis with a <strong>“genetic benefits management company”</strong> called Generation Health.  <strong>Their plan is much more to worry about if you ask me as it could restrict patient access to certain drugs</strong> too as this begins to fall under areas of “health insurance” compensation as they want to manage testing costs for payors.  Pay attention here:</p> <p><u><strong>“Genetic Benefits Manager” is the CVS program venturing in this area – be aware.</strong></u></p> <h6><a href="http://ducknetweb.blogspot.com/2009/11/cvs-caremark-launching-collaborating.html"><font size="2">CVS Caremark Launching Collaborating with Generation Health To Launch Program to Predict Patient Response for a Dozen Drugs With Genetic Testing</font></a></h6> <p>Again, I don’t understand the fuss over the kit being available over the counter versus sending off for it on the web and again I don’t see people breaking the doors down to get one as we other more important issues with getting medications we need now and ensuring patients can afford them.  It sounds like time for a little collaboration at the FDA on this topic and a thorough look at the CVS plan too while they are at it.  As patients we will of course be aware of anything that could stand to restrict access and lead to further analysis for risk management purposes, but<strong> worrying about having the box available for over the counter purchase here to me looks like the whole issue has turned into a “wild good chase” for now</strong>.  BD  </p> <blockquote> <p>Walgreen Co. reversed a decision to carry genetic test kits in its stores after the U.S. Food and Drug Administration began looking into the supplier. <br />The drugstore chain, based in Deerfield, Ill., had planned to begin stocking its shelves Friday with the Pathway Genomics home test kit, which the manufacturer claimed could provide information on the risks of getting conditions such as Alzheimer's and heart disease, and also examine the likelihood of passing on health problems to children.</p> <p>The product claims to assess the risk of dozens of health conditions, but some scientists and physicians had expressed concerns. Earlier this week, the National Society of Genetic Counselors issued a statement saying that receiving genetic information without input from a doctor "increases the chance for misunderstanding or misinterpretation of results."</p> </blockquote> <p><a href="http://www.latimes.com/business/la-fi-dna-kits-20100513,0,7943427.story">Walgreen holds off on carrying Pathway Genomics genetic test kit - latimes.com</a></p> <p></p> <p></p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:997c8a08-6967-4964-9a01-778b6ea1bf62" class="wlWriterEditableSmartContent">Technorati Tags: <a href="http://www.example.com/Walgreens" rel="tag">Walgreens</a>, <a href="http://www.example.com/Pathway+Genomics" rel="tag">Pathway Genomics</a>, <a href="http://www.example.com/healthcare" rel="tag">healthcare</a>, <a href="http://www.example.com/DNA" rel="tag">DNA</a>, <a href="http://www.example.com/sequencing" rel="tag">sequencing</a>, <a href="http://www.example.com/drug+store" rel="tag">drug store</a>, <a href="http://www.example.com/genetics" rel="tag">genetics</a>, <a href="http://www.example.com/disease" rel="tag">disease</a>, <a href="http://www.example.com/retail+drug+stores" rel="tag">retail drug stores</a></div>

Walgreens Changed Their Minds on Selling Home Genomic Test Due to FDA Inquiry – What Is The Big Deal?

Pathway Genomics and a few others have been doing this on the web for a while now and you will have consumers getting confused thinking tha...

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HealthTap App Offers “Doc in the Box” Service for Patients to Ask Question From Registered Doctors For Opinions And Then the Peer Groups of MDs Rate Each Other’s Answers? Enough Time For This?

<p>Yet one more way to talk to a doctor.  There’s a free version and then you can also enroll for a paid service.  The one good thing the site has is access to the entire PubMed database indexed with relevant information searched.  They are talking about their HIPAA complaint message service as well with being able to upload images and documents to the doctor <img align="right" alt="image" border="0" height="78" src="http://lh5.ggpht.com/-8P5KjGxVdQI/UGKzgnbgoOI/AAAAAAAA-EI/TIBX6fsnjCo/image%25255B4%25255D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="194" />to help answer your questions, although this is not slated as a diagnosis service so an opinion I guess is the better choice of words here?  Also I would think this communication is right inline with the government “Direct” program.  Doctor’s have up to 72 hours to answer messages in their queue.  It says here doctors get paid for their time and said the potential is up to $100.00 an hour so I guess this means selling de-identified data somewhere along the line as the small subscription fee doesn’t seem like it’s going to cover the doctor’s time.  I could be wrong but from what I read that’s probably a good indication here that data will be sold.  <br clear="all" /> <br clear="all" />I see also where doctors can answer question if they want without being reimbursed too, so how many will jump in that line?  I did see where they open it up to medical students so that could be helpful for educational purposes in that area.  Doctors get points for answering questions and this is supposed to increase their business and networking capabilities. <strong> This will be interesting to see if this catches on or not and doctors can have their own HealthTap page.  I received an email telling me they were giving me the opportunity to install their widget and said they have over 14,000 doctors licensed…and they are just starting up?</strong>  They certainly didn’t want to pay a poor little blogger to advertise either.   In closing, I’ll let you figure out if this has value and if doctors have the time to rate each other on the website as it states they are rated by their peers.  BD    <br clear="all" /> <br clear="all" /><iframe style="width: 439px; height: 248px" height="315" src="http://www.youtube.com/embed/XoRW5xf9omc?rel=0" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe><a href="https://www.healthtap.com/"> <br clear="all" /> <br clear="all" />HealthTap</a>, an app allowing users to ask questions of a community of more than 15,000 medical doctors, is beefing up its mobile and Web application. It is integrating the wealth of published medical data in the <a href="http://www.ncbi.nlm.nih.gov/pubmed">National Library of Medicine’s PubMed</a> database with its existing services.</p> <p><a name="pagebreak"></a></p> <p>The doctors cannot offer diagnoses to patients on HealthTap, but they can answer questions as more people turn to the Web for medical information. <br clear="all" /> <br clear="all" />The explanations doctors provide are — like their advice — rated by their peers. The better the community deems their colleague’s contribution to be, the higher their rating. In that way, the app serves as both informative for users who need advice on health issues and, potentially, great public relations for doctors in search of new patients. <br clear="all" /> <br clear="all" /><a href="http://www.washingtonpost.com/blogs/innovations/post/medical-app-healthtap-launches-feature-that-lets-doctors-translate-medical-research-for-the-masses/2012/09/25/6be364da-0687-11e2-a10c-fa5a255a9258_blog.html">http://www.washingtonpost.com/blogs/innovations/post/medical-app-healthtap-launches-feature-that-lets-doctors-translate-medical-research-for-the-masses/2012/09/25/6be364da-0687-11e2-a10c-fa5a255a9258_blog.html</a></p>

HealthTap App Offers “Doc in the Box” Service for Patients to Ask Question From Registered Doctors For Opinions And Then the Peer Groups of MDs Rate Each Other’s Answers? Enough Time For This?

Yet one more way to talk to a doctor.  There’s a free version and then you can also enroll for a paid service.  The one good thing the site ...

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ONC Working On Another Consumer Health IT Awareness Program–Magpie Healthcare Again With No Role Models in Sight?

<p>Ok so the title here is bound to get some attention and the individual listed in this post is the “only” one at the ONC that has publicly admitted she uses what they proclaim is good for everyone else..  Where’s the rest of the folks at the ONC, do they use a PHR or do they just repeat what is in the news and what they “believe” is good for everyone else?  If you read at the Medical Quack you know I am an advocate of personal health records and “good” consumer health IT applications, not those that just do “one” thing.  </p> <h4><a href="http://ducknetweb.blogspot.com/2011/04/nih-announces-plan-to-develop-medical.html"><font size="2">NIH Announces Plan to Develop Medical Image Sharing for PHRs-Role Models Would Help Stamp Out “Magpie Healthcare”</font></a></h4> <p>I have an entire section devoted to all types of information on PHRs and probably one of the largest on the web, so thus I feel the need to speak out a little bit as I do my best to be a “hands on”person and not repeat like magpie as the web is full of that today so hopefully when I can share in that fashion it makes a difference. Who do you want to teach you how to drive a car, a person that drives a car or one who read a book about how to drive but doesn’t drive one…case closed there if you will.  Back in September of 2010 I wrote this post to indicate how a new avenue of showing value needs to come along.  <img align="right" border="0" src="http://lh4.ggpht.com/_v3zjJigoAPE/TI_7P4iFcoI/AAAAAAAAhWM/OXP5HGkiBY8/image_thumb.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px"></p> <h4><a href="http://ducknetweb.blogspot.com/2010/09/whats-on-agenda-tonightworld-of.html"><font size="2">What’s On the Agenda Tonight–World of Warcraft or Work on My Personal Health Record</font></a></h4> <p>About the same time I wrote this about HHS, does they participate?  We don’t now as we still have this paradigm of reliance on experts that truly may not exist with lack of participation or at least we never hear about it.  I’m not making this stuff up either as go to your average doctors office and talk about PHRs, good chance they have never heard of them and odds for that even get better when talking with consumers.  This is not the web, this is real time face to face discussions, in other words the “real world” which sometimes gets lost with discussions on the web and we have all done that to a degree, self included.  </p> <h6><a href="http://ducknetweb.blogspot.com/2010/06/hhs-national-plan-to-improve-health.html"><font size="2">HHS National Plan to Improve Health Literacy – Not Going To Happen Until We Focus on Using Technology (The Tool for Literacy) Which Includes Role Models at HHS And Other Places in Government</font></a></h6> <p>I would think that perhaps some of the REC centers could use a little follow up as this one in Orange County, where we have a ton of tech companies and information available is non existent compared to great efforts in other parts of the US. <strong> </strong></p> <h4><a href="http://ducknetweb.blogspot.com/2011/08/orange-county-california-rec-center-for.html"><font size="2">Orange County California REC Center For Doctor Assistance with Medical Records Appears to be a Bust So Far…</font></a></h4> <p><strong>Aren’t the folks at the ONC every going to get out of the box and maybe try being role models?  We need those.   What do those experts do for themselves that could have value to share and inspire others?  This is<img align="right" border="0" src="http://lh3.ggpht.com/_v3zjJigoAPE/TKYXI9HNaQI/AAAAAAAAh1M/7da7_nnWx-c/image_thumb%5B7%5D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px"> not an easy task to get the attention of the consumer too I realize that because I have been doing it myself for about 3 years on PHRs, but role models and participating and sharing the value is one big missing element here, so get over yourselves and jump on the consume bandwagon here and participate to inspire others.  </strong></p> <h6><a href="http://ducknetweb.blogspot.com/2011/02/relying-on-experts-when-they-may-not.html"><font size="2">Relying on Experts When They May Not Exist–Many Intelligent and Smart People But Do We Have Misconceived Paradigms-TED</font></a></h6> <p><u>I don’t see Microsoft wasting any time with pushing HeatlhVault as they are in the news all the time with new developments and I cover them here.</u>  I have interviewed <a href="http://www.healthvault.com/"><img align="right" alt="image" border="0" height="55" src="http://lh5.ggpht.com/_v3zjJigoAPE/THgaxUGfUHI/AAAAAAAAg3U/HtPUR5oTdV4/image%5B19%5D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="152"></a>healthcare executives from Microsoft who “do use Healthvault” themselves and they are not afraid to talk about it, called the internal sell here but value still needs to be seen there for participation as well.  As a matter of fact,<strong> </strong><a href="http://blogs.msdn.com/b/familyhealthguy/archive/2011/07/31/time-for-a-summer-vacation-at-onc.aspx"><strong>Sean over at the Family Health Guy</strong></a> blog (HealthVault) <u>asked you guys to take a break, right?</u>  So while you are taking a break maybe think about showing some value for consumers and share the wealth?  You kind of bore me and maybe others with the current efforts and <u>I’ll still stand strong with the FDA recalls/cellphones as being huge vehicle that would drive this</u> and yes it means big time collaboration but the consumers are worth it, right as we all today seem to end up on the short end of the stick so much, and this would be a great area to make a difference.    </p> <p><strong>Another good example of PHR mentality was all the huge press that Google Health being discontinued received?  Why?  It was being <a href="https://www.google.com/accounts/ServiceLogin?service=health&nui=1&continue=https%3A%2F%2Fwww.google.com%2Fhealth%2Fp%2F&followup=https%3A%2F%2Fwww.google.com%2Fhealth%2Fp%2F&rm=hide"><img align="right" alt="image[14]" border="0" height="59" src="http://lh6.ggpht.com/_v3zjJigoAPE/THgax4ZeHhI/AAAAAAAAg3Y/CnyA1N6bPJs/image%5B14%5D%5B7%5D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image[14]" width="148"></a>discontinued due to lack of interest so why all the press?</strong>  How many are going to miss it for goodness sakes but many took the opportunity to use it as subject matter for writing articles and again <u>most of those who did that have never touched a PHR so what an oxymoron with public views and the press</u> as well on this topic.  The folks in the press could tune up a little her too as again this is consumer health IT.  </p> <p>Everything today is not at it seems <grin>, so let’s get some reality back in the picture ok?  <strong>In the meantime I am guessing that most will continue to choose playing World of Warcraft versus working on their PHR, you need a new game folks and “tag”  you are it.  Does the Surgeon General use the Surgeon General’s PHR….inquiring mind may just want to know.  BD</strong>  </p> <blockquote> <p>WASHINGTON – The Office of the National Coordinator for Health IT will widen its efforts in mid-September to bring consumers into its orbit of tools and outreach with a campaign to get the public more involved in their health and health care.</p> <p>ONC will develop activities to explain the value of health IT tools, such as electronic health records (EHRs), personal health records (PHRs) and mobile phone applications. </p> <p>ONC plans to include a variety of organizations that touch consumers to participate in the effort and to seek their ideas for how to involve patients, according to Lygeia Ricciardi, ONC’s senior policy advisor for consumer e-health, at an Aug. 9 meeting of <a href="http://nationalehealth.org/consumers/"><strong>the Consumer Consortium on eHealth</strong></a>. </p></blockquote> <p><a href="http://www.govhealthit.com/news/onc-plans-consumer-health-it-campaign">ONC plans consumer health IT campaign | Government Health IT</a></p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:00e0ccf5-20ef-47b1-ab9e-b4436391ec23" class="wlWriterSmartContent">Technorati Tags: <a href="http://technorati.com/tags/NIH" rel="tag">NIH</a>,<a href="http://technorati.com/tags/ONC" rel="tag">ONC</a>,<a href="http://technorati.com/tags/PHR" rel="tag">PHR</a>,<a href="http://technorati.com/tags/personal+health+records" rel="tag">personal health records</a>,<a href="http://technorati.com/tags/medical+imaging" rel="tag">medical imaging</a>,<a href="http://technorati.com/tags/medical+reocrds" rel="tag">medical reocrds</a>,<a href="http://technorati.com/tags/healthcare" rel="tag">healthcare</a>,<a href="http://technorati.com/tags/Health+IT" rel="tag">Health IT</a>,<a href="http://technorati.com/tags/HealthVault" rel="tag">HealthVault</a>,<a href="http://technorati.com/tags/EHR" rel="tag">EHR</a>,<a href="http://technorati.com/tags/Magpie+Healthcare" rel="tag">Magpie Healthcare</a></div>

ONC Working On Another Consumer Health IT Awareness Program–Magpie Healthcare Again With No Role Models in Sight?

Ok so the title here is bound to get some attention and the individual listed in this post is the “only” one at the ONC that has publicly ad...

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Intuitive Surgical Sued In New York Over Death of 24 Year Old Woman Arising from the Use of the daVinci Robot During a Hysterectomy

<p> <br clear="all" />This is unusual as the robot has been sold and delivered<img align="right" height="121" src="http://lh4.ggpht.com/_v3zjJigoAPE/TVduA1LB0cI/AAAAAAAArQI/TqwiMidX-UM/image_thumb%5B5%5D.png?imgmax=800" style="display: inline; float: right" width="150" /> to many hospitals across the US but there’s a time and place for a law suit it appears as the press release states the patient died 2 weeks after the surgery as the arms of the robot are not insulated and the patient received internal burns from electrical currents that jumped over to healthy organs. <br clear="all" />In another case related to the death of his daughter, a separate lawsuit has been filed stating the surgeon was careless with not seeing the damage done by the robot.  I was at a mall last year and saw an exhibit set up for the robot, which is kind of strange marketing.  <br clear="all" /> <br clear="all" /> </p> <h5><a href="http://ducknetweb.blogspot.com/2011/02/davinci-surgical-robot-does-roadshow-at.html">DaVinci Surgical Robot Does a Roadshow At An Orange County Mall</a> <br clear="all" /> <br clear="all" /></h5> <p> <p> <p> I did an article a while back too with the Kinect box from Microsoft being used with the robot and what was fascinating about this was not just using hands but the fact that the Kinect device could map “off limit” areas so in other words the robot had “do not pass go zones” and stayed within the surgical area and I don’t know if that would have been of any help here though since it was electrical but worth a thought.  Johns Hopkins was experimenting with the fields and the gestures with the da Vinci.  </p> </p> </p> <p> <p> <p> <br clear="all" /> <br clear="all" /></p> <h5><a href="http://ducknetweb.blogspot.com/2011/02/kinect-and-davinci-surgical-robot-do.html">Kinect And daVinci Surgical Robot Do Simulated Surgery Suturing Together (Video)</a></h5> <p> <p> <br clear="all" />The company is doing well as they have over $3 billion in assets according to the story here and again sad that a life was lost but will bring to the forefront the need for training and education again with all the new technologies we do have that can save lives.  BD  <br clear="all" /></p> </p> <p> <p> --------------------------------------- <br clear="all" /> <br clear="all" /> <div style="padding-bottom: 0px; padding-left: 0px; width: 397px; padding-right: 0px; display: block; float: none; margin-left: auto; margin-right: auto; padding-top: 0px" id="scid:5737277B-5D6D-4f48-ABFC-DD9C333F4C5D:2a2b8ea5-a67b-445b-92ae-9dad2279f77f" class="wlWriterEditableSmartContent"><div id="9f0405ed-ca46-4969-9b80-707de542cb2d" style="margin: 0px; padding: 0px; display: inline;"><div><a href="http://www.youtube.com/watch?v=YsY_A0kLh-g" target="_new"><img alt="" galleryimg="no" onload="var downlevelDiv = document.getElementById('9f0405ed-ca46-4969-9b80-707de542cb2d'); downlevelDiv.innerHTML = "<div><object width=\"397\" height=\"223\"><param name=\"movie\" value=\"http://www.youtube.com/v/YsY_A0kLh-g?hl=en&hd=1\"><\/param><embed src=\"http://www.youtube.com/v/YsY_A0kLh-g?hl=en&hd=1\" type=\"application/x-shockwave-flash\" width=\"397\" height=\"223\"><\/embed><\/object><\/div>";" src="http://lh6.ggpht.com/-hVFRg5ExKA4/T31BsqEun5I/AAAAAAAA6Nw/1YdfZQZ42Gs/videof3f366439364%25255B4%25255D.jpg?imgmax=800" style="border-style: none"></a></div></div></div> <br clear="all" /> <br clear="all" />Over the last few years there has been a lot of debate on the web about the expense and the surgical outcomes that the robotic procedures provide. There have been many who have had no problem but with technology today it sounds like this comes back to education and training and sad to lose a 24 year old woman over a very common procedure that is done all the time. <br clear="all" /> <br clear="all" /> <p>NEW YORK, April 4, 2012 /PRNewswire/ -- The father of his deceased 24 year old daughter has commenced a lawsuit in New York against Intuitive Surgery, Inc., the maker of the da Vinci surgical robot, alleging that the device caused her death.  She was only 24 years old so at that age I am guessing she had some type of illness or complications to have this at such a young age.  Intuitive stated the surgeon had not been trained by their company and that is when unintended errors, burns, etc can occur. </p> </p> <p> <p> <br clear="all" /> <br clear="all" /></p> <p>In his complaint, filed by the firm of Rheingold, Valet, Rheingold, McCartney & Giuffra LLP of New York City, Gilmore McCalla asserts that when his daughter was having a hysterectomy in a Bronx hospital in August 2010, the robot caused burns to an artery and her intestines, which led to her death two weeks later.   </p> <p>The complaint alleges design flaws in the da Vinci robot, including un-insulated surgical arms and use of electrical current which can jump to healthy internal organs and tissue. <br clear="all" /> <br clear="all" />It also alleges that physicians are not properly trained on the device, and that Intuitive Surgery has failed to run randomized tests as to complications with its robot.  </p> <p>The McCalla complaint, filed in the federal court in New York City on April 4, 2012, 12civ2597, also asserts that the manufacturer has suppressed reports of complications, and has oversold the merits of its da Vinci robot to hospitals considering buying it.  <br clear="all" /> <br clear="all" />The machine costs of upwards of $2 million to purchase and then has a sizeable annual maintenance cost.  </p> <p>McCalla is also asserting, in separate litigation, that the surgeon operating the robot and the hospital where the procedure was being done were careless, in part in not discovering the damage done by the robot.  </p></p></p></p></p>

Intuitive Surgical Sued In New York Over Death of 24 Year Old Woman Arising from the Use of the daVinci Robot During a Hysterectomy

This is unusual as the robot has been sold and delivered to many hospitals across the US but there’s a time and place for a law suit it ...

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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

<p>It’s been a while since I talked about this “code hosing” tactic here and that’s exactly what it is and now that we have the extra support of the World Forum on Privacy, they too aren’t buying it and included their doubts in their recent report.  As I have read so far around 3 million people in the US have been scored?  Has anyone been told what their FICO score is with medication adherence?  I would guess probably not although the fact that this bogus “scoring” system exists and turns profits for the company is not a secret itself, the results are and you may not ever know you have been scored.  </p> <p>If you read their web page all they need is a name and address to score you, and again we have <img align="right" alt="image" border="0" height="67" src="http://lh6.ggpht.com/-LDJ0LqkSEC8/U50flbBP9eI/AAAAAAABKmk/s5nWPCYBo9A/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="348" />not one clue on what their data sources are and for all we know they rely on unreliable sources like Facebook, and other social networks out there.  Heck what if they found out your doctor’s name too and that’s not unusual as query monsters go after everything they can get.  Look what we found with MD listings and what if they compared you doctor and the prescriptions with the other data to score you?  Look at this hoax on MD Ratings sites and please don’t use them as a safe reference as they are just there to collect ad revenue and don’t care about the accuracy on what is online about the doctors.  There’s dead doctors listed and ones that have retired, doctors on staff at hospitals they have never set foot in and so on.</p> <h5><strong><a href="http://ducknetweb.blogspot.com/2014/06/top-doctor-for-miami-va-healthcare.html">Top Doctor For Miami VA Healthcare System Lost Medical License in New York, Had Issues With Florida Board of Medicine, But On the Internet He Still Works and Takes New Patients in New York With Plenty of Insurers… </a></strong></h5> <p>The FICO medication adherence scores are sold to companies doing clinical trials and to health insurance companies and enough on the latter as we know what they do with data as they continuously score you again and again with any additional miniscule piece of data they get.  How do we know about the accuracy of this test?  We don’t because it’s proprietary and they have the black box formula, so to trust them is totally stupid as they don’t care what your score is, they want to make money selling it.  Of course depending on your score, you may get denied care, money, etc. </p> <p>This is just one example of what goes on out there with the <a href="http://www.worldprivacyforum.org/2014/04/wpf-report-the-scoring-of-america-how-secret-consumer-scores-threaten-your-privacy-and-your-future/">“Scoring of America”</a> and it totally non transparent, so it’s really hard to jump for joy and get excited when the government does a data dump of something I’ll probably never use and media uses it to create more stinking data news that for the most part could also without.  Here’s right from the website and if this formula is proprietary and we can’t replicate to check for accuracy then it should be banned as illegal. </p> <p><img align="left" alt="image" border="0" height="315" src="http://lh3.ggpht.com/-Wjh861daudU/U50fmMgpKBI/AAAAAAABKms/IdgAuokp8S4/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="595" /></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>This is part of what keeps inequality growing in the US and the link below has lot more detailed information on this process.  This is only one bogus “scoring” that we know about.  <a href="http://ducknetweb.blogspot.com/2013/03/insurance-companies-are-buying-up.html">What kind of scores do insurers give you</a> when the look at your MasterCard and Visa records that they buy?  How about <a href="http://ducknetweb.blogspot.com/2014/05/this-call-may-be-recorded-for-quality.html">your voice that’s recorded at insurer call centers</a> to determine your current state of mind?  It could go on as what happens when your voice score is then combined with your credit card expenditure scores and ran together for another score?  By the way most all of this gets sold too as we have a huge data selling epidemic in the US with little care or concern as to how it impacts the consumer but generates big money for those buying and selling our personal data.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/06/the-true-dangers-with-corporate.html">The True Dangers With Corporate Obsessive Algorithmic Scoring of US Consumers - It Creates More Flawed Data For Sale And Makes Banks and Companies Wealthier As the Pace of Inequality Accelerates … It</a></h5> <p>So for this reason, such practices need to be banned as there’s no transparency here, no justification that the scoring is accurate at all, white pages or not, there’s nothing except the fact that someone makes money on the thought that they have decision making scoring data about us on hand.  </p> <p>Watch video # 1 in the footer and see how how we all get duped with things that are just not true.  If you want to see more like this and get further educated, visit the <a href="http://www.ducknet.net/attack-of-the-killer-algorithms/">Killer Algorithm page</a> and learn up on how this works and when to be a skeptic today, a lot of code hosing taking place.   BD  </p>

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

It’s been a while since I talked about this “code hosing” tactic here and that’s exactly what it is and now that we have the extra support o...

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One More Data Seller In Beta, You Give Access to Twitter, Facebook And Other Social Media Accounts And “The Feed of Your Credit Or Debit Cards”…And You Get Paid $8.00..Algo Duping And the Attacks of the Killer Algorithms Continue…”Suckers”

<p>The first thing I have to say here is “suckers”…I’ll tell you the<img alt="image" border="0" height="122" src="http://lh5.ggpht.com/-Qa-KtIesOhM/UvwWCBiEBdI/AAAAAAABJYg/68Tn-nzAmT8/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="187" /> mathematicians are just putting it out  there to see how much data they can scrape and if you don’t wake up to this one…well you are really bliss and can’t tell where the virtual world leaves off and where the real world is, and the problem is virtual world can do harm in the real world too.  Hey I have folks I know at Microsoft that are engineers agreeing with me..geez…so wake up.  The movie HER does a good job of showing how this is a huge problem…folks are messed up and can’t tell what really has value.  </p> <p>The big pitch is “sell your data” and others, Google included have pondered around in this area…so they are telling you selling it here and cash out cheap as your data will be mined and sold anyway (grin).  </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>As far as your credit card data, well you are out of luck there with any dollars coming back to you as United and Blue Cross already buy that data and know about every candy bar, tampon, bottle of wine, shoes, that you buy and what size.  Blue Cross said they do it to make sure you don’t take a turn towards obesity and watch to see if you start buying clothes a size larger (grin)..that’s what they said and I know you can’t make that stuff up and we all know better than that as they query it with tons of other information…they really think we are stupid I swear and anything to “dummy you down” works out there today.   Here’s a good essay to read below about being a skeptic…</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>By the way too MasterCard has some new marketing for you…they think you need to know what your “<img align="right" height="59" src="https://encrypted-tbn1.gstatic.com/images?q=tbn:ANd9GcRJsy5_-1cPjzaPKJ1bNbOsyA0E5vLocojVTXPwC_UMW1X2avqTmg" style="float: right; display: inline" width="150" />persona” is…well they tell you what your persona is (grin) and my gosh jump for joy and get so excited over this would you?  It will make you just fall all over that “Virtual Engagement Bureau” they created…see what I mean about virtual and real confusion!   If you buy into that marketing routine, you really shouldn’t be reading this blog as you don’t get it.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/12/mastercard-as-well-as-other-financial.html">MasterCard As Well As Other Financial Institutions Using Big Data To Get Into Your “Online Pants” As Many Consumers Seem To Be Accidentally And Inadvertently Leaving Their “Internet Fly” Open</a></h5> <p>And guess what, they talk about hooking up Fitbit, the original mobile device/app that I think created this monstrous data selling model.  What do I know…I said would it sell data even <a href="http://ducknetweb.blogspot.com/2008/10/human-audit-trail-to-automatically.html">before they released it</a> <a href="http://ducknetweb.blogspot.com/2009/09/fitbit-wireless-device-monitors-your.html">(from my archives</a>)..you read it here first.  <a href="http://ducknetweb.blogspot.com/2014/02/cvs-tobacco-announcementgood-marketing.html">The other day with the big CVS news…</a>the corporation will just scrape and sell more of your data to make up for no tobacco..that’s why I sad what huge marketing scam as I could care less about what else they sell, just get my prescriptions done right, what I go there for.  <a href="http://ducknetweb.blogspot.com/2014/02/barclays-brokers-caught-selling.html">Temptation got really big and illegal too at Barclays</a>..read this one, makes the Target breach look minimal and by the way the bank is Facebook’s new partner in the UK with a<img align="right" alt="image" border="0" height="130" src="http://lh6.ggpht.com/-1wLBLdQrAjE/UvwWCnwHl6I/AAAAAAABJYo/VgvakW4JisE/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="353" /> start up company.  Walgreens is making at least one billion if not two by now selling data.  </p> <p>Ok so how long before the mobile apps and devices that collect your data start finding a way to use those online dating algorithms that addict?  The mathematicians know how to do it to keep you clicking.  People click on anything.  The other day I made a “shell” of a MeetMe profile, no picture, 2 lines of nothing text, posted it and it had all kinds of hits…lol.  Wake up folks..<strong>that even surprised me to see piranha like activity like that.</strong>  So here’s my question, how long before all these mHealth apps work with the dating services to find you a date when you enter data that they can sell?  I said that on Twitter earlier today too.  Heck even IBM Watson wants in on the action.  This is all the virtual world coming into the real world and again the confusion.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/02/ibm-watson-invests-in-start-up-company.html">IBM Watson Invests in Start Up Company Welltok–Big Data Joins Forces With The Data Selling Platforms…</a></h5> <p>Time to license and excise tax all data sellers.  BD  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/02/time-has-come-to-license-and-tax-data.html">Time Has Come to License and Tax the Data Sellers of the Web, Companies, Banks, Social Networks..Any One Making a Profit-Latest Microsoft/Google Privacy War Helping the Cause –Consumers Deserve to Know What Is Being Sold and To Who in a Searchable Format</a></h5> <p> <hr />Hogan says that almost 1,500 people have signed up during the beta trial, and that within a few months the service will be open to everyone. The company also might offer people the option of sharing data from lifelogging devices such as the FitBit or parts of their Web search history.</p> <p><strong>Datacoup is running a beta trial in which people get $8 a month in return for access to a combination of their social media accounts, such as Facebook and Twitter, and the feed of transactions from a credit or debit card.</strong> The New York City-based startup plans to make money by charging companies for access to trends found in that information, after it has been removed of personally identifying details.</p> <p>Most people already trade their personal data every day. By typing into Google’s search box, or using a grocery store loyalty card, they get a free service or discount in return for letting marketers glean prized traces of their behavior. Now Datacoup CEO and cofounder Matt Hogan says he is offering a way for people to get involved more directly in the market for information about their activities. “If a consumer wants to make an educated decision, they should be able to sell their data to who they want,” he says.</p> <p>Hogan argues that encouraging people to think more about their data and its value could inspire them to demand more transparency from other companies that sell personal information. “We’re in the consumer’s corner,” he says. “I happen to believe that putting you in control of your own asset, your data, makes for a more efficient market.”</p> <p><a href="http://www.technologyreview.com/news/524621/sell-your-personal-data-for-8-a-month/?utm_campaign=socialsync&utm_medium=social-post&utm_source=twitter" title="http://www.technologyreview.com/news/524621/sell-your-personal-data-for-8-a-month/?utm_campaign=socialsync&utm_medium=social-post&utm_source=twitter">http://www.technologyreview.com/news/524621/sell-your-personal-data-for-8-a-month/?utm_campaign=socialsync&utm_medium=social-post&utm_source=twitter</a></p>

One More Data Seller In Beta, You Give Access to Twitter, Facebook And Other Social Media Accounts And “The Feed of Your Credit Or Debit Cards”…And You Get Paid $8.00..Algo Duping And the Attacks of the Killer Algorithms Continue…”Suckers”

The first thing I have to say here is “suckers”…I’ll tell you the mathematicians are just putting it out  there to see how much data they c...

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AMA and United Healthcare Combine Efforts to Once Again To Push CMS To Institute Algorithmic and ICD Coding To Rip Off Patients/Deny Access–It’s the Next Chapter of Excess Scoring in the US To Keeps Inequality/Segmentation Rolling

<a href="https://1.bp.blogspot.com/-ye4PkzPIxJ0/XU7_PRsdbdI/AAAAAAABNUM/LFLSSC3faK0xDeavZVliv-tpTZso3v9IwCLcBGAs/s1600/HealthcareQuants.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="526" data-original-width="705" height="238" src="https://1.bp.blogspot.com/-ye4PkzPIxJ0/XU7_PRsdbdI/AAAAAAABNUM/LFLSSC3faK0xDeavZVliv-tpTZso3v9IwCLcBGAs/s320/HealthcareQuants.JPG" width="320" /></a>If you have not seen the latest with these two, take a look at to how they want to use segmentation for profit.  It is so much of a "One Trick Algo” World out there anymore, the can’t hardly create enough bullshit commentary to cover up what’s really going on.  These two have been doing stuff like this for years, as I’ve written about a lot of it during the active years of my blog.  Way back in the early days of small developers creating EMRs before the government got involved, there were many of us that just sat back and wondered why the AMA always showed full on preference for anything United Healthcare (namely the Ingenix subsidiary which was being run by former CMS director Andy Slavitt at the time) came out with.  It just went on and on and you too can search in the web’s archives and find a lot of it, as well as just searching my blog for that matter.  AMA has been making money selling Ingenix (now Optum) coding books forever on their site.  Here’s a link from 2010 below as an example of the cushy AMA/UNH relationship over the years. <br /> <br /> <a href="http://ducknetweb.blogspot.com/2010/09/clickfreemd-selling-software-ehr.html">ClickFreeMD Selling Software EHR, Practice Management Bundled Records Solution–Emphasis on AMA Endorsement And Software “Powered” by Ingenix–Tethered or Untethered</a><br /> <br /> Now we have this data plague as I call it of an issue of Excess Scoring.  I wrote about that a few years ago as our entire country is totally whacked out on the fact that everything needs to be scored, and that’s not true at all, some of the best things in life are NOT scored.  Here’s some back links.  <br /> <br /> <a href="http://ducknetweb.blogspot.com/2015/09/excess-scoring-of-us-consumers-us.html">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..</a><br /> <br /> <a href="http://ducknetweb.blogspot.com/2015/10/the-end-of-consumer-common-sense-in-us.html">The End of “Consumer Common Sense” in the US-Fueled by Excess Scoring for Profit, Sustained By Media Publications Serving To Further The Inability For Simple Every Day Life Decisions…</a><br /> <a href="http://ducknetweb.blogspot.com/2016/03/united-healthcare-now-offering.html">United Healthcare Now Offering Employers Wearable Wellness Devices-</a><br /> <br /> <a href="http://ducknetweb.blogspot.com/2016/03/united-healthcare-now-offering.html">UnitedHealthcareMotion–More Data To Mine And Sell With Related Risk Assessment Scoring Processes About You-Excess Scoring</a><br /> <br /> Actually when I was communicating with a former CMS executive about this, they said it was right out of United Healthcare's 2010 report, the stratification report, which also went way over the top on telling people how UNH thought they should raise their kids and indeed this is right on the same line of thought with these ICD Codes.  Doctors, nurses alike think the the AMA and United Healthcare are out of their minds and can see especially with Part D, its a way to lop on more risk so UNH can bill the government more money, called RISK FIDDLING.<br /> <br /> <a href="https://www.blogger.com/$Outlier5.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/$ICD_Proposed6.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/$HealthcareQuants5.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a>So get a load of this nonsense on how the AMA and United Healthcare want to code you, so they can use the result sin run you through a ton of other data bases to deny or allow access.  That’s what this is all about if you haven’t figured it out yet.  You should also know that once you get coded or tagged with this nonsense coding and US caste system type of scores, that it never comes off.  You will be stuck with one of these balls and chains forever, so hey WTF, let’s score everyone with Z60.82 for Inadequate social interactions.  This is such a piss poor model that I bet even the Quants that created it must be cringing, you know they don’t have to like or believe all the crap their employers want them to do but they have families to feed. <br /> <br /> <br /> <div class="separator" style="clear: both; text-align: left;"> <a href="https://1.bp.blogspot.com/-jFx7voRaabg/XU7_TDhNTXI/AAAAAAABNUQ/dGXAwIAcVIsetXVdLqC1nwF5hKSSSXhogCLcBGAs/s1600/ICD_Proposed.JPG" imageanchor="1" style="outline-width: 0px !important; user-select: auto !important;"><img border="0" data-original-height="505" data-original-width="790" height="408" src="https://1.bp.blogspot.com/-jFx7voRaabg/XU7_TDhNTXI/AAAAAAABNUQ/dGXAwIAcVIsetXVdLqC1nwF5hKSSSXhogCLcBGAs/s640/ICD_Proposed.JPG" width="640" /></a></div> You are already getting the crap scored out of you every time you fill a prescription, and yes it’s the PBMS using this scoring system that was created with Ingenix algorithms that were sold to Express Scripts in 2010, yeah another Andy Slavitt algo game for cash, as UNH made him and his former partner, Senator Warren’s daughter, Amelia quite wealthy in 1999 when UNH bought their company, which was basically nothing more than a script discount operation and they made money from the PBMs.  So here’s how the pharmacists are directed to “score” you or they can lose their jobs.  <br /> <a href="http://ducknetweb.blogspot.com/2015/07/patients-who-pay-cash-when-filling.html">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…</a><br /> <a href="https://www.blogger.com/$Outlier5.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/$ICD_Proposed6.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/$HealthcareQuants5.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/$Outlier5.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/$ICD_Proposed6.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/$HealthcareQuants5.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a>The bottom line here is that the AMA and United Healthcare are making complete fools of everyone thinking that some brainchild coding is going to change anything, as it won’t, it will more than likely end up costing more money as of course it will end up requiring software updates, right…LOL…and the AMA will get paid royalties for creating new CPT codes that will have to go along to match the ICD diagnosis codes so doctors can get paid to throw you under the Bad Algo Coding bus where you will not only see potential limitations in care today, but this will follow you forever and make it harder for you to jump through more algorithmic hoops that the Quants will model.  If you’re not getting this, then watch my video at the link below and then continue on to watch the 4 videos from others and see how far down in the algo toilet you might be.  <br /> <br /> <strong><a href="http://ducknetweb.blogspot.com/2017/11/algorithms-scoring-metrics-privacy-and.html">Algorithms, Scoring Metrics, Privacy and more in today’s Healthcare business world–The Healthcare Algo Cartel</a></strong><br /> Again I’ve been writing about algo abuse and and cheating code for years, and it’s happening everywhere, as with software you can do something about anything, create little virtual worlds where folks function and create new little virtual values, but what happens when the real world comes knocking?  The dupes sadly go click on One Trick Algos for even a deeper saturation of perception deception.  That’s what this coding BS for care here is all about and somebody needed to say it, as they are virtual values that will not end up helping you one bit, but the AMA and UNH will profit royally as they have practices algorithms deception for years.  I think today it’s only 15% of the MDs in the US are members of the AMA, so many have dropped out as it’s more of a lobby for money now versus representing doctors in the US and this movement has been going on for years.  UNH is and has been the king pin for Quant modelers for years so everything modeled mathematically from that corporation needs extensive scrutiny as it geared for shareholders first, patients second, the massive number of algorithmic subsidiaries tells that story well.  <br /> <br /> We need to index and license ALL data sellers so we can get an idea of what’s really going on in the black box scoring algorithms executing code unknown everyday, and remember we just see the front ends so remember there’s a whole other reality in how those algos collect your data, score you, screw you, etc. for the sake of corporate profits.  <br /> <br /> <br /> <a href="https://gogetfunding.com/index-and-license-all-data-sellerssharers-in-the-us/">“One Trick Algo World” Needs to be Licensed and Indexed–Spurious Correlations “For Profit” Are Out of Control</a><br /> <br /> <div class="separator" style="clear: both; text-align: center;"> </div> <br /> <br />

AMA and United Healthcare Combine Efforts to Once Again To Push CMS To Institute Algorithmic and ICD Coding To Rip Off Patients/Deny Access–It’s the Next Chapter of Excess Scoring in the US To Keeps Inequality/Segmentation Rolling

If you have not seen the latest with these two, take a look at to how they want to use segmentation for profit.  It is so much of a "On...

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Look No Further Than Wisconsin To See the Connection Between “Digital Illiterate Lawmakers” With New Law “No Web Cams During a Non Surgical Abortion Procedure” - This Says It All!

<p>I talk a lot about digital illiteracy with many lawmakers, why?  Because it’s true <a href="http://lh6.ggpht.com/-kah-Gzbko9o/T5QoWLkFyWI/AAAAAAAA6nI/evEesQ4aq9I/s1600-h/image%25255B7%25255D.png"><img align="right" alt="image" border="0" height="164" src="http://lh6.ggpht.com/--ziBgEnQZUQ/T5QoWRk81CI/AAAAAAAA6nQ/rVl16EFWKAs/image_thumb%25255B2%25255D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="138" /></a>and all you have to do is read the news.  It’s amazing that in the rapidly developing world of technology we have today that you still see these throw backs to the 70s.  They haven’t quite figured it out yet that technology in healthcare is here and is developing and changing rapidly.  Those of us in technology literally “laugh” at laws as such as we see right to the point here and scratch our heads as to “why” laws as such are created.  Even those who are not big techs scratch their heads too as web cams are like part of every part of life.  One wonders if these folks use smart phones too?  Outside the US when news of such is read I kind of wonder what other countries have to say about some of this too?  <br clear="all" /> <br clear="all" /><strong>We all know the governor is not too smart if you go back to the phone call to where a radio personality sucked him in to a “fake” call from one of the Koch brothers,</strong> which was really hysterical, but in another way very sad as that’s’ the level of intelligence sitting in that office, scary.  These folks that put so much effort into controlling abortions could really re-direct themselves to work on some very serious issues by all means. <strong> Back in 2011, about a year ago I wrote on this topic and it was bringing to the forefront how digital illiteracy was leading back to this “default” topic of abortions</strong> and as far as I can tell, it’s about all they can muster up to control and talk about as laws dealing with technology certainly seem to be over their heads.  So even a year ago the connection I made between digital literacy and lawmakers was pretty much on target.  <br clear="all" /> <br clear="all" /></p> <h5><a href="http://ducknetweb.blogspot.com/2011/05/digital-illiteracy-still-plagues-law.html">Digital Illiteracy Still Plagues Law Makers–Severe Focus on Abortion Rights Proves It–Is This Where Our Lawmaking Knowledge Leaves Off or Even Begins? Scary…</a></h5> <h4> </h4> <p>I just wonder if they even think about how they look to the rest of the world, and seriously it’s like a bunch of “loose cannons” running around and of course a “digital formatted law” would probably even be a bigger crime <grin>. <br clear="all" /> <br clear="all" /><strong>In a time when everyone else is looking at big data and have the ability to better sort large amounts of data, do you think lawmakers have thought this could be a good idea to help them?</strong>  So far I have not seen any evidence in that direction either, and on a federal level too. <br clear="all" /> <br clear="all" /></p> <h5><a href="http://ducknetweb.blogspot.com/2011/04/ibm-watson-capabilities-being-pitched.html">IBM Watson Capabilities Being Pitched to Financial Industry-Congress Must Not Have Felt They Needed This So Further Behind We Fall With Effective Intelligent Lawmaking</a></h5> <p> <br clear="all" /><strong><u>So now we have a “no web cam” consultation law</u></strong>…when the rest of the world is moving forward with telehealth, I swear others looking in too have to <img align="right" height="134" src="http://lh6.ggpht.com/-ROQ09n8bxEs/Td8618FLx4I/AAAAAAAAyII/2pjZoyIV7XU/image_thumb%25255B10%25255D.png?imgmax=800" style="display: inline; float: right" width="169" />just be rolling over laughing at such a law as it saves money and gives people better access to care.  I guess they don’t read the news and are not too concerned over better healthcare because this is related to that “default topic of abortions for the digitally illiterates”.  Last year a federal judge blocked abortion rules in Kansas, so I mean what is up with these out of touch folks as there’s yet another bunch of digital illiterates in lawmaking.  <br clear="all" /> <br clear="all" /></p> <h5><a href="http://ducknetweb.blogspot.com/2011/07/kansas-health-abortion-rules-blocked-by.html">Kansas Health Abortion Rules Blocked by Federal Judge Who Put The “Digital Illiterate Whack Job” Lawmakers” In Their Place And Maybe That is the 70s</a></h5> <h4> </h4> <p> <p><strong> In a round about way even the Vatican is getting tired of the digital illiterates in office even though they have their beliefs regarding abortions, they are not out trying create laws and they too see a need for better digital literacy</strong>, especially in the financial world, so again these folks in Wisconsin and their “web cam” law are really looking pathetic and the link below fell into one of my posts about “The Attack of the Killer Algorithms”, which basically again talks about digital illiteracy of lawmakers and how banks and big business control all with servers running 24/7 making life impacting decisions about all of us, and the lawmakers in Wisconsin can’t see this and continue this battle on abortions with huge amounts of time and money spent on this.  This is really sad that this is what is in office today. <br clear="all" /></p> </p> <p> <p> <br clear="all" /></p> <h5><a href="http://ducknetweb.blogspot.com/2011/10/attack-of-killer-algorithms-part.html">“Attack of the Killer Algorithms” Part 3–Vatican Doesn’t Like It Either–Occupy Wall Street Belongs in New York As They Don’t Do Code or Algorithms in Washington–Only Find time To Talk Abortions</a></h5> <h4> </h4> <p>The time and money spent here even made it’s way to Washington and a couple months ago there was a hearing on women’s health and no women were invited.  I have respect for all their views but please keep it out of lawmaking and respect the views of others.  Again the latest on no web cams has more than just me looking at the severe digital literacy and mental capacities of those in office for sure as<strong> how in the world can this be controlled?  <br clear="all" /> <br clear="all" />How is one going to determine that an “illegal web cam” consult was done?  These folks just don’t get technology at all and are looking “dumber” all the time as I would rather have them jump on the <a href="http://lh4.ggpht.com/-TkirBuHIlOM/T5QoWhex-uI/AAAAAAAA6nY/7XKy7SI9IZ0/s1600-h/image%25255B14%25255D.png"><img align="right" alt="image" border="0" height="160" src="http://lh3.ggpht.com/-KiNOAfmcfIQ/T5QoW_A340I/AAAAAAAA6ng/MqtxxQBq-oQ/image_thumb%25255B4%25255D.png?imgmax=800" style="background-image: none; border-bottom: 0px; border-left: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: right; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" width="202" /></a>band wagon and get up to speed with where many already are.</strong>  I took my link for the Komen foundation off my page and replaced it with Planned Parenthood when the analytics of where to best spend their money became a big political issue for the “digital illiterates” as they don’t realize how analytics are moving the money around, see the picture below at the post on how this intertwines too with the big even on Wall Street as some of philanthropy today has gotten out of touch too.  The analytic folks though are smart and know the digital illiterates can be manipulated and they do that, get their money where they want it and I wonder if corporate US sits back and somewhat laughs at the fact that they can manipulate the digital illiterate lawmakers too?  Komen also last year got a little out of bounds for suing other charities for the use of the word “Cure”, so what’s that tell you, big business and business intelligence analytics at work.  <br clear="all" /> <br clear="all" /></p> <h5><a href="http://ducknetweb.blogspot.com/2012/01/komen-foundation-cuts-of-funds-to.html">Komen Foundation Cuts of Funds to Planned Parenthood - Wall Street Was Lit up in “Pink” Last Week For Fund Raising from Hedge Funds and Other Financial Companies</a></h5> <h4> </h4> <p><img height="307" src="http://lh6.ggpht.com/-j1Q4JLjl_Dg/TyjBLs87vOI/AAAAAAAA5Hc/iGmczFPd2mg/image%25255B4%25255D.png?imgmax=800" style="display: block; float: none; margin-left: auto; margin-right: auto" width="425" />Poor Planned Parenthood is once again in the middle of this battle so again who’s going to monitor those dastardly web cams in the potential case that one might be doing a consult for an abortion?  Clearly they have no clue what this would entail with data trails and so forth…hysterically sad on on the levels of digital literacy.  In addition physicians can face felonies if violating the law.  The web cam phrase really takes the cake though and shows how far behind these lawmakers are and how they need to somehow attach themselves to “real” world out there as they are looking “dumb” and “dumber” every day when the need for “control” forces them into a box to where they think they can control “web cams” and how they are used, while the rest of the world moves forward.<strong> I don’t know how else to say this but these folks just look plain stupid and in my opinion are the “whack jobs” that somehow work on the emotions of the public when we all know the math and the algorithms are controlling who gets what today.   BD</strong> <hr /> <br clear="all" /> <br clear="all" />MILWAUKEE (Reuters) - Planned Parenthood of Wisconsin has suspended non-surgical abortions in response to a new state law that makes it harder for women to have the procedure, a move that followed anti-abortion measures in several Republican-controlled states.</p> <p>T <br clear="all" /> <br clear="all" />he law, which took effect on Friday, requires women visit a doctor at least three times before having a drug-induced abortion, forces physicians to determine whether women are being coerced into having an abortion and<strong> prohibits women and doctors from using web cams during the procedure. <br clear="all" /></strong> <br clear="all" /><a href="http://news.yahoo.com/wisconsins-planned-parenthood-suspends-non-surgical-abortions-175324214.html">http://news.yahoo.com/wisconsins-planned-parenthood-suspends-non-surgical-abortions-175324214.html</a></p></p>

Look No Further Than Wisconsin To See the Connection Between “Digital Illiterate Lawmakers” With New Law “No Web Cams During a Non Surgical Abortion Procedure” - This Says It All!

I talk a lot about digital illiteracy with many lawmakers, why?  Because it’s true and all you have to do is read the news.  It’s amazing th...

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Aetna Ends Up Buying Humana for $37 Billion-More Medicare Advantage Plans Under One Roof, Stock Buy Backs And the Never Ending Puzzle of Healthcare Profits by the Algorithm….

<p>So we are all watching to see how insurance merger mania goes and here’s the next after Centene bought Health Net a couple days ago.  In the Medicare Advantage market Aetna is the distant third behind United and Humana so with purchasing the #2 Medicare Advantage insurer this moves Aetna into the #2 spot.  According to what has been published so far, there won’t be any changes yet as far as operations and<img align="right" alt="image" border="0" height="87" src="http://lh3.googleusercontent.com/-k6swCJqe7Sc/VZau_G2qnLI/AAAAAAABMbQ/JTK88uygVas/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="280" /> Humana will operate as they have.  We know down the road this will change but for now it seems to be like a subsidiary.  United has been clawing up the back side of Humana on contracts as well with pricing themselves cheaper.</p> <h5><a href="http://ducknetweb.blogspot.com/2014/09/humana-loses-major-contract-in.html">Humana Loses Major Contract in Wisconsin to the “Too Big To Fail Insurer, United”</a></h5> <p>What we all wonder about though is the CMS payback that Medicare has said they want back, around $70 Billion in fraud that insurers bilked the agency for by using risk fiddling formulas.  I assume this might be one of the reasons that consolidation of company functions might be down the road a bit.  This move takes Humana out of the vulnerable spot light at least for now as Aetna owns the insurance licenses the company has.  Earlier I had written about the value of the licenses with health insurers and the Medicare proposed collection of the Medicare fraud money.  </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>Aetna was also reported firing more doctors in California this week with not meeting their “standards” so again <img align="right" alt="image" border="0" height="107" src="http://lh3.googleusercontent.com/-xl-qJ9KqV5I/VZau_2oNBYI/AAAAAAABMbY/HDaczH1KW2s/image%25255B15%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" />as well as with United we have a lot of Secret Scoring of Doctors going on here.  It’s actually gone on in California for a while as I have had conversations with doctors who have been dropped by Aetna and actually a couple of them said “what a relief” to not have to be bound to all those performance algorithms as usually one really sick patient puts them out of the “algorithm” quality game anyway and there’s nothing they can do when such occurs.  So that’s a little bit about how doctors get fired, one sick patient and they can’t fiddle the numbers enough to Aetna’s satisfaction, they’re out as well as the big mess of red tape the doctors have to deal with to be in network.  United does the same thing and has fired quite a few doctors in California.  Both Aetna and United both bailed out of the individual policy programs in California last year and probably for good reason as the networks were so limited, it was very hard to find doctors within those networks.  </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>Humana still hold the south Tri-Care Contract and I think that comes up for bid again either later this year or next year as they run for 5 years so Aetna will get that with the purchase as well.  When the contracts for Tri-Care come up, well who’s going to be left to bid could be an interesting question.  Both insurers also have some healthy stock buy back programs going as well and you pay for those with your premiums.  </p> <p>The board of directors directors will include 4 from Humana and will grow in size as well.  These are very complicated mergers as well.  Insurers have just absolutely buried themselves with data complexities, some of which is pretty useless but they have to decide what to do with their masses of burial grounds of data that basically do nothing today and of course the insured pay for all of that.  </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>In addition you have the data selling subsidiaries of Humana and Aetna to consider as well and their work with pharma companies to analyze and market consumers.  You can’t always believe 100% that insurers are just getting stuck on high drug prices to pay, they work and sell data together as well.  <strong>We all grew real tired too of all the failed Aetna apps that they thought would just jump out there and change people’s behaviors to what “they” want for profit too:)</strong> </p> <h5><a href="http://ducknetweb.blogspot.com/2013/08/pharma-and-health-insurance-companies.html">Pharma and Health Insurance Companies Pairing Up, Humana’s Analytics Subsidiary and Lilly To Figure Out How to Save (Make) Money and Provide Better Patient Care–Selling Research Data That Competes With FDA Sentinel Initiative</a></h5> <p>Humana has also fiddled around a little in the EMR business offering discounts to doctors who buy Greenway systems.</p> <h5><a href="http://ducknetweb.blogspot.com/2013/08/humana-offers-financial-incentives-for.html">Humana Offers Financial Incentives for Primary Care Physicians To Use Greenway EHR PrimeSUITE–Up to 85% Reimbursement Possible</a></h5> <p>Humana also made the news with possible trading violations as well. </p> <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><strong>Aetna ended up stalling off their Ingenix overcharge payments to doctors long enough to where a lack <img align="right" alt="image" border="0" height="81" src="http://lh3.googleusercontent.com/-nN4cRMik8zM/VZavA1Z8ocI/AAAAAAABMbg/9NuiX1QwqWY/image%25255B22%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" />of interest loophole kept them from having to pay doctors for the 15 years of Ingenix (United Healthcare) bad algorithm use to gain bigger profits.</strong>  Here’s the original settlement that was announced and Aetna never paid at the links below.  In addition, remember who’s running Medicare today?  It’s the former CEO of Ingenix, Andy Slavitt who created all these algorithms and formulas that allowed insurers to collect unprecedented amounts of money that was flawed but yielded bigger profits for insurers.  Interesting as Aetna never paid this but took a write off for it.  Couple back links below on the history of this.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/01/aetna-payment-of-120-million-to-settle.html">Aetna Payment of $120 Million To Settle 15 Year Ingenix/United HealthCare Out of Network Erroneous Payment Algorithms Cuts Income for 4th Quarter</a></h5> <h5><a href="http://ducknetweb.blogspot.com/2012/12/one-more-court-case-settles-for-120.html">One More Court Case Settles for $120 Million With Aetna For Around To 13 to 15 Years of Short Paying Doctors Using Defunct United Healthcare (Ingenix) Data Base for Out of Network Reimbursements</a></h5> <p>Humana also owns some doctors groups like this one they bought a few years ago.  United Healthcare is the king of that though as they own tons of doctors groups under the “Optum” subsidiary.  That gets real interesting too as in some areas you have Optum managing Humana insurance plans, so a subsidiary and a large one of United manages other insurance plans.  So there’s more than just insurance groups in this buyout for sure, so don’t lose sight of that with subsidiaries where all the action takes place half the time.  </p> <h5><a href="http://ducknetweb.blogspot.com/2011/09/humana-to-acquire-md-care-hmo-in.html">Humana to Acquire MD Care HMO in Southern California–HMO/IPA Purchases Continue With Insurers</a></h5> <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 were also all kinds of interesting marketing plans that have taken place over the years too, look at this one for example. </p> <h5><a href="http://ducknetweb.blogspot.com/2010/04/humana-and-cigna-partnering-to-sell.html">Humana and Cigna Partnering to Sell Medicare Humana Advantage Plans To Employers In Cigna’s Data Base</a></h5> <p>Aetna has had their news worthy issues as well…this first one is kind of a big one.</p> <h5><a href="http://ducknetweb.blogspot.com/2013/12/aetna-gets-hit-with-federal-lawsuit.html">Aetna Gets Hit With Federal Lawsuit Accusing CEO and Board of Directors Of Providing False And Misleading Information To Shareholders–SEC Violation</a></h5> <p>When United has fired doctors, in some areas Aetna has come in and picked them up.  Think there’s any chance<img align="right" alt="image" border="0" height="102" src="http://lh3.googleusercontent.com/-Ae65wKyeWDU/VZavCB1UF_I/AAAAAAABMbo/EJpdEYi21kk/image%25255B19%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="268" /> of getting a somewhat accurate listing of doctors out there any more with insurers?  Good luck as those in Congress and otherwise like us are just frustrated to no end and as long as most of areas of insurance are run by cost algorithms rather than a care focus, this problem will not go away but rather get worse with trying to figure out who’s in network any more.  <strong>Again you just have to laugh at these so called “experts” with no data mechanics logic demanding that insurers do a better job with listing doctors in networks as the insurers themselves are victims of their own complexities they built and the “experts” seem to be too dumb to see it and keep demanding change.  Those experts are looking for some Algo Fairies indeed, what I call frequently refer to as the “Sebelius Syndrome”.  </strong></p> <h5><a href="http://ducknetweb.blogspot.com/2013/10/united-healthcare-drops-300-southwest.html">United Healthcare Drops 300 Southwest Florida Doctors While Aetna Announces It Is Expanding Medicare Advantage Doctor Networks With Employer Sponsored Medicare Advantage Plans, No Word Yet On Individual Polices–Clustered Algorithm Analytics Creating “Black Box” Risk Assessments</a></h5> <h5><a href="http://ducknetweb.blogspot.com/2012/09/arent-these-health-insurance-contracts.html">Aren’t These Health Insurance Contracts a Bitch!Aetna Suing City of Jacksonville Over Decision to Award Contract to Florida Blue- Battle of the Algorithms</a></h5> <h5><a href="http://ducknetweb.blogspot.com/2012/04/aetna-notifies-130-texas-doctors-that.html">Aetna Notifies 130 Texas Doctors That It Will Terminate Their Contracts on July 1 – E & M Codes Primary Levels 4 and 5 Billing Analytics For Peer Comparison Used To Substantiate the Decision - Video</a></h5> <p>When it comes to medical operating loss, one might wonder if Aetna will let Humana in on their Cayman Islands re-insurance program too.  Read that one if you want to see some real complexities and questionable backers, bonds in the Caymans.  I know just what you want to read about when all you want to do is get a little healthcare but this is the world the US government allowed to grow to where we have to finance stock buy backs with premium payments as well in order to just go to the doctor or hospital.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/01/aetna-completes-200-million-dollar.html">Aetna Completes $200 Million Dollar Cayman Island Re-Insurance Multi Year Protection Bond Deal</a></h5> <p>Ok so what’s next?  I’ve said a few times that Aetna is a mini United as they have seemed to emulate of what United has done with healthcare by the algorithms.  When you write about this stuff for years, patterns are pretty easy to spot.<strong>  So the big <img align="right" alt="image" border="0" height="262" src="http://lh3.googleusercontent.com/-_Iwtgo3P3ok/VZavCzPzatI/AAAAAAABMbw/UUJ5H1uIKqs/image%25255B26%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="374" />question now is United I suppose with coming in as a bigger fish here and again the question of why is a former United Healthcare Executive and one time Goldman Sachs banker running Medicare?  There’s way too much power in that spot with even just timing the $70 billion dollar fraud money back program.</strong>  </p> <p>When you think of it that way, these Medicare Advantage insurers have a lot to loose there with some revenue, so with this fraud cloud of $70 billion hanging there, why are these companies so over valued at times?  Good question to think about maybe.  Here’s the future sadly with pushing more expense to the insured individual and less coverage and Handy Andy <strong>(Andy Slavitt, head of Medicare) who did that for years with under paying doctors with Ingenix is in the driver’s seat to do that at Medicare.  </strong>It is what he did for years and was sued all over the place for it with cheating algorithms of Ingenix, so bad to the point they had to change the name to Optum Insights as way too many were bit by the false positives those algorithms created.   BD  </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> <h5><a href="http://ducknetweb.blogspot.com/2014/09/seniors-facing-some-sharp-medicare.html">Seniors Facing Some sharp Medicare Advantage Premium Increases And Many Plans are Being Dropped As CMS Gets Their Next Dose of Said Algorithmic Fraud To Sort Out With the Risk Fiddlers…</a></h5> <p>Stay tuned for the next chapter of the complex World of Algorithmic Mergers and Acquisitions of Health insurers…BD</p> <p> <hr />Insurance giant Aetna Inc. <a href="https://fortune.com/company/AET">AET</a> -2.63% </a>is to buy Humana Inc. <a href="https://fortune.com/company/HUM">HUM</a> -2.87% </a>for $37 billion, in a deal that will create the second-largest managed care company in the U.S. behind UnitedHealth Group <a href="https://fortune.com/company/UNH">UNH</a> -1.27% </a>.</p> <p>The deal is the first in an expected wave of consolidation across the sector as health insurance companies look for ways to bulk up and reduce costs to stay competitive in the post-Obamacare world. It will transform Aetna, which has traditionally focused on employers’ health care plans rather than individuals’.</p> <p>Aetna has had to pay a relatively steep premium to get its hands on Humana: the offer is nearly 30% above where Humana’s shares were trading in May, before news of a possible sale leaked. The prize is a base of 3.2 million Medicare Advantage-enrolled customers that will more than triple its existing Medicare membership.</p> <p><a href="https://fortune.com/2015/07/03/aetna-to-buy-humana-for-37-billion/">https://fortune.com/2015/07/03/aetna-to-buy-humana-for-37-billion/</a></p>

Aetna Ends Up Buying Humana for $37 Billion-More Medicare Advantage Plans Under One Roof, Stock Buy Backs And the Never Ending Puzzle of Healthcare Profits by the Algorithm….

So we are all watching to see how insurance merger mania goes and here’s the next after Centene bought Health Net a couple days ago.  In the...

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