In the news today in the OC we have news with MemorialCare Medical Foundation buying into SimonMed imaging with owning over 50% (controlling interest) with yet one more “new” subsidiary called “Wave Imaging, LLC” This is moving quite fast as it was just in 2011 that the announcement was made that Optum, a subsidiary of United Health Group purchased Memorial IPA, which is now the MemorialCare Medical Foundation a not for profit company still? Hmmm….so now there’s a big stake and investment here with imaging centers.
OptumHealth (Subsidiary of United Healthcare) Takes Over Memorial IPA in California-Subsidiary Watch
There’s also some investing and ownership with with surgical centers. We are all aware of hospital systems buying up surgical centers and there’s also insurance company subsidiary action here too. Via the MemorialCare subsidiary of Optum, the subsidiary of United HealthGroup created a new venture or subsidiary called Beach Surgical Holdings, LLC in February of 2013 .
“Beach was created in February when the foundation entered a joint venture with Birmingham, Ala.-based Surgical Care Affiliates LLC.”
Monarch Healthcare, one more Optum tiered subsidiary the article stated was involved here, and well, remember this story…
United Healthcare Acquisition of Monarch Healthcare HMO Already Causing Confusion and Access Problems for Blue Shield Patients in Orange County
In April the Non profit MemorialCare subsidiary of Optum, tiered subsidiary of United HealthGroup bought a 51% (controlling interest) of a specialty practice in Laguna Hills, California, Digestive Disease Center. The center is affiliated Saddleback Medical Group .
Now in April of 2013, MemorialCare Medical Foundation, the sub of Optum, and the tiered sub of United added the group from the Digestive Disease Center to Beach Surgical the which was created by the system in February of 2013, see links above, so by sub, by sub by sub we have insurer controlling interest here with again 51% ownership. So this doctors’ group has a subsidiary of a big insurer with controlling interest, where all the action is taking place today with insurance companies, subsidiaries. Monarch was in here with this as well who was purchased by Optum, a for profit subsidiary, so this doctor’s group is under a “for profit” subsidiary unless the structure has changed since the purchase.
So whether it’s an imaging service or gastrointestinal services you need, a cut goes to the big conglomerate in one way or another be it cash or otherwise.. Again I’m not a legal expert but having a not for profit division of a for profit big insurance company can surely lead to questions I think. How does that work? We do know there are tax break benefits in here and the ability to secure grants. Not-for-profit is gaining ground because it more accurately reflects how these organizations work they say.
Most nonprofit/not-for-profit organizations do make profits. It’s just that the profits are reinvested into company operations. Ok so where do the profits get reinvested? Can we tell? Does one subsidiary benefit or suffer from the profits or losses of the other? I guess we have one big “tiered mysterious not for profit group” Again when SEC listings come in to play..how does the “not for profit” exemption play? So when a patient visits an imaging center that is 51% owned by the not for profit subsidiary of a subsidiary that is for profit, where do the dollars go?
Do take a look at the official SEC listing if you don’t believe that all the action is happening with subsidiaries today. Maybe this is why there was no need to participate in the California exchange, they have enough money and the business intelligence algorithms and models they use state that the profit yield from issuing policies doesn’t have a high enough yield and they don’t want the “risk “ exposure? This decision is not under the radar as it relates to selling policies, what most think is all health insurers do, not the case with all the mergers, acquisitions and business intelligence models built. Government can’t keep up with this and end up behind the 8 ball sadly.
United Healthcare Announces Their Departure From the Individual Health Insurance Market in California, Who’s Next?
"We are looking forward to further expanding our Digestive Disease Center relationship with Monarch gastroenterologists though this collaboration with MemorialCare Medical Foundation," says Bart Asner, M.D., CEO of Monarch HealthCare. "This offers an excellent opportunity to broaden our outpatient capabilities to achieve better care, lower cost and a superior experience for patients."
Anytime you wonder about why healthcare and health insurance is so expensive, look no further than the complexities of the financials of health insurers as you will find many answers right here. “You can do anything with software” said Mike Osinski (who created the software models used by bank for all the sub prime loans) to include data platforms that create profit centers where they did not exist yesterday and with steroid type marketing and “creating the need, we do get duped. Osinski also said that the models don’t always play out as designed and well all now that song.
This is why I suggest all watch this collection of videos that are done by people smarter than me that will give you some insight. They are not that complex to be over the head either but rather will clue you in on how math models are not held accountable, how some lie for profit and how they move the money. Banks and insurance companies have pretty much just morphed into software companies that control and move a lot of money.
Banks Are Actually Just Software Companies and the Same Can Pretty Much Be Said for Health Insurance Companies As Well-5 Unspoken Reasons Tech Projects Fail
By the way they do have a for profit bank for health savings accounts with somewhere around a billion on deposit and there’s some foreign investments here like China Gate.
UnitedHealth Group Owns a Bank With Deposits Surpassing a Billion – OptumHealth Bank FDIC Insured
Here’s yet one more controversial acquisition by Optum the subsidiary of United HealthGroup.
States Slowly Getting Insurance Exchanges Set Up as Federal Exchange Hub Built By United Health Group Subsidiary. QSSI Still Remains a Mystery
As I have read the subsidiary of Optum, LHI was originally created years ago to be a government contract vendor with a former director of HHS on staff at the time. He’s no longer there and I would guess that change took place when the Optum subsidiary bought the company. The LHI subsidiary in the United group does VA exams and big DOD occupational health events. Information quote from the website below…
“We have administered private occupational health services in support of various federal agencies including the Centers for Disease Control and Prevention (CDC), Federal Occupational Health Service (FOHS), Department of Defense (DoD) and the Veterans Health Administration (VHA). We support a wide variety of customers, including: National Institute for Occupational Safety and Health (NIOSH), U.S. Army Medical Command (MEDCOM), the Army Reserve, Army National Guard, Air Force Reserve, Air National Guard, Army Dental Command, Navy Reserve, Army Corps of Engineers, Coast Guard, Military Sealift Command and other Federal agencies. LHI also supports a number of private sector clients with occupational health services, including four of the Class 1 railroads operating in the United States.”
There is just so much complexity here as there’s other subsidiaries that do things that affect healthcare nationally in a big way, like some of these subs where I have made some blog posts.
consulting for drug and devices for the FDA and clinical trials
clearinghouse sub to work with Epic medical records
data mining medical information and records, and here
hospital analytics and software even used by the VA
contract with Tri-Care where DOD was sued to secure
some additional HMOs in Florida, low & middle income housing in New Mexico
HIE technologies and analytics
some miscellaneous EMR software
Optum cloud platform to sell software,
more analytics with software that helps set up insurance exchanges,
an in house pharmacy benefit manager, fraud prevention analytics
One does have to wonder how all the subsidiaries function and where and when interactions with others take place, how do you keep it all straight and what data sharing capabilities are there? Could one share or sell to the other sub? We don’t’ know any of this but with complexities you can’t rule anything out today without researching it.
Subsidiary Watch-Corporate Conglomerate Insurers Reduce Compensation Contracts Using One Subsidiary Then Market Same MDs With Another Subsidiary in Health IT
I must have been out of my mind 4 years ago when I wrote this post (grin).
Are You Insured by a Technology or Insurance Company
Or these posts from the archives…it’s all about the models and nobody has been looking for a lot of accountability with math…is it because of all this physical pain (real scientific study) it creates (grin). It’s all about the models, not the data…BD
Does the US Government Need a Department of Modeling and Algorithms–Is Data Addiction and Abuse the Next Up and Coming 12 Step Program, Some Classic Posts & Topics Revisited
Tustin-based MemorialCare Medical Foundation said today that it entered a joint venture with Phoenix-based SimonMed Imaging to operate five imaging centers in Orange and Los Angeles counties.
The foundation is the medical group arm of the $2 billion MemorialCare Health System, a nonprofit that is moving to Costa Mesa later this year from Fountain Valley.
The joint venture has been established as Wave Imaging LLC. MemorialCare Medical Foundation owns 51% of the venture, with Simon, which has 53 facilities in four states, holding the remaining 49%.
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