Medical Quack

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

<a href="https://www.blogger.com/blogger.g?blogID=3741684961227307530" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=3741684961227307530" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=3741684961227307530" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://2.bp.blogspot.com/-DN2en0D1OOs/VnGK0wq8qRI/AAAAAAABMnQ/OLPAoVydEp0/s1600/equippp.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=3741684961227307530" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=3741684961227307530" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=3741684961227307530" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><img border="0" height="88" src="http://2.bp.blogspot.com/-DN2en0D1OOs/VnGK0wq8qRI/AAAAAAABMnQ/OLPAoVydEp0/s320/equippp.png" width="320" />I have had some conversations with pharmacists who are on a pay for performance metric program based on this program and they don’t like it.  The big reason is the data that is provided to them is flawed.  The program finds information around the web about patients and combines it into a report that pharmacists must look up.  In addition they need to fix the flawed data that is reported.  You are probably not aware of this program as a patient but it exists and it is full of flawed data, being that you are reported as being non compliant if it does not located enough data about you.<br />
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These scores are being sold to pharma and to insurance companies.  Yesterday I read an article that just about made me choke, with an executive being quoted as saying “don’t waste your time on this patient, spend more time on this one as they show they are taking their medications”…again here we go again with flawed data.  You can look at the link below to see an actual conversation I had with a pharmacist and how this works.  They hate it as the executives from the EQuiPP program are constantly breathing down their backs as the pay for performance numbers are not improving fast enough, when in fact the data is not correct.  Patients who pay cash are being classified in error as Outliers.<br />
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<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></h5>
Do you not think these flawed scores will be used to deny or allow access?  Better think on that one again.  <img align="right" src="http://lh3.googleusercontent.com/-WTU_WavuGLg/VYjYaFce1MI/AAAAAAABMZA/DCNNtafnZm8/image%25255B8%25255D.png?imgmax=800" style="display: inline; float: right;" /> We know CMS is having a hard time today with many of their models with flawed data and in turn not improving care to the patient.  Also, don’t confuse medication prediction scores with “actual” facts that PBMs use to see who’s filling their prescriptions.  Those are actual transactions that have taken place where most of the predictions scoring is pure bullshit.  <br />
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<a href="http://ducknetweb.blogspot.com/2015/10/cms-medicare-part-d-program-with.html">CMS Medicare Part D Program With Medication Therapy Management–Here Comes the Flawed Medication Adherence Prediction Scores, Make Sure Jane Doe Gets the “Cheap Meds”..</a></h5>
All pharmacy benefit managers today are using some kind of prediction scoring and just take a look at the screenshot right off the Express Scripts page to the right here.  Do you see open discrimination here?  You should as they use 300 “secret” metrics created by some algorithm to give you a “secret” score that you can’t have or see.  If the code were ever broken down so we could see the metrics here I’m sure you would see all kinds of queries related to race, etc. as you can already see one in the image for “income” and “age” if under 65 years old.  You are being scored on many things you can’t change which is not fair. <br />
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<a href="http://ducknetweb.blogspot.com/2015/06/medication-adherence-predictions-enter.html">Medication Adherence Predictions Enter the World of Quantitated Justifications For Things That Are Just Not True, Members of the Proprietary “Code Hosing” Clubs Out There Destroying Your Privacy</a></h5>
All of this “scoring” costs  lot of money and in healthcare today, we are paying for tons of predictive queries and software platforms that offer little or no ROI and this is a big one.  We come right back to Excess Scoring of US Consumers and we get no benefit at all.  Here’s some additional links below if you want to catch up on what’s going on today with all of this.  Pretty much all of this goes back again to a division of Untied Healthcare, called Ingenix, which is now Optum Insights which created such “scoring” of patients as that’s what they do.  In addition, you can find some <a href="http://ducknetweb.blogspot.com/2015/11/optumrx-united-healthcare-buys-home.html">shocking “Cronyism” political ties</a> here that might help make more sense of what’s going on and who’s pocket all of this is feeding.  <br />
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<a href="http://ducknetweb.blogspot.com/2014/06/fico-medication-adherence-scoring.html">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</a></h5>
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<a href="http://ducknetweb.blogspot.com/2010/10/express-scripts-new-program-to-contact.html">Express Scripts- New Program to Contact and Predict Patients Who May Not Be Taking Their Medicine Based On Ingenix Algorithms–We Want the Revenue Please Don’t Stop</a></h5>
All in all, predictive medication scoring also helps pharma substantiate the high prices of their drugs as for years it’s been a media circus of “keep blaming the patient” for non perfect results.  I learned that tidbit from a former executive and code writer at the NISS many years ago.  Anyway, pay attention here is this is what your pharmacist does today for their performance metrics, dealing with the flawed data that comes down the line.  Former President Jimmy Carter made a speech not too long ago about the US not being a democracy any more and how now is becoming more of a dictatorship and here’s one big example of how this works with using algorithms and flawed data created by coders and developers to control individuals in the US.  BD  <br />
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CAMP HILL, Pa.--(<a href="http://www.enhancedonlinenews.com/">EON: Enhanced Online News</a>)--Rite Aid Corporation (NYSE: RAD) announced today that pharmacists across its nearly 4,600 locations chainwide are now utilizing Pharmacy Quality Solutions’ (PQS) EQuIPP, an information management platform that provides access to performance data across key patient care quality metrics, including those focused on medication adherence and appropriate medication use. Rite Aid is the largest drugstore chain to provide EQuIPP access to all pharmacists.<br />
“Value-based healthcare is here to stay and that’s why it’s important for Rite Aid to provide our pharmacists with the resources and tools they need to deliver improved health outcomes for their patients,” said Jocelyn Konrad, Rite Aid executive vice president of pharmacy. “Our pharmacists are committed to providing excellent care to their customers, and with EQuIPP, we’re empowering them to make an even greater difference in the health and wellbeing of their customers and succeed in today’s healthcare environment.”<br />
<a href="http://www.enhancedonlinenews.com/portal/site/eon/permalink/?ndmViewId=news_view&newsId=20151216005752&newsLang=en&permalinkExtra=Rite-Aid-Pharmacists-EQuIPP-Platform-Measure-Patient-Focused">http://www.enhancedonlinenews.com/portal/site/eon/permalink/?ndmViewId=news_view&newsId=20151216005752&newsLang=en&permalinkExtra=Rite-Aid-Pharmacists-EQuIPP-Platform-Measure-Patient-Focused</a>

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

I have had some conversations with pharmacists who are on a pay for performance metric program based on this program and they don’t like it....

Wednesday, December 16, 2015

OptumRX (United Healthcare) Buys Home Infusion Company AxelaCare-Using Algorithms To Determine Your Care With Being Financed By A “Too Big to Fail” US Health Insurance Company…

<p>We all know the home drug infusion business is growing as companies send out technicians and clinical personnel<img align="right" alt="image" border="0" height="76" src="http://lh3.googleusercontent.com/-4bp4zSXi8Kg/VlipMAi12BI/AAAAAAABMms/zHsPGg9bkbk/image%25255B11%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; margin: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="187" /> to administer treatments at home versus making a trip to the hospital or to the doctor’s office.  This is yet one more subsidiary added to the approaching 400 or so subsidiaries of United Healthcare, and of course this is one is “tiered” under the Optum subsidiary.</p>  <p><a href="http://www.axelacare.com/">AxelaCare</a> treats patients in 44 states and Washington DC.  Infusion medications are sent via mail to the patient to receive and then a nurse shows up to administer the medication.  You can see this goes right in hand with the <a href="http://ducknetweb.blogspot.com/2015/07/united-healthcare-having-big-bond-sale.html">OptumRx pharmacy benefit management.</a>  By the time this gets rolled in, even those insured by Cigna will be having this therapy managed by United Healthcare.  Any one see any anti-trust possibilities here?</p>  <h5><a href="http://ducknetweb.blogspot.com/2015/10/if-you-are-insured-by-cigna-guess-what.html">If You Are Insured by Cigna, Guess What You Have a New Pharmacy Benefit Manager Named United Healthcare</a></h5>  <p>Of course, you won’t be able to use cash to pay for this type of therapy as it will be mailed to you and there’s already<a href="http://www.marketvisual.com/d/55fec4d5-6bff-44b5-810c-0905ffe2e4d6"><img align="right" alt="image" border="0" height="150" src="http://lh3.googleusercontent.com/-7AOFFwyKT8s/VlipNJXpknI/AAAAAAABMm0/ht6vfGqALyw/image%25255B8%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="394" /></a> a big war on cash at the drug stores with CMS and private industry already scoring people as non compliant there to also get everything on a data trail of credit cards where everything you do is tracked.</p>  <h5><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></h5>  <p>So while everyone was worried about the big stir up with United Healthcare politically stirring up the news with the Affordable Act insurance policies , you had this purchase going on as well.  United/Optum has grown by acquiring other companies.  In addition if you can’t afford care, there’s another option at Optum (which you have to pay for) with a “discount card” called <a href="https://www.optumhealthallies.com/ha/public/indexDtc.jhtml;sessionid=NMFVDTZQMAUEGCW5GZIBQBY">Health Allies.</a>  This company was founded by current CMS head, Andy Slavitt and the daughter of Senator Elizabeth Warren, <a href="http://www.bankrate.com/finance/financial-literacy/spotlight-amelia-warren-tyagi-1.aspx">Amelia Warren Tyagi</a> in California when both of them got together at a “beach house” as it was quoted in an interview in California from knowing each other at the McKinsey Group.  We all know what “The Firm” (McKinsey) group is today, the “CEO school” basically as written about in the book called <a href="http://www.barnesandnoble.com/w/the-firm-duff-mcdonald/1113830078?ean=9781439190999">“The Firm: The Story of McKinsey and Its Secret Influence on American Business”.</a>   Being that Warren’s daughter now runs a company that is stated to compete with McKinsey, one could speculate if the agency had anything to do with the fact that a former United Healthcare Executive ended up running the NHS i the UK as well.  You can ponder that one if you like.  The company finds McKinsey like people to run companies.  </p>  <p>You can go here for the <a href="http://www.marketvisual.com/d/55fec4d5-6bff-44b5-810c-0905ffe2e4d6">visual history on Health Allies</a> and take a look.  I might guess both Warren’s daughter and Current CMS Head Andy Slavitt made a big haul here with United buying Health Allies and I think allowed Mr. Slavitt to go further and create the<strong> Ingenix subsidiary of United Healthcare</strong>, which has a huge history of not being honest with their math models and algorithms.  <strong>We also can’t over look Lois Quam who Hillary Clinton hired to work for her in the 90s and later in the State Department as well with her influence</strong> in allowing one insurer to gain so much power and authority as well.  Here’s a <a href="http://www.nytimes.com/2014/12/07/fashion/weddings/lois-quam-and-arshad-mohammed.html?emc=eta1&_r=2">New York Times article announcing the Lois Quam marriage in 2014 to Azizali Mohammed,</a> a correspondent, based at the State Department in Washington, so we’re back to Hillary Clinton connections again here.   Maybe today with all the uprising with Muslims this is worth a mention, as some of this does come into play with writing healthcare policy, just look at the news.   </p>  <p><strong>Lois Quam was a high ranking executive at United Healthcare who was responsible for the AARP and PacifiCare acquisition that was also <img align="right" alt="image" border="0" height="187" src="http://lh3.googleusercontent.com/-NMcNziGCKts/VlipNnWQqDI/AAAAAAABMm4/iBizErnw7Uo/image%25255B2%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="129" />given the job of being head Global Health Initiative from Obama</strong> and that project failed after a couple of years and was dumped.  Here’s a background summary of how Ingenix operated under the leadership of Andy Slavitt and all the lawsuits filed over the use of their algorithms.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/09/another-united-healthcare-ingenix.html">Another United Healthcare (Ingenix) Lawsuit Settling Over 9 Million-Short Paying Ambulatory Surgery Centers-Current CMS Director and One Time Goldman Sachs Banker, Andy Slavitt was CEO of Ingenix for Years…</a></h5>  <p><strong>With all the mergers and acquisitions today, I feel it’s important for consumers to be aware of who’s bottom line you are feeding with your healthcare today as United/Optum is pretty much just “hiding in plain site”</strong> and taking advantage of the fact that people don’t bother to look and read.  Here’s another example of the new Optum Clinical Labs subsidiary and we don’t know who jumped in to add the additional $32 million in funding here either.  With United’s current <a href="http://www.cargill.com/news/releases/2015/NA31896655.jsp">CEO now sitting on the board of Cargill,</a> corporation, well one could speculate, was it one of the hedge funds that food company operates?  The investors in the new Optum Clinical Labs subsidiary was kept in secret with the SEC filing.  </p>  <p>If you read the article you can see the purchase of yet another company, MedExpress who blankets several states with many urgent care centers and advertises to buy even more doctor’s practices if they want out.  Two states in particular, Pennsylvania and Massachusetts are pretty heavily populated with the centers as well as West Virginia.  West Virginia is where our current HHS Secretary has her roots as well, before serving as chief of staff for former Secretary of the Treasury, Bob Rubin who just about killed this country while he was in office and worked both at Goldman Sachs and Citbank.  <a href="http://fortune.com/2015/04/27/bob-rubin-sheryl-sandberg-facebook/">Bob Rubin these days, though, blames the polarity in the US on Facebook</a> and that is good for a laugh and a half you could say.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/05/optum-clinics-holdings-new-subsidiary.html">OPTUM Clinics Holdings, New Subsidiary Incorporated In 2015 Raises Over 36 Million (Exchange of Shares) From Investors Unknown-Form D Used to Maintain Secrecy Of Who They Are For Now…</a></h5>  <p>We also have Anthony Welters, the Executive VP Assistant to the CEO of United Healthcare <img align="right" height="536" src="http://lh3.googleusercontent.com/-dclAvjnezyI/Vi7i3HcWjII/AAAAAAABMkc/j5mxORCgLmA/image%25255B4%25255D.png?imgmax=800" style="float: right; display: inline" width="382" />who also has been elected to the <a href="https://www.carlyle.com/about-carlyle/team/anthony-welters">board of the Private Equity firm Carlyle,</a> who just experienced a loss on the last quarter reports that could have some impact in the direction of healthcare investments.  In addition to the Health Allies firm mentioned above, let’s not forget the Optum full custodial saving bank.  It’s an interesting read here as those who put their money in an HSA here when they reach $2100 in savings, also get marketed to put that money in Mutual Funds, so here you go, spend it on the healthcare you need or gamble in the markets with mutual funds for your care?  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/10/united-healthcare-owns-bank-optum-bank.html">United Healthcare Owns a Bank-Optum Bank That Will Collect Your HSA Money, Give You a MasterCard to Empty It Out-Which Enables Even More Data Mining and Selling Transactions About You</a></h5>  <p>One has to wonder though on whether or not any anti-trust inquiries will appear?  Currently Loretta Lynch (see image on the right) who serves as the head of the Department of Justice used to represent United Healthcare with their anti-trust suits, so go figure.  It’s pretty interesting how all this seems to just circle back in one form or another to United Healthcare, you think?  <a href="http://ducknetweb.blogspot.com/2015/10/cms-medicare-part-d-program-with.html">You can read here too how</a> this entire algorithmic process on “scoring” consumers on medication adherence predictions which are flawed had their roots with Ingenix algorithms as well.  Basically the link below tells about where all of this is going, with a lot flawed data being able to produce flawed profiles on consumers and what you get access too is or will be “scored”, so we’re back to the Attack of the Killer Algorithms where nobody looks at the data, on the results the queries pump out.  </p>  <h5><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></h5>  <p>The scary thing here is one health insurance company forming a monopoly at HHS and CMS today and we are seeing lack of competition here and again too much power from one US corporation.  There have been and currently are several executives of United who serve over at the CAP (Center for American Progress) who is the think tank that writes healthcare policy for HHS today.  That is scary too as you will also find folks like Dr. Zeke Emanuel and Jonathon Gruber over there as well as members, writing policy.  If you have ever read much of Zeke Emanuel’s books or articles, it’s hard to ignore the fact that he’s walking commercial for Optum and United Healthcare, been that way for a few years now.  </p>  <p>Anyway word to the wise here is pay attention to who’s acquiring and financing who as it does impact the type, quality and amount of healthcare services you will be able to receive.  We have a lot of models breaking over at CMS that were mentored over the years by United Healthcare, so pay attention as companies will continue to push broken models on consumers as they make money for the corporations with little care about whether they work for consumers.  As I said in another post <a href="http://ducknetweb.blogspot.co.uk/2014/05/people-dont-work-that-way-world-of.html">“People don’t work that way”…</a>and even Google can’t figure it out either as they are studying their own internal employees to learn.  </p>  <p>So be aware if you are a client of AxelaCare for your drug infusion needs, you get to put more money to the bottom line of United Healthcare, the “too big to fail” health insurer with a monopoly interest over the US government it appears today.  The link below kind of follows suit there as you can’t even find HHS/CMS really supporting the FDA, the agency that also falls under their jurisdiction.  It’ all about the 6 Degrees of Bob Rubin (Secretary Burwell) and a former Goldman Sachs Banker (CMS Director Andy Slavitt) running the show, while everyone else sleeps at the wheel.  BD</p>  <h5><a href="http://ducknetweb.blogspot.com/2015/11/hhs-joins-optum-labs-as-research.html">HHS Joins Optum Labs as Research Partner–Back Peddles Support of FDA Sentinel Program That Does the Same Thing-More Impact from the Six Degrees of Bob Rubin Running Healthcare in the US</a></h5>  <hr />Purchasing AxelaCare was a strategic move for OptumRx to further its strategy of improving care and reducing costs by integrating information and services.   <p>AxelaCare's electronic patient outcomes assessment technology, CareExchange, reports real-time patient data on the clinical efficacy of drug regimens, which will work together with Optum's analytics tools to support treatment decisions.</p>  <p>"With an aging population accessing new and more medications, AxelaCare enhances OptumRx’s ability to deliver the best care to the growing number of consumers managing complex conditions through at-home infusions," a release said. "Together, AxelaCare and OptumRx will expand the scope of treatments that can be offered in the home rather than in higher-cost institutional settings."</p>  <p>Optum employs 10,000 people total, with 1,200 of them in Overland Park. AxelaCare will bring 1,500 people to the company.</p>  <p><a href="http://www.bizjournals.com/kansascity/news/2015/11/17/optumrx-buy-axelcacare-health-solutions.html">http://www.bizjournals.com/kansascity/news/2015/11/17/optumrx-buy-axelcacare-health-solutions.html</a></p>

OptumRX (United Healthcare) Buys Home Infusion Company AxelaCare-Using Algorithms To Determine Your Care With Being Financed By A “Too Big to Fail” US Health Insurance Company…

We all know the home drug infusion business is growing as companies send out technicians and clinical personnel to administer treatments at...

Friday, November 27, 2015

HHS Joins Optum Labs as Research Partner–Back Peddles Support of FDA Sentinel Program That Does the Same Thing-More Impact from the Six Degrees of Bob Rubin Running Healthcare in the US

<p>We know Optum Labs is there to make money, selling slots to drug, device companies and others to have the “use” of mining <img align="right" alt="image" border="0" height="165" src="http://lh3.googleusercontent.com/-qpioVhvQo8g/VkyhkkjyifI/AAAAAAABMmQ/adodDSf-30s/image%25255B6%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="237" />their data.  So far all we have had of any significance reported is the same thing Kaiser reported from their registry information on hip and knee replacements.  A big part of how Optum makes their money is selling data and access to data.  What’s really interesting is that the same type of data mining operation was set up at the FDA and it in turn gets very little press, the agency that approves the drugs and devices that are allowed to be sold in the US.</p>  <p>Boston Scientific is also a research member here and pretty much what we have seen there is the closing of a few California locations and manufacturing moved from the US to Costa Rica for stents.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/05/boston-scientific-joins-optum-united.html">Boston Scientific Joins Optum (United Healthcare) Labs - Research for the Good With Profits Built In For Those Providing Medical Records And Data…</a></h5>  <p>Here’s a bit from the archives on the FDA data mining effort at the link below.  So, this kind of tells me there’s more to this than just research for better drugs, care, and devices, it’s all about money and what gets spent on our healthcare.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/02/fda-sentinel-and-mini-sentinel-data.html">FDA Sentinel and “Mini”Sentinel Data Base Is Growing and Becoming A Very Useful Tool</a></h5>  <p>Speaking of the FDA, United/Optum also owns a consulting firm that helps drug and device companies get their products approved by the FDA and there’ some trial information mixed in there too.  There’s also the ChinaGate United Subsidiary in China that works to get more Chinese drugs and devices distributed within and outside of China as well.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2011/09/united-healthcare-optum-owns-consulting.html">United Healthcare (Optum) Owns A Consulting Firm for FDA Drug and Device Approvals, Clinical Trials–CanReg - Subsidiary Watch</a></h5>  <p>Anything out of Mayo on their use of the Labs with ground breaking research....so far nothing…but they make money<img align="right" src="http://lh4.ggpht.com/_v3zjJigoAPE/SgyYmrRtv_I/AAAAAAAAPr0/zj6tygciyAg/image%5B5%5D.png?imgmax=800" style="float: right; display: inline" /> letting the Labs use patient electronic medical records.  It’s kind of strange that HHS is not even supportive of their own FDA efforts with the Sentinel Data Base, right?  Again this goes to show the long time relationship and a bit of cronyism with HHS and United Healthcare as well.  If you poke around a bit more than you might read about our current head of the DOJ, Loretta Lynch, she used to represent United Healthcare with anti-trust suits, so you can just about figure she’s do nothing with insurance carriers when it comes to anti-trust, or at least this company.  Of course we all may or may not know by now that Secretary Burwell was a former Chief of Staff for Bob Rubin that was one of the big three that turned the US economy on it’s ear with abandoning Glass Steagall and furthering the allowance of derivatives in the stock markets.  If you want more background on all of that, visit the <a href="http://www.ducknet.net/attack-of-the-killer-algorithms/">“Killer Algorithms” page</a> where there are some videos from people smarter than me that will give you the history and explain the fact.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/09/optum-labs-add-four-additional-data.html">Optum Labs Add Four Additional Data Miners To the Collaboration Looking for Data…</a></h5>  <h5><a href="http://ducknetweb.blogspot.com/2013/10/unitedhealthgroup-and-aarp-get-cozier.html">UnitedHealthGroup and AARP Get Cozier, AARP Still Gets Paid for Marketing Use of AARP Name As AARP Becomes an Optum Labs Data Selling Promoter Amidst Doctor Complaints Received Relative To United Firing of 5500 MDs–Subsidiary Watch</a></h5>  <p>Not too long ago as well Mayo decided to outsource their revenue cycling to Optum 360 as well, so more money for United there.  I read a few of the job reviews from folks about how they were fired from the hospital and re-hired by Optum 360 to work in this area and most seemed to be really disappointed in the loss of benefits 360 provided versus the benefits they previously enjoyed when employed directly from the hospital.   <a href="http://ducknetweb.blogspot.com/2015/10/if-you-are-insured-by-cigna-guess-what.html"><img align="right" alt="image" border="0" height="187" src="http://lh3.googleusercontent.com/-emboDBRHJAA/VkyhlN4iMUI/AAAAAAABMmU/dnwSxv49Q_Q/image%25255B2%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="137" /></a></p>  <h5><a href="http://ducknetweb.blogspot.com/2015/04/mayo-clinic-is-latest-to-outsource.html">Mayo Clinic is the Latest to Outsource Revenue Cycling to Optum 360, A United Healthcare/Dignity Health Company Pursuing Hospital Contracts All Over the US For Profit…</a></h5>  <h5><a href="http://ducknetweb.blogspot.com/2013/10/united-healthcare-adding-yet-one-more.html">United Healthcare Adding Yet One More Subsidiary to the Very Large Number of Subs They Already Own/Operate-Optum and Dignity Healthcare (A System Wide Cerner EHR Client) Form New Venture Called Optum 360–Subsidiary Watch</a></h5>  <p>The subsidiary game along with mergers and acquisitions as well it getting so bizarre that people insured by Cigna probably have no clue that their new pharmacy benefit manager is United Healthcare via the Catamaran PBM acquisition.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/10/if-you-are-insured-by-cigna-guess-what.html">If You Are Insured by Cigna, Guess What You Have a New Pharmacy Benefit Manager Named United Healthcare</a></h5>  <p>We truly have some folks in top places in government that seem to live way too virtual and forget about the real world half the time.  You can see it all the time on Twitter with posts of selfies and other such nutty stuff.  I knew when Obama and Biden jumped in to posting selfies, we lost them to virtual world values and chances were slim of either coming back.  Look at Secretary Burwell and all the selfies she posts, looks a bit lost, especially the selfie with a bicycle helmet on a few days after John Kerry fell of his bike in France.  What’s wrong with these people?  They just create noise and now think being a member of this big Optum data base is going to save the world or the US?  It’s crazy that HHS and CMS don’t even support their own efforts of the FDA under current government structures?  Optum supports and pay for a bicycling team so is this where all the bicycle focus comes from, to where all at the White House think they need to talk about their bicycle habits?  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/06/cms-chasing-wild-virtual-horses-big.html">CMS Chasing Wild Virtual Horses-A Big Distraction on the Hope of Finding Some “Algo Fairies” By Giving Entrepreneurs Access to Medicare Claims and Other Data…Marketing & Astro Turfing “The Sebelius Syndrome”..</a></h5>  <p>Look who’s running CMS?  We have Andy Slavitt, the former Goldman banker and United Healthcare executive that everyone sued over his crooked algorithms?  I have a few former CMS folks that have taken time to fill me on on quite a bit of history with both HHS and CMS a<img align="right" src="http://lh4.ggpht.com/-SY08Bt8wa40/UlyAOJSv2II/AAAAAAABIIo/Tg8ePmVDuL4/image%25255B27%25255D.png?imgmax=800" style="float: right; display: inline" />nd this is not good with one company having such a huge monopoly.  The link below will tell you more about Mr. Slavitt, who President Obama has nominated to run CMS.  If you have paid attention to the news in the last few days, he seems very much distracted with social networking comments and just not in touch at all.  Seriously why does the President of the US need a personal Facebook page?  I see an addiction here perhaps and virtual and real world values being confused.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/09/another-united-healthcare-ingenix.html">Another United Healthcare (Ingenix) Lawsuit Settling Over 9 Million-Short Paying Ambulatory Surgery Centers-Current CMS Director and One Time Goldman Sachs Banker, Andy Slavitt was CEO of Ingenix for Years…</a></h5>  <p>Here’s another option from the Optum Bank with Health Savings Accounts…be aware as when you hit the magic number of $2100 in savings, on comes the marketing to get you to place some or all of that money in mutual funds instead of using it for healthcare when you need it.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/10/united-healthcare-owns-bank-optum-bank.html">United Healthcare Owns a Bank-Optum Bank That Will Collect Your HSA Money, Give You a MasterCard to Empty It Out-Which Enables Even More Data Mining and Selling Transactions About You</a></h5>  <p>You also have United/Optum poking around in the medical records arena too and this archives article tells you a bit more and for goodness sakes the ONC portion of HHS hired a former United Healthcare lawyer to investigate and write policy on privacy…good luck there as so far there’s been nothing but a paycheck handed out to this individual.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2013/11/united-healthcare-optum-insight.html">United Healthcare (Optum Insight Subsidiary) Wants To Be Your Allscripts, Epic And GE Centricity EHR Consulting Service Starting With Implementation And Beyond</a></h5>  <p>So again cronyism and one big healthcare insurer that’s become too big to fail it appears here.<a href="http://www.youcaring.com/other/help-preserve-our-privacy-/258776"><img align="right" border="0" src="http://lh5.ggpht.com/-WjSMddBKiho/VAJ2n8h7WcI/AAAAAAABLOU/rTfddMqQxlU/GoFundMe%25255B5%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" /></a>  Just recently Vermont voted on universal healthcare and guess what, if it has been successful, Optum was right at the door wanting a contract to manage it.  Colorado should be aware of this potential when they take their vote on the same topic.  </p>  <p>There’s absolutely little or no benefit for us as consumers with this partnership at all, other than just more ways to algorithmically play God and deny access to services or other benefits we may need for our care.  Again, this looks really bad doing this and not even being in full support of their own FDA agency with the Sentinel Program.  It’s all about making money, selling more data.  </p>  <p><a href="http://www.youcaring.com/other/help-preserve-our-privacy-/258776">We need to index and license all data sellers in the US</a> as this is getting out of hand and the data in many areas has become flawed, profiles created about us are flawed..but the cash registers keep on putting money in the banks.  BD  </p>    <hr />CAMBRIDGE, Mass.--(<a href="http://www.businesswire.com/">BUSINESS WIRE</a>)--OptumLabs, the collaborative health care research and innovation center co-founded by Optum and Mayo Clinic, announced that the U.S. Department of Health and Human Services (HHS) has joined the collaborative as a research partner.    <blockquote>   <p>“We are grateful to have HHS as a new partner and welcome its active engagement as we focus on new initiatives that can directly translate to improvements in patient care.”</p> </blockquote>  <p>Agencies under HHS’s purview will now have the opportunity to develop and lead innovative health care research using OptumLabs’ big data resources, which link de-identified medical claims and clinical data to provide holistic views of populations and patient care.</p>  <p>“As HHS and its affiliates seek opportunities to improve the health, safety and well-being of all Americans, we believe that partnering with private-sector organizations such as OptumLabs will help accelerate the discovery of new health care models and practices,” said Susannah Fox, chief technology officer of HHS. “We are eager to collaborate with OptumLabs and its partners on a variety of initiatives that harness the power of health data to improve patient care and outcomes.”</p>  <p>The first research project to be conducted through this arrangement is with senior scientists at the Agency for Healthcare Research and Quality (<a href="http://cts.businesswire.com/ct/CT?id=smartlink&url=http%3A%2F%2Fwww.ahrq.gov%2F&esheet=51226722&newsitemid=20151118005115&lan=en-US&anchor=AHRQ&index=1&md5=8826d30946f5bcc2fcd9bd12ae0e8cdf">AHRQ</a>), the lead federal agency charged with improving the safety and quality of America’s health care system. The agency will compare and contrast health care trends identified in its Medical Expenditure Panel Survey (<a href="http://cts.businesswire.com/ct/CT?id=smartlink&url=http%3A%2F%2Fwww.ahrq.gov%2Fcpi%2Fabout%2Fotherwebsites%2Fmeps.ahrq.gov%2Findex.html&esheet=51226722&newsitemid=20151118005115&lan=en-US&anchor=MEPS&index=2&md5=1b13eb39f81eb5f59d968b6a49dc92e9">MEPS</a>) with those identified in real-world administrative health care claims records for the commercially insured population in OptumLabs’ databases, with the goal of increasing the value of MEPS to researchers exploring health care costs. MEPS collects data on the health services that Americans use, the cost of these services and how they are paid for.</p>  <p>HHS and its agencies also will work with OptumLabs on other projects, including research related to population health and the economics of health care – such as identifying whether disparities exist and can be measured in health care delivery at the national and local levels. All research is performed using de-identified outcomes-based data that can help answer questions about improvements in health care quality and delivery.</p>  <p>“Government is a key stakeholder in health care, and through this partnership now has a seat at the table of our collaborative community at OptumLabs,” said Paul Bleicher, M.D., Ph.D., CEO of OptumLabs. “We are grateful to have HHS as a new partner and welcome its active engagement as we focus on new initiatives that can directly translate to improvements in patient care.”</p>  <p>OptumLabs, with one of the largest de-identified patient databases in health care, is the first open, collaborative research and innovation center designed to accelerate health care innovation, leading to improved patient care and patient value. More than 100 research projects are currently underway or in development, and members of OptumLabs and its partner organizations have published more than 20 articles in leading health research journals.</p>  <p><a href="http://www.businesswire.com/news/home/20151118005115/en/U.S.-Department-Health-Human-Services-Joins-OptumLabs">http://www.businesswire.com/news/home/20151118005115/en/U.S.-Department-Health-Human-Services-Joins-OptumLabs</a></p>

HHS Joins Optum Labs as Research Partner–Back Peddles Support of FDA Sentinel Program That Does the Same Thing-More Impact from the Six Degrees of Bob Rubin Running Healthcare in the US

We know Optum Labs is there to make money, selling slots to drug, device companies and others to have the “use” of mining their data. So fa...

Wednesday, November 18, 2015

Where to Find Cheap Generic Prescription Drugs Less Than a Lot of Co-Pays-Use Cash-And Leave the Insurance, Reward Card, And Pharmacy Benefit Credentials at Home..

<p>I have been asked this question many times and with the war on both cost of drugs and the war on cash, I thought this might be helpful to put some links in as a reference.  Granted all the drugs you need won’t be on the lists perhaps, but there’s enough of them that cover a lot of what is commonly prescribed. </p>  <p>You want to make sure that you do not show the insurance or pharmacy benefit manager credentials as something<a href="http://resources.samsclub.com/MediaICN/2013/HealthyLiving/English_V2.pdf"><img align="right" alt="image" border="0" height="294" src="http://lh3.googleusercontent.com/-1iexAyUfa88/VkAuqwg3uwI/AAAAAAABMl8/qgfOR1y9CRs/image%25255B4%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="208" /></a> might go a bit awry in the processing of your prescription.  Some of the stores now have a pretty big reporting system that track when you fill your prescription, how you pay for it (those eternal credit card records that are bought and sold) and more.  I’ll put links at the bottom of this post that will explain how that work with selling your prescription data and “scoring” you for “predictive” medication adherence, a very flawed program out there.</p>  <p>Filling your prescriptions using Cash and without any access to your insurance and pharmacy benefit manager can actually save you money as the co-pays from the PBMs are higher than the generic prices listed here.  These are the latest updates I could find and some do change from time to time.  </p>  <p>Wal-Mart has a ton of $4.00 and $10.00 prescriptions, go get your prescription filled and no questions asked.</p>  <h5><a href="https://www.onu.edu/files/walmart_4.pdf">Wal-Mart Generic Drug List</a></h5>  <p>Sam’s Club, also a part of Wal-Mart offers the $4.00 and $10.00 prescriptions.  You need to be a member and pay an annual fee, but they do have some “free” prescriptions available as well.</p>  <h5><a href="http://resources.samsclub.com/MediaICN/2013/HealthyLiving/English_V2.pdf">Sam's Club Generic Drug List</a></h5>  <p>For now anyway until CVS takes over the pharmacies at Target stores, you can still get your $4.00 and $10.00 generic prescriptions there.  Again this will be changing soon as CVS takes over their pharmacy operations.</p>  <h5><a href="http://www.target.com/pharmacy/generics-alphabetic">Target Generic Drug List</a></h5>  <p>Here’s the news on Target and CVS from a prior blog post.</p>  <h5><a href="http://ducknetweb.blogspot.com/2015/06/target-stores-sells-pharmacy-and-clinic.html">Target Stores Sells Pharmacy and Clinic Business to CVS, Uses Debt to Finance and Drops $1 Billion From Stock Buy Backs, Gains a Lot More Consumer Data to Mine and Sell..</a></h5>  <p>Kroger stores also have quite an extensive list of $4.00 and $10.00 prescription refills.</p>  <h5><a href="http://www.4dollardrugs.com/wp-content/uploads/2014/05/Kroger-20140514.pdf">Kroger Generic Drug List</a></h5>  <p>CVS and Walgreens have “valued” priced generics but most are not this cheap and of course you will need to have a membership card or be wired into the Pharmacy Benefit manager.  </p>  <p>CVS is really getting tough with their PBM Caremark management and will charge you higher co-pays if you go to a store that sells tobacco, and that takes care of the places to where you can get a $4.00 or $10.00 prescription.  Read the blog post below on what they are doing.  Most are going to get prescriptions and could care less about the tobacco products in the store anyway and it was nothing more than a big PR campaign for the most part.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/10/cvs-to-charge-consumers-higher-co-pays.html">CVS To Charge Consumers Higher Co-Pays With Prescriptions Filled at Drug Stores That Still Sell Tobacco Products–Killer Algorithms Attacking Once Again To Make Sure CVS Gets the Prescription Revenue And Your Data To Score And Sell</a></h5>  <p>Here’s the CVS list.  </p>  <h5><a href="https://www.caremark.com/portal/asset/GE_CVSCaremark_ValuePricedGenerics_DL.pdf">CVS Generic Drug Listing (no prices)</a></h5>  <p>Walgreens has a $5.00, $10.00 and $15.00 tier plan and you’ll probably have to “join” their club to get the savings, which means they will have all your data to sell in the process.   I didn’t see a list for Rite-Aid but if regulators give the approval Walgreens is taking those stores over soon and you can look forward to some store closures and cut backs in the near future.  </p>  <h5><a href="http://www.walgreens.com/images/psc/pdf/PSC_2_0_VPG_List_FINAL_32312.pdf">Walgreens Generic Drug Listing</a></h5>  <p>CVS/Caremark is really into making money as well as Walgreens with selling prescription data, each chain making about $ 2 billion dollars a year selling your data and it all gets connected via those rewards cards and your insurance plan cards.  They both send data to big companies like IMS who stores about 85% of the world’s prescription data.  </p>  <p>Ok so the deal to keep a little of the privacy we have is to pay cash and don’t use any of those rewards or insurance and pharmacy benefit credentials.  Every time you fill a prescription you are scored to predict on whether or not you will take your meds.  By using cash, you may be called an “Outlier” in your score and get a score to defaulting you to non compliance.  I’ll include a link below that describes how that<img align="right" height="241" src="http://lh3.googleusercontent.com/-WTU_WavuGLg/VYjYaFce1MI/AAAAAAABMZA/DCNNtafnZm8/image%25255B8%25255D.png?imgmax=800" style="float: right; display: inline" width="379" /> process works via an interview I had with a pharmacist that told me all about it. </p>  <h5><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></h5>  <p>Just for conversation purposes, here’s a look at how Express Scripts secretly scores you (a secret as you can’t see it or have that score even though it is sold to pharma and insurance companies) on whether or not their algorithms think you will take your meds.  This goes on everywhere with all pharmacy benefit managers and with data sent to big healthcare data brokers like IMS.  As you can see from the image here, none of the metrics shown have anything to do with taking medications.  One that stands out is “children in the household”..why single this out as watching too much TV, spending a lot of time at the gym, and so on could also distract anyone for example. </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/06/medication-adherence-predictions-enter.html">Medication Adherence Predictions Enter the World of Quantitated Justifications For Things That Are Just Not True, Members of the Proprietary “Code Hosing” Clubs Out There Destroying Your Privacy</a></h5>  <p>Here’s a bit about IMS and the data they buy and sell.  Have you ever ended up on a clinical trials potential list where your name has been bought and sold?  I am on a list of “known blood thinner” users, and it’s a big problem as I get called and solicited and have never been prescribed blood thinners in my life but have to live with the flawed data sold about me all the time as I can’t fix it and find all the sources selling it.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/01/need-any-more-proof-that-data-selling.html">Need Any More Proof That Data Selling is An Epidemic Out of Control IMS Health Files for an IPO And Holds 85% of the World’s Prescription Data</a></h5>  <p>So there you have it and and I hope this is helpful and through adding some information on prescription data selling I hope this might also help you see yet one more angle to war on cash, in other words get patients to use and electronic transaction via a credit card so they can “score” you and might even play a role in denying you access someday to a drug you may need.  The link below tell even more about “scoring” and denying access in many areas that you may not even know exist.  BD</p>  <h5><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></h5>

Where to Find Cheap Generic Prescription Drugs Less Than a Lot of Co-Pays-Use Cash-And Leave the Insurance, Reward Card, And Pharmacy Benefit Credentials at Home..

I have been asked this question many times and with the war on both cost of drugs and the war on cash, I thought this might be helpful to pu...

Sunday, November 08, 2015

Catholic Hospital Takes Horizon Blue Cross Insurance Company to Court-Tiered Hospitals With Additional Policy Discounts Unfair to Hospitals of Faith–Killer Algorithms At Work..

<p>Well what’s not to say we’ll see more of this.  Yes indeed it’s getting complicated to get healthcare today.  We have the elite list and the cheap list it appears with insurance plan offerings.  I said a while back that there are armies of Quants hired from banks and other financial firms, i.e. high frequency trading companies who are now creating the models for the contracts and you see it more every day.  When you can take an insurance policy model and apply a Quant model on top of an actuarial model and check the impact on policies with stock, yeah they’ll do it.  It’s being done already.  Horizon of course is not alone as it’s all over the industry.  <img align="right" alt="image" border="0" height="189" src="http://lh3.googleusercontent.com/-VQoN31vhsOs/Vj96Uiqb1CI/AAAAAAABMls/eun70gkkiJE/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="254" /></p>  <p>The ability to get healthcare and math models for profit are reaching some very interesting plateaus you could say.  Before you venture out and get care, you have to go to your computer and see if anything has changed as things do change rapidly and what was in network today could be out tomorrow or in a case like this, switched to another algorithmically created tier.  Math and healthcare are tied at the hip today with contracts.  The link below goes back about a year.</p>  <h5><a href="http://ducknetweb.blogspot.com/2014/10/data-scientistsquants-in-health.html">Data Scientists/Quants in the Health Insurance Business–Modeling Beyond the Speed and Capabilities of Humans To Keep Up With The Affordable Care Act–Turning Into A World of Killer Algorithms That We All Hate..</a></h5>  <p>What’s even more interesting with all of the changes, CMS thinks fining insurers will make a difference-not.  It doesn’t work as this form of mathematically rating doctors and hospitals along with allowing access unfortunately looks like it’s here to stay as nobody will do a thing about it.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/08/cms-considering-fines-for-inaccurate.html">CMS Considering Fines for Inaccurate Doctor Listings, Not a Realistic Fix As Complex Doctor Scoring Algorithms Are Found At The Root of the Problem-Enter the Health Insurance Quants…</a></h5>  <p>So with this story, we have Catholic Hospitals who are being placed in a tier that is out of reach for certain health plans.  If this is not proof of being able to get care based on what you can afford to pay, I don’t know what is.  What makes this even more interesting is the fact that Horizon held on to and used the old Ingenix calculations that were short paying doctors all across the country.  The formulas were still being used when other insurers, after being sued, discontinued the practice.  The Ingenix formulas were licensed to almost all major insurers and for a number of years provided additional income for United Healthcare until caught by then NY Attorney General Cuomo.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/08/ingenix-optum-united-healthcare.html">Ingenix (Optum-United Healthcare) Lawsuits Still Bouncing Around Out There–One Recently Settled in New Jersey With Horizon Blue Cross Blue Shield That Was Still Using the Flawed and Corrupt Data Base for Out of Network Payment Calculations</a></h5>  <p>As you can read more below and at the link for the full story, the Bishops have sent a letter asking Horizon to at least allow the Catholic hospitals the opportunity to apply for Tier One status.  Life and healthcare is just one big lawsuit sadly.  BD </p>  <p><a>     <hr />TRENTON</a> — Arguing it was "wrongly excluded" from a line new of discounted insurance plans, Saint Peter's University Hospital Friday sued to stop Horizon Blue Cross Blue Shield of New Jersey from selling the policies without giving the New Brunswick hospital a chance to participate.</p>  <p>The hospital's attorney, Jeffrey Greenbaum, confirmed he filed an injunction in state Superior Court in Middlesex County asking a judge to prevent the state's largest insurance company from selling OMNIA Alliance policies that will offer consumers a 15 percent discount from their other products in 2016.</p>  <p>Horizon announced the OMNIA Alliance plans in September and described them as offering affordable and high quality care with a focus on preventing illness and managing chronic conditions. Other carriers, such as Aetna, also offered tiered networks to curb costs. But with 3.8 million customers, Horizon wields considerable buying power.</p>  <p>Horizon has stressed that it will continue to offer most of its existing plans – giving consumers a variety of choices, and Tier 2 hospitals and doctors plenty of business.</p>  <p>The excluded hospitals — many of them Catholic, located in cities or serve many uninsured and Medicaid clients — say they fear they will fall into economic crisis.</p>  <p>New Jersey Catholic Conference, an organization that represents the bishops, sent a letter last week asking Horizon CEO Robert Marino to let hospitals apply for Tier 1 status.</p>  <p><a href="http://www.nj.com/healthfit/index.ssf/2015/11/nj_hospital_sues_horizon_to_stop_new_discounted_in.html">http://www.nj.com/healthfit/index.ssf/2015/11/nj_hospital_sues_horizon_to_stop_new_discounted_in.html</a></p>

Catholic Hospital Takes Horizon Blue Cross Insurance Company to Court-Tiered Hospitals With Additional Policy Discounts Unfair to Hospitals of Faith–Killer Algorithms At Work..

Well what’s not to say we’ll see more of this. Yes indeed it’s getting complicated to get healthcare today. We have the elite list and the...

Sunday, November 08, 2015

CVS Laying Off 150 Employees at Headquarters, Meanwhile at the CareMark Florida Ranch A New 500 Personnel Facility to Add Support for Mail Order Drugs In the Works..

<p>You can’t make this stuff up and of course this is a big push to save money and get more folks on mail order prescriptions.  That sector of CVS is growing and it makes money as you can refill prescriptions easier on an automated basis.  Insurers can get billed as soon as “the pills go in the bottle” so as a patient you get loaded up faster.  I used to watch this with my mother as she had CVS Caremark mail order drugs and she had drawers of medications with 3-4 month supplies all shipped in the big prescription bottles.  She was also a diabetic and boy the strips were way more than <img align="right" alt="image" border="0" height="199" src="http://lh3.googleusercontent.com/-Go2tKk5wRY0/Vj4sw23s9rI/AAAAAAABMlU/pdlLE7_0mGY/image%25255B8%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="285" />she needed as well and those too were sent in bulk.  Here’s the <a href="https://www.pharmacist.com/cvs-caremark-proposes-florida-operation-500-jobs">story on what’s happening in Florida.</a>  So we have a minus 150 at the headquarters and a potential plus of 500 in Florida to focus on more mail order and data selling business.  </p>  <p><em>“Officials in Orange County, FL, have awarded an incentive package to Caremark, a division of CVS Health, to bring in a pharmaceutical operation that could create up to 500 jobs in the county. County commissioners approved Caremark's request in a vote of 6-1. Caremark, which is headquartered in Rhode Island, plans to establish a support operation in Orange County for its pharmacies in the southeastern United States. The jobs to be created include 100 pharmacists and 350 pharmacy techs. The company would add 275 jobs by the end of 2016 and another 225 jobs in 2017. The incentive program requires the average salary of the new jobs to be at least 115% of the county's average salary of $42,604. Meanwhile, Caremark would be in line for $1.5 million in tax refunds from the state—or about $3,000 per job—with the county contributing up to $300,000.”</em></p>  <p><strong>Let’s not forget the higher co-pay that CVS will use if you go to a store that still sells tobacco…keep reading and see what interests CVS has with alcohol below at the end of this post.  It’s like we have the fox guarding the hen house at times.  </strong></p>  <h5><a href="http://ducknetweb.blogspot.com/2014/10/cvs-to-charge-consumers-higher-co-pays.html">CVS To Charge Consumers Higher Co-Pays With Prescriptions Filled at Drug Stores That Still Sell Tobacco Products–Killer Algorithms Attacking Once Again To Make Sure CVS Gets the Prescription Revenue And Your Data To Score And Sell</a></h5>  <p>We knew their entire program was nothing but market</p>  <p>We all know CVS makes a lot of money selling our personal data as well.  It has to be going beyond the 2 billion a year by now as they keep expanding this all the time.  You can read about the IBMWatson partnership here, which is just about everywhere now as IBM has suffered 13 quarters of declining losses and their huge stock buy backs might be catching up to their financial engineering schemes.  IBMWatson by all means is not the only show in town with mining big data and running queries.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/07/cvs-and-ibm-watson-projectplease-make.html">CVS and IBM Watson Project–Please Make It Stop-13 Quarters of Declining Profits for IBM, Is This Is What We Get, More Algorithms Biting Us Constantly So More Data Can Be Mined and Sold Resulting In Excess “Scoring” of US Consumers..</a></h5>  <h5><a href="http://ducknetweb.blogspot.com/2015/04/cvs-to-share-more-medication-adherence.html">CVS to Share More Medication Adherence Love With New Contracts–Will Have More Data to Sell…</a></h5>  <p>As another contrast, look at the money CVS is putting in the e-commerce data selling business..not one, not two, but three centers so they can figure out which area of the country can write the best algorithms to capture and sell more consumer data and soak into all of it on the web.  You can see Rhode Island was left out here and they went to Boston and the Silicon Valley instead for computer code to make more money for them selling our personal data.  New York was also mentioned as there’s a ton of code hosers there as well, look at the stock exchanges and there’s code hosers that used to work for banks and high frequency firms who can spin up algorithms to get more of your money as that’s what they have done for years.  There’s quite a few of those looking for work as banks continue with their layoffs.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/11/cvs-to-open-new-e-commerce-technology.html">CVS to Open New E-Commerce Technology Centers in Boston, New York and Palo Alto– Need “New Code” to Make Bigger Profits While They And Others Continue to Destroy “US Consumer Dignity” With the Exploitations…</a></h5>  <p>There’s also a “war on cash” that exists with pharmacy benefit management too and I wrote about that a while back and CareMark is right in there with Express Scripts, Optum RX and a bunch more with not being able to find enough data about you and thus you get “scored” as an outlier by default who’s not medication adherence compliant with a metric of predictions that have nothing to do with taking meds.  I wrote this post after having a long talk with a pharmacists who told me what’s going on from their neck of the woods and how it impacts their jobs and pay for performance.  These “pharmacy techs” now employed by the groves are becoming a massive area of decision making and even push pharmacists at drug stores </p>  <h5><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></h5>  <p>I had the same pharmacist tell me about dealing with CVS techs and almost demanding that the drug store put the patient on automatic refill, stating a conversation with the patient had taken place with getting the patient ok.  Having been burned on this a few times, the pharmacist replied “no” and said that a call to the patient first would be the appropriate line of action versus taking the word of a CVS tech that the patient had said ok.  If you go back a little bit on this, CVS got in hot water about this exact same topic at the drug stores a while back with giving pharmacists “quotas” to meet on converting prescriptions to CVS from other pharmacies.  Some good journalism exposed that story with internal CVS emails.  We should also remember that <a href="http://ducknetweb.blogspot.com/2013/10/not-to-be-outdone-by-walgreens-in-data.html">Nancy Deparle,</a> the White House chief architect for Obamacare sits on the CVS board with shares of stock and makes some money there as well.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2012/10/the-prescription-auto-refills-still-out.html">The Prescription Auto-Refills Still Out There With CVS and Others as Pay for Performance Efforts Ramp Up at US Corporate Retail Pharmacies To Meet Quotas and Make Those Profit Numbers for the Shareholders</a></h5>  <h5><a href="http://ducknetweb.blogspot.com/2012/08/the-automatic-prescription-refill.html">The Automatic Prescription Refill Algorithm Causing Havoc at CVS When Not Personally Authorized By the Patient–Attack of the Killer Algorithms Chapter 40</a></h5>  <p>CVS also kept losing pain reliever prescriptions in California and were under the heat on that charge as well.<img align="right" alt="image" border="0" height="215" src="http://lh3.googleusercontent.com/-kvh4Ys92OYA/Vj4sxvjBkCI/AAAAAAABMlY/U7deuivRfqE/image%25255B3%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="251" /></p>  <h5><a href="http://ducknetweb.blogspot.com/2014/03/cvs-drug-stores-could-face-29-million.html">CVS Drug Stores Could Face $29 Million in Fines For Losing Track of Prescription Pain Killers At California Stores - Don’t Worry About Tobacco So Much And Go Hunt Down That Missing Vicodin..</a></h5>  <p>In addition, we had the DEA raids in Florida a few years ago that closed a couple CVS stores and brought on a case with their drug distributor, so it is interesting that Florida once again is being chosen for a new CareMark distribution facility.  They make money selling drugs and filling prescriptions by all means, either in the stores or by mail order.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2012/02/dea-raids-2-cvs-stores-in-florida-and.html">DEA Raids 2 CVS Stores in Florida and Suspends License of Drug Distributor Cardinal Health–Lots of Oxycodone</a></h5>  <p>So it appears via automation or whatever criteria used by CVS, that their profits and money makers are located outside of the corporate offices for now.  We don’t know exactly what areas in the main office were impacted.  By the way in an unrelated story, CVS in California under fire for selling homeopathic medicine that was just basically alcohol and water at their stores.  A woman drank 6 bottles of the CVS Constipation Relief medicine and got drunk in camera.  Maybe time for CVS to really look into what’s the shelves today as well?  If they video does not play, <a href="http://www.nbclosangeles.com/investigations/CVS-Laxative-Constipation-Relief-Alcohol-342025991.html">use this link to view at the site</a> as it was having issues when I posted.  BD</p> <script type="text/javascript" charset="UTF-8" src="http://www.nbclosangeles.com/portableplayer/?cmsID=342208601&videoID=yPdWn3ekeysx&origin=nbclosangeles.com&sec=investigations&subsec=&width=430&height=260"></script>  <p> </p>  <hr />WOONSOCKET, R.I. — Drugstore chain and pharmacy benefits manager CVS Health is laying off 150 people, a spokesman said Friday.   <p>The company has informed the workers it is eliminating their jobs in December, spokesman Michael DeAngelis said. Seventy of the jobs are at the company’s headquarters in Woonsocket.</p>  <p>DeAngelis said the cuts follow a “thorough evaluation process” and represent a small fraction of the company’s more than 200,000 employees in the United States, 7,000 of whom are in Rhode Island.</p>  <p><a href="http://timesleader.com/news/492753/cvs-health-laying-off-150-people-in-operational-review">http://timesleader.com/news/492753/cvs-health-laying-off-150-people-in-operational-review</a></p>

CVS Laying Off 150 Employees at Headquarters, Meanwhile at the CareMark Florida Ranch A New 500 Personnel Facility to Add Support for Mail Order Drugs In the Works..

You can’t make this stuff up and of course this is a big push to save money and get more folks on mail order prescriptions. That sector of ...

Saturday, November 07, 2015

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

<p>How many people know that Optum has a bank?  They don’t offer any retail services outside of an Health Savings Account to the public but many companies offer this for people who have a high deductible health insurance policy.  You can <a href="http://www.yelp.com/biz/optumhealth-bank-salt-lake-city">read through Yelp</a> and make your own opinions if you want to dive in a bit more.  The bank is located in Salt Lake City and most of what one would do with this “custodial” bank would be online<img align="right" alt="image" border="0" height="90" src="http://lh3.googleusercontent.com/-iYDYa3JAfYU/VjT7b3yu4UI/AAAAAAABMkw/h3QohrR537I/image%25255B3%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="234" /> of course.  There are other Health Savings Accounts around of course to choose from.  Well here we have MasterCard who we should all know by now are just marketing and mining your data to who ever seems to have the money to buy anymore.  Here’s a company names Argus, who buys credit card information and then continues on to “score” you.  We’re not talking credit scores here, but anything they can think of where they can take data, score you with some query some Rogue software engineer came up with to make money.</p>  <h5><a href="http://ducknetweb.blogspot.com/2014/08/argus-analytics-produces-share-of.html">Argus Analytics Produces “Share of Credit Card” Data On Consumers - Digs Up The Dirt on Your Credit Card Behavior Patterns-US Consumer Protection Agency Is A Client-We Are Paying for Richard Cordray’s Slow Education Process</a></h5>  <p><strong>With Ben Carson all of a sudden touting Health Savings Accounts, you kind of might wonder how much money United Healthcare could be donating to his Presidential campaign?  Why would this appear as such a high item on his agenda?</strong> </p>  <p>Another firm in the Health Savings Account business, Health Equity just bought off most of Bancorp’s HSA accounts, which was 170,000 accounts, $400 million in deposit.  Pay attention to this as your Health Savings Account can be bought and sold like let’s say a mortgage.  The one benefit of a<img align="right" alt="image" border="0" height="109" src="http://lh3.googleusercontent.com/-kQhEvDBccMs/VjT7cdiSPgI/AAAAAAABMk0/ZW0Wt_LynAU/image%25255B11%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="168" /> Health Savings Account, which is why they exist is that they are tax free.  Most folks get into a Health Savings Account through their employer, although some are available outside those parameters.  If you have one at work from your employer, then if you leave, you need to transfer or close the account for the most part.  </p>  <p>So how convenient is this, for United to have full on bank that provides this service, as it certainly goes to compliment all the high deductible plans they offer, right?   The high deductible policy guidelines to qualify are $1300 for an individual and $2600 for a family.  There are limits on how much money you can put in these accounts as well.  Last I read there is over $2 billion on deposit at the Optum Bank.  </p>  <p>Now when you tie your account to an Optum MasterCard, here come the fees, quite a few of them, so no surprise there.  I think United Healthcare is second only to maybe IMS with being one of the largest healthcare data sellers in the US.  With around 350 subsidiaries, to include pharmacy benefit management, they have a ton of your data to score and sell on any type of model and query they decide to build.  As I recently reported, if you are insured by Cigna, you get United Healthcare now as your pharmacy benefit manager, more on that at the link below, with the impact of mass mergers and acquisitions of healthcare companies.</p>  <h5><a href="http://ducknetweb.blogspot.com/2015/10/if-you-are-insured-by-cigna-guess-what.html">If You Are Insured by Cigna, Guess What You Have a New Pharmacy Benefit Manager Named United Healthcare</a></h5>  <p>MedPoint is United’s (aka Optum) data selling unit that’s been around for years collecting and selling your <img align="right" src="http://lh5.ggpht.com/_v3zjJigoAPE/SkL9GOgy_rI/AAAAAAAATec/4yxb2jf7CV8/image_thumb%5B5%5D.png?imgmax=800" style="float: right; display: inline" />prescription data.  As a matter of fact, they licensed and probably still collect a lot of money from this, their algorithms to companies like Express Scripts to “score” you on the flawed Medication Adherence Prediction Metrics which are totally discriminatory as the metrics are secret and you can’t see them.  The name Ingenix, at least in the US has now been changed to Optum.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2010/10/express-scripts-new-program-to-contact.html">Express Scripts- New Program to Contact and Predict Patients Who May Not Be Taking Their Medicine Based On Ingenix Algorithms–We Want the Revenue Please Don’t Stop</a></h5>  <p>So again, there’s more data to collect and sell and more importantly “score” about you generated by using a MasterCard with your Health Savings account.  I had a conversation recently with an Apple employee and he had no clue that his Optum Credit Card data was in the arena to be sold.  How convenient is this though for United to take the Optum banking data and roll it right in to all the data scoring and metrics that are done with other areas of Optum.  </p>  <p>It’s also interesting that the Optum bank of course is marketing this MasterCard for other purchases when they can and these might fall out of the qualified areas with your Health Savings Account.  It’s interesting to note that their website states that you can only withdraw $10,000.00 in a 24 hour period.  How many people have that much money in their Health Savings account?  Not many.</p>  <p>The Optum Bank says you can invest your money in “mutual” funds to help save for future health expenses.  The site also lists this disclosure “<strong>Investments are not FDIC-insured, are not guaranteed by Optum Bank and may lose value”.   Guess what, another suggestion here on how to get your Health Savings Account money in the stock markets, right?</strong></p>  <p>Again, you are covered with a normal Savings Account here, but not if you venture out beyond by the FDIC of up to $250,000.  How many other health insurers own a bank?  None that I’m aware of.  </p>  <p>Wealth Management, is also a service offered, so again most HSA accounts are not that big for the most part, so how much wealth can be managed?  Again the big sell is getting more data transactions ramped up on the MasterCard you can use as a debit card.  United does other “card” programs, again all to collect, mine and do more scoring of your data and the flawed results can be astounding with certain data files.  </p>  <p>The insurer will get you in the grocery store and with vending machines, again all to track more of what you do.  If that isn’t enough for you, look at this subsidiary of United Healthcare with their <a href="http://lacrossetribune.com/news/local/lhi-puts-knowledge-on-healthy-eating-menu-with-knourish/article_d6d23a0a-1465-5e7f-8b5c-3ffdaeb03d1f.html">vending machine that does not take cash…</a>here goes the war on cash again.  LHI is a government contractor that is owned by United Healthcare that does a lot of things from giving vets their disability physical and findings and sends it off to the VA to inoculating and performing physicals on soldiers before they are sent out of the country on duty, and that’s a lot of money made there as well.  Now LHI is out to get you using more United Healthcare cards.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/07/united-healthcare-finds-yet-another-way.html">United Healthcare Finds Yet Another Way to Track You At the Grocery Store–Healthy Savings Card That Will Give You Discounts and Track What You Buy..</a></h5>  <p>In other Optum news, another long standing legal case of crooked algorithms created by Ignenix (now called Optum) <img align="right" alt="image" border="0" height="116" src="http://lh3.googleusercontent.com/-vAI8dKNefXs/VjT7dPeXFzI/AAAAAAABMk8/3iScXaEP4Eg/image%25255B10%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="169" />was recently settled.  Andy Slavitt, who is currently running CMS was the brainchild here and is a former Goldman Sachs banker who was the CEO and ran the Ingenix subsidiary of United Healthcare for years.  Why Obama nominated him for the job full time is beyond me, but as of now he’s “acting” as the chief administrator.  See how this all ties together with old Mr. Slavitt leading the way to connecting health insurance to banking?  The Optum bank has been around for a while and is located in Salt Lake City.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/09/another-united-healthcare-ingenix.html">Another United Healthcare (Ingenix) Lawsuit Settling Over 9 Million-Short Paying Ambulatory Surgery Centers-Current CMS Director and One Time Goldman Sachs Banker, Andy Slavitt was CEO of Ingenix for Years…</a></h5>  <p>Those working at banks and financial institutions probably are more likely to have an employer provided Health Savings Account.  Earlier this year the Optum bank now is now using <a href="https://www.bogleheads.org/forum/viewtopic.php?t=163140">Admiral Funds on Vanguard Funds,</a> a way to avoid fees and snare some folks into the stock market, maybe not in a large way, but that’s the incentive here.  Here’s a video plug below…on getting you into the market and funds..$2100.00 is what you need as a minimum.  Pay attention to all the “healthcare” information they want as well.  Again, combine that with MasterCard transactions and more and shortly they have one heck of a data file on you, not to mention all that rolls in from Prescription data too.  </p>  <p><iframe height="315" src="https://www.youtube.com/embed/ABEelaoA5LI" frameborder="0" width="420" allowfullscreen="allowfullscreen"></iframe></p>  <p>You be the judge here, are you really helping yourself with healthcare savings, or are you being marketed to dump it out with a MasterCard or get the money into the stock market?  What do you think?  </p>  <p>Why does Ben Carson see this as such a good deal?  Is United a big backer of his campaign?  You can transfer dollars back to your HSA from the Mutual Funds, that is if they are doing ok.  </p>  <p>In addition, this Optum bank also loans companies and doctors money, all done with funds on deposit from you.  Be careful what you sign up for with this bank and the HSA opportunities.  BD</p>

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

How many people know that Optum has a bank? They don’t offer any retail services outside of an Health Savings Account to the public but man...

Saturday, October 31, 2015

If You Are Insured by Cigna, Guess What You Have a New Pharmacy Benefit Manager Named United Healthcare

<p>First question out of the barrel might be “how can that be”.  It’s really not too difficult to figure out.  A short while back United Healthcare bought a pharmacy benefit manager named Catamaran, and actually took on $10 billion in debt to acquire them.  This has been in the news for a while actually, so how did you end up with United Healthcare.  It’s easy, Catamaran is the Pharmacy Benefit Manager for Cigna, so when<img align="right" alt="image" border="0" height="250" src="http://lh3.googleusercontent.com/-XHSvyCC6Ly0/Vi7i2iz25hI/AAAAAAABMkY/pP9kI46N7qE/image%25255B8%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="219" /> United bought the company, it became a subsidiary of United Healthcare, so there you go.  The company is now a subsidiary of the huge too big to fail health insurer, who actually gets 2/3rds of their revenue from insurance policies and the rest from selling software and algorithms for a big chunk of the other third.</p>  <h5><a href="http://ducknetweb.blogspot.com/2015/07/united-healthcare-having-big-bond-sale.html">United Healthcare Having a Big bond Sale to Finance Purchase of Catamaran Pharmacy Benefit Management Company, Huge 10.5 Billion</a></h5>  <p>United already has their own Pharmacy Benefit Manager called Optum RX and Catamaran is going to be merged together with them, so there you go.  In time the name Optum RX will be the only name you see.  Both Cigna and United are members of the S&P 500 and run stock buy backs.   So now, portions of your policy premiums can go to not one but two buy back programs…a two fer.  Last year in 2015 Cigna spent about $1.63 Billion in buying back stocks and of course United spent a bunch more than that as they are so much larger, although I read somewhere that United’s buybacks were reduced a bit to allow this acquisition of Catamaran.  If you keep up a little on stock news, then you’ll know how the S&P index has been diving and when stock buy backs grow to big dollars, well people lose jobs and things get cut, again all to allow the companies to buy more of their own stock back and give the CEOs a lot more money.  </p>  <p>As a matter of fact, United’s CEO, Hemsley just joined the board of Cargill, and what’s one of their big focuses, <a href="http://www.cargill.com/products/pharmaceutical/index.jsp">pharmaceuticals.</a>  All this starting to make a little more sense when you connect some dots?<strong>  Cargill is Minnesota's largest privately held company.  Cargill also offers farmers services and is the evil twin brother of Monsanto, so real place for </strong>Hemsley, right?  Just like Monsanto, Cargill feeds on family farmers and Cargill is the world’s largest trader of grains, the world’s largest privately held corporation.  If you ever have any doubt United is all about money, well what do you think now?</p>  <p><strong>In other news on the Pharmacy Benefit Manager purchase, Independent pharmacists filed a class action lawsuit against Catamaran.</strong>  Can you guess why?  The independent pharmacists are getting lowballed.  They might seem to fit the United Healthcare model of Ingenix, now called Optum Insights that lowballed MDs on payments for 15 years and had many law suits filed against them.  Just as a side note, Obama nominated Andy Slavitt to run CMS, and he was the CEO of Ingenix, the low balling company, do we want him at CMS?  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/03/united-healthcare-buys-catamaran.html">United Healthcare Buys Catamaran Pharmacy Benefit Manager Just As the PBM Gets Hit With A Class Action Lawsuit For Low Balling Pharmacy Reimbursements..And More Patient Data to Sell and Analyze For Profit</a></h5>  <p>This might indeed have a lot to do with why Anthem and Cigna want to merge.  Neither company has an in-house pharmacy benefit manager and relies on 3rd party PBMs like Express Scripts and Caremark for their services, and some smaller PBMs that existing out there among the giants.  For Cigna, as it stands now they are pretty much “hooked” into supporting the PBM subsidiaries of United Healthcare.  It takes time and is expensive to change a few million patients over to another PBM and the rates United charges them can go up too.  Could be a big squeeze by United, which they are known for doing when the opportunities fall into their laps.  One merger and patients now get to support the stock of 2 health insurance companies.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/07/anthem-and-cigna-merge-whats-in-it-for.html">Anthem and Cigna Merge, What’s In It For Consumers, Nothing Really, But There Will Be a Massive Data Mess of Analytics, Budgets, and You’ll Never Get An Accurate Listing of MDs in Network…</a></h5>  <p><strong>United Healthcare has already beat the crap out of Express Scripts in Florida</strong> in taking business away from them and moving it in house to Optum RX, which by the way is now the largest PBM in the country with the acquisition and merging of Catamaran, so United has 2 “large” credits to their name being the largest insurer in the US as well.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/05/optum-clinics-holdings-new-subsidiary.html">Optum Clinics Holdings, New Subsidiary Incorporated In 2015 Raises Over 36 Million (Exchange of Shares) From Investors Unknown-Form D Used to Maintain Secrecy Of Who They Are For Now…</a></h5>  <p>So you may have heard about Cigna pulling out of Florida for Obamacare insurance and it may have had something to do with this taking place and Optum RX taking over the pharmacy benefit management of so many people in Florida.  See how this worked earlier this year.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/05/express-scripts-to-lay-off-400-people.html">Express Scripts To Lay Off 400 People Tampa As United Healthcare Moves Patients To Their Own Pharmacy Benefit Management Company-Subsidiary Watch</a></h5>  <p>But when functioning with another subsidiary, United was not always a foe for Express Scripts, as Ingenix provided the algorithms for the company to begin this bogus “medication prediction adherence scoring”.  Here’s the link below and this is not to be confused with actual clinical records for monitoring, the prediction part as it is used now is pretty much junk very discriminating as the 300 metrics used have zero to do with taking meds.</p>  <h5><a href="http://ducknetweb.blogspot.com/2010/10/express-scripts-new-program-to-contact.html">Express Scripts- New Program to Contact and Predict Patients Who May Not Be Taking Their Medicine Based On Ingenix Algorithms–We Want the Revenue Please Don’t Stop</a></h5>  <p>This occurred in 2010 and now it has evolved to the next link below…this is flawed data and if you don’t have enough they can mine, you default to non compliant..great stuff right?  Do you have kids in the home..ding..they’ll distract you from taking meds, is your partner non compliant…ding their influence will rub off on you…see the screenshots right off their site.  Of course they are not alone as you have FICO, Caremark and many others doing the same stuff and probably using those old Ingenix metrics and adding a few of their own.  Of course, United, (Optum Insights, formerly known as Ingenix) probably has a gazillion patents on these more than flaky “scoring” processes that serve up flawed data all the time.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/06/medication-adherence-predictions-enter.html">Medication Adherence Predictions Enter the World of Quantitated Justifications For Things That Are Just Not True, Members of the Proprietary “Code Hosing” Clubs Out There Destroying Your Privacy</a></h5>  <p>Check this link out too for more on the war on cash at the pharmacy too.  If PBMs can’t dig up enough data on you, again you<img align="right" alt="image" border="0" height="491" src="http://lh3.googleusercontent.com/-dclAvjnezyI/Vi7i3HcWjII/AAAAAAABMkc/j5mxORCgLmA/image%25255B4%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="350" /> default to non compliant and now are labeled an Outlier as you pay cash.  This is very common with seniors as they pay $4.00 cash at Wal-Mart and are in fact no way non compliant, it’s just a data game to give drug companies more ammo to keep their prices high by blaming consumers, doctors and pharmacists for being bad boys.  It’s a joke, but the perception deception joke keeps working as the media taunts is with it all the time.  I get tired of reading the articles that are so bogus with promises of saving money with compliance as nobody can put a precise dollar on it, so blank those stories out as they are usually some form of <a href="http://ducknetweb.blogspot.com/2015/04/news-rigging-has-arrived-astroturf-and.html">news rigging and astro-turfing.</a>  </p>  <p><strong>So what do you think?  You premiums get to help support not one buy two health insurers and truckloads of false consumer medication adherence scores.</strong>  The scoring is all about selling your data.  In healthcare, United is the #2 data seller in the US as it’s more than just insurance and prescriptions, as they have over 350 subsidiaries they operate.  </p>  <p>Here’s yet another reason for Cigna to maybe want to be a little less close to United…look at this new subsidiary and they want to buy up doctor practices all across the county and look what the raised to do this..another $36 million.  There’s around 350 urgent care clinics already.  Will the Optum/United Pharmacy Benefit Management be connected here, you bet it will be as it’s easy money to capture some more drugs and data to sell.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/05/optum-clinics-holdings-new-subsidiary.html">Optum Clinics Holdings, New Subsidiary Incorporated In 2015 Raises Over 36 Million (Exchange of Shares) From Investors Unknown-Form D Used to Maintain Secrecy Of Who They Are For Now…</a></h5>  <h5><a href="http://ducknetweb.blogspot.com/2015/04/optum-united-healthcare-buys-medexpress.html">Optum (United Healthcare) Buys MedExpress Urgent Care Business- 141 Full Service Clinics In 11 States–Company Advertises They Are In the Market to Buy Your MD Practice, As A “Too Big To Fail Insurer” Moves Forward With More Acquisitions</a></h5>  <p>Mayo likes Optum and is an Optum Labs member and now is outsourcing all it’s revenue cycling to them as well.  So hospital folks get fired and hired back at less pay and fewer benefits, or a degradation of benefits.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/04/mayo-clinic-is-latest-to-outsource.html">Mayo Clinic is the Latest to Outsource Revenue Cycling to Optum 360, A United Healthcare/Dignity Health Company Pursuing Hospital Contracts All Over the US For Profit…</a></h5>  <p>Last but not least, all this will just keep on happening as we’ll never get any help from DOJ Loretta Lynch as she used to represent United Healthcare with Anti Trust Lawsuits, so how’s that for the kicker at the end of all of this?  See the image of the letter<img align="right" src="http://lh3.ggpht.com/-cOCVFGTtmx8/UmB-R83r4zI/AAAAAAABIMY/0H4-dbr3Oeo/image%25255B7%25255D.png?imgmax=800" style="float: right; display: inline" /> United wrote to Grassley to make sure she got approved.  You almost have to laugh at when she says she’s going after Wall Street bankers who are indeed much smarter than her and can code her right under the table with her using legal verbiage only, been going on in this country for years.  The code hosers are in control.</p>  <p><strong>So anyway, there’s some big news for all you folks with Cigna Health Insurance policies and a bit more on how the big gun United operates with over 350 subsidiaries,</strong> and by the way who also owns a bank with a few billion on deposit.  You get a health savings account and then the bank gives you a Master Card to use to dump it all out and create even more data about you to sell.  Check out this subsidiary…dialed in to the FDA too and some <a href="http://ducknetweb.blogspot.com/2013/10/unitedhealthcare-doesnt-want-to-let.html">low income housing investments here.</a>  </p>  <h5><a href="http://ducknetweb.blogspot.com/2011/09/united-healthcare-optum-owns-consulting.html">United Healthcare (Optum) Owns A Consulting Firm for FDA Drug and Device Approvals, Clinical Trials–CanReg - Subsidiary Watch</a></h5>  <p>It just doesn’t seem to get any better with United and now the CEO sits on the board of Cargill, as I said above, the evil twin of Monsanto.  Sorry to rain on the parade of all those insured by Cigna but maybe things will change early enough bit it’s a flipping 10 year contact Cigna signed with Catamaran so you may be stuck with United doing your pharmacy benefit management and selling your data for quite a while.  BD </p>

If You Are Insured by Cigna, Guess What You Have a New Pharmacy Benefit Manager Named United Healthcare

First question out of the barrel might be “how can that be”. It’s really not too difficult to figure out. A short while back United Health...

Monday, October 26, 2015

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…

<p>This is topic that maybe does not get enough attention, simply due to the fact that today, consumers  are just blasted with a score for this and a score for that, basically establishing a brain washing process to where we are becoming a “Dupes of Hazard” community in the US and maybe beyond.  There have been many articles talking about the lack of common sense but most have not touched into what is causing all of this.  Stop and think, every where you read, you need a flipping “score” or you need to go search out some statistics to make a simple every day decision.  <img align="right" alt="image" border="0" height="109" src="http://lh3.googleusercontent.com/-hQwKm4C4AtE/ViuglyD14aI/AAAAAAABMjw/eSs-lXuEAAE/image%25255B16%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="291" /></p>  <p>Certainly there are times when you do need research and need to read up, but those lines and simple every day decisions are becoming more gray by the day.  In addition, some of the areas you go to do research are filled with “flawed data” created by proprietary software models that are not reviewed but rather just say “trust me, I can give you the information on this website” per se.  Surveys can be helpful at times but they too are way overdone and so many of them have back end functions that are just there to mine and scam some data to sell from your response, depends on who’s doing the survey and what’s at stake.  I stay away from all of them myself as I can’t always tell what’s a data mining survey to capture data for sale or one that is just a simple survey anymore.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/05/privacy-duping-of-america-intangible.html">Privacy Duping of America-The Intangible Threat Model Has Changed Significantly-Companies Hide The Code On the Web, $180 Billion Dollar A Year Business, Welcome to The Duperville World of Inequality..</a></h5>  <p>The government also is a big proponent of “scoring” as you see it everywhere and they too seem to think that “scoring” and digesting such scores are the big answers everyone needs…not so.  Look at HHS and CMS for a couple big examples.  They can’t stop scoring and think they need to offer us more scores, and in turn “score us” some more to where it becomes an area where you just turn off.  CMS scores on hospitals are pretty much useless as consumers pretty much have to go to the hospital “in network” and if it has a less than desirable score, who wants to see that.  If you need a procedure you want to think that the facility is capable and that you will have a good experience as the insurers too have scored those hospitals, so who’s right?  </p>  <p>Insurers of course will tweak hospital and doctor ratings and scores to steer people to search out those in network,<img align="right" alt="image" border="0" height="67" src="http://lh3.googleusercontent.com/-O2GX98HeCEE/ViugmZmrGTI/AAAAAAABMj0/beX3ek7IOvQ/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="348" /> and thus so, if consumers want their medical bills paid with a larger dollar amount, they go there.  The research needed here is to find the doctors and hospitals who are in network.  As a matter of fact insurers make it harder for you all the time to research as their own systems are so complex, they have a hard time breaking it down for the consumer to research with firing doctors all the time with quant manufactured models that pretty function like financial models.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/02/united-healthcare-extending-narrow.html">United Healthcare Extending Narrow Networks in California–More Secret Scoring of Doctors in the US–Telling The Doctors If They Are “Allowed” To Be In Network…</a></h5>  <p>Sure there is data that makes us smarter, but how many times do you see articles on the web about stupid studies that lean on the side of making a common sense decision, all the time.  One that circulates out there a lot is about how much sleep you need.  To me, this is common<img align="right" alt="image" border="0" height="256" src="http://lh3.googleusercontent.com/-HY99L9qGYgs/Viugm-4xpdI/AAAAAAABMj8/8kaexvH1rac/image%25255B11%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="357" /> sense as if I don’t get enough, my body tells me, so what’s so difficult about that?  Sure there are real problems with people who for what ever reason “can’t sleep, but that’s a different issue all together.  Are you going to spend all this time and clutter your mind with how much sleep you need to in turn become much more insecure as all the media tells you to do this?  It’s pretty much what’s going on to where you can’t make a simple determination of whether or not you are getting enough sleep, which has pretty much been common sense. </p>  <p>We have a ton of what I call “Crap Apps” out there as well with some developer writing a few queries to help with decision making.  There are a few that are worth your time with some of this but more commonly most are just crap.  All the medication apps to “help you” remember to take meds are pretty much just data miners and data selling equipped.  For years I have used Outlook, and can do it on my phone to schedule a simple reminder to take of something, be it take a pill or take care of a task..works well for me and again I can stay away from the Crap Apps and keep things simple and use technology that doesn’t invade my privacy.  </p>  <p>You also have useless websites like Healthgrades that are on the web to make money with ad exposure.  This week they put out a story about how people don’t research hospitals well enough and that 1 in 6 patients could have made better choices with going to hospital that specializes in their needs.  Of course for the STAT RAT FEVER folks they are all over this,<img align="right" alt="image" border="0" height="171" src="http://lh3.googleusercontent.com/-pLbrOSew69I/ViugnZa21CI/AAAAAAABMkE/L-plUGeUIPU/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="355" /> but it’s a useless piece of garbage report as it entails nothing about what hospitals were “available” in network or the cost..so again, dump their studies and you can read the link below as what they do is just junk outside of giving you an address and phone number for a doctor or a hospital.  I found my former MD who had been dead for 8 years listed on their site an still seeing new patients.  The use of their site for credible research is like out the window and don’t waste your time.  Word of mouth with doctors and hospital selections still seem to be at the top and for good reason.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/11/why-does-hospital-that-was-closed-by.html">Why Does A Hospital That Was Closed By The Feds In 2013, that Put “Fake” Screws In Patients Backs, Has A CEO/Owner Who Admitted Fraud/Patient Endangerment And Is Waiting Sentencing And Who Bribed A State Senator, Still Show On Healthgrades With Five Star Ratings?</a></h5>  <p>So next time when you are at a simple decision making process, do some soul searching and think about what you are doing, are you running to the web to look at statistics that really have no impact on your decision as the media tells you to look at sites and to use certain apps.  Try and figure out when you are polluting the process in your own head and run to find stats, maybe just out of habit.  Watch this video below which is also in the footer of this blog of what I call 4 “should see” pieces of information.  </p>  <p><strong>Are you sucking in to quantitated justifications for things that are not true?</strong>  </p>  <p><iframe height="315" src="https://www.youtube.com/embed/qiQwZ6inbOM" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe></p>  <p>And as I mention all the time, these efforts make money, big money for US corporations and we have a situation I call Excess Scoring in the US and if you buy into this over done behavior, you too will lose the ability to make every day “common sense” decisions and you’ll find yourself becoming a bit more insecure in your own abilities.  Give this some thought next time you are trying to figure out where the perfect butt is, how much sleep you need and so on.  The link below goes into more detail and how the US Government uses this process as well, be aware  </p>  <h5><strong><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></strong></h5>  <p>If we can hang on to our ability to continue to use our common sense, a lot of the broken models and crap apps we are told we need will eventually go away and hopefully only the ones that are truly useful will survive.  BD  </p>

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…

This is topic that maybe does not get enough attention, simply due to the fact that today, consumers are just blasted with a score for this...

Saturday, October 24, 2015

CMS Medicare Part D Program With Medication Therapy Management–Here Comes the Flawed Medication Adherence Prediction Scores, Make Sure Jane Doe Gets the “Cheap Meds”..

<p>You know they are going to use these flawed medication adherence scores to determine who gets what with medications.  This is horrifically flawed.  Regulation won’t work and CMS should work towards getting lower drug prices instead of this model that comes back to pound consumers again.  That is the problem and this model will fail and people will not always get the drugs they need.  If you have not read it, <img align="right" src="http://lh3.googleusercontent.com/-WTU_WavuGLg/VYjYaFce1MI/AAAAAAABMZA/DCNNtafnZm8/image%25255B8%25255D.png?imgmax=800" style="float: right; display: inline" />take a look at the garbage pharmacy benefit managers are popping out there to score you.  Yes this is a secret score using 300 secret metrics that you can’t have or see, but it gets sold to guess who, drug companies and insurance companies.  Are you a male, you get a ding, do you have kids in the home to distract you from taking meds, you get another ding and so on.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2015/06/medication-adherence-predictions-enter.html">Medication Adherence Predictions Enter the World of Quantitated Justifications For Things That Are Just Not True, Members of the Proprietary “Code Hosing” Clubs Out There Destroying Your Privacy</a></h5>  <p>You can’t make this stuff up as Express Scripts even brags about their “scoring” metrics.  We have excess scoring in the US that produces way too much flawed data.  It’ gets better, they can take the flawed medication score of your partner and ding you for that, with being around a person they have determined is not medication compliant with this junk science.  It is junk and all of this scoring and record keeping with this data makes your drugs more expensive as it’s not free to run this stuff.  When we talk layers of “crap data” that could be removed to save money, this is one of them.  These are crap predictions and not actual monitoring records to see when you pick up your prescriptions either.  That is monitoring but Medication Prediction Adherence scoring is crap as if they don’t have enough data, guess what, you default to non-compliance.</p>  <p>Now CMS of course more than likely will lean on this junk science to play God and determine who gets what meds in order to save money.  We all know our doctors are pretty good about telling us about less expensive generics so we can afford them so again this is a layer of junk science that CMS will lean on to save money, and patients may not get the medications they need.  There are times when the generic won’t work or has not worked and if you have some big fake target that says your score shows you are not “predicted” to be compliant, they may not give you the meds.  People with Medicare Part D are already feeling this and I had a conversation with a pharmacist that told me exactly how this works from their end.  All those folks scored non compliant require the pharmacists to contact them, ask they why they are not taking their meds and you know what 90% of them say?  They are taking their meds and pay cash and buy them at Wal-Mart or other places cheaper than the big chain drug stores…cash…and the pharmacists are told by the software they use, these folks are Outliers!  Nice huh?</p>  <h5><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></h5>  <p>CMS is drinking the Kool-Aid here as if you go to the first link here, look at the big page where Express Scripts<img align="right" src="http://lh5.ggpht.com/_v3zjJigoAPE/SkL9GOgy_rI/AAAAAAAATec/4yxb2jf7CV8/image_thumb%5B5%5D.png?imgmax=800" style="float: right; display: inline" /> says curing non-adherence would provide drugs for many others..what a crock of numbers nobody can predict.  FICO does this crap too with their medication adherence prediction scoring that’s a secret and states all they need is your name and address and they can give you a score and predict how compliant you will be.  This is nothing more than another score for them to sell and make money.  Drug companies love this stuff as it helps them maintain high drug prices by pushing more blame to consumers all the time.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2014/06/fico-medication-adherence-scoring.html">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</a></h5>  <p>Where did all this predictive medication adherence scoring get started?  Look no further than Ingenix, now called Optum Insights as back in 2010 we had this announcement that Express was going to use their algorithms to score you.  By the way, the current head of Medicare is Andy Slavitt, former CEO of Ingenix who’s the brain child of this scoring and is a former Goldman Sachs banker who was sued all over the place for their algorithms that ripped off doctors on out of network pay.  <a href="http://ducknetweb.blogspot.com/2015/07/doctors-in-network-leave-united.html">Currently in many areas, United pays doctors around 12% less than Medicare rates</a>.  Initially Ingenix profiling was used to underwrite but it has graduated to adherence prediction profiles as that allows for a lot more data to be sold.   All the PBMS do this now.  </p>  <h5><a href="http://ducknetweb.blogspot.com/2010/10/express-scripts-new-program-to-contact.html">Express Scripts- New Program to Contact and Predict Patients Who May Not Be Taking Their Medicine Based On Ingenix Algorithms–We Want the Revenue Please Don’t Stop</a></h5>  <p>So here we go again, CMS drinking that United Healthcare flavored Kool-Aid with Medicare D with reducing the cost of drugs, not with better negotiating with pharma companies, but rather by taking it out of the patient’s hide once more.  What a chicken way to do business is it not?  You know they will be dragging this junk science prediction adherence scoring in there to make decisions as PBMs with regular insurance are already doing such, consumers get hurt so big corporations can continue to get rich.  Drive them crazy, pay cash for all your prescriptions.  This model will fail as the pilots will be denying access to drugs for those in the programs, while MDs get a whopping big $2.00 per month to subscribe to these methodologies and save a consumer $2.00.  This will require more time and effort than the results will show with any ROI and doctors are already buried in too much administrative mumbo jumbo.  So how many Quants did it take to design this model and from where?   BD  </p>  <p>   <hr />The Centers for Medicare and Medicaid's new Part D pilot for medication therapy management will offer performance payments to plans that achieve reductions in <a href="http://www.healthcarefinancenews.com/directory/fee-service-ffs">fee-for-service</a> expenditures and fulfill quality and other data reporting requirements, according to information released by CMS on Wednesday.</p>  <p>Insurance plans that demonstrate reductions in Medicare Part A and B costs of care for their members by a minimum of 2 percent will receive a fixed $2 per member per month increase in the subsidy to the plan premium, which will decrease the beneficiary's portion of the premium, CMS said.</p>  <p>The program is aimed at reducing medication related issues in patients as current medication therapy management has not produced the expected results, according to Minter.</p>  <p>The question CMS is trying to answer is, he said: Does providing regulatory flexibility and financial incentives to stand alone Part D plans encourage more effective medication therapy management programs?</p>  <p><a href="http://www.healthcarefinancenews.com/news/cms-test-performance-based-medicare-part-d-program-targets-rising-drug-prices?mkt_tok=3RkMMJWWfF9wsRovuqXMZKXonjHpfsX56e4kW6K0lMI%2F0ER3fOvrPUfGjI4IRcVjI%2BSLDwEYGJlv6SgFQ7LHMbpszbgPUhM%3D">http://www.healthcarefinancenews.com/news/cms-test-performance-based-medicare-part-d-program-targets-rising-drug-prices?mkt_tok=3RkMMJWWfF9wsRovuqXMZKXonjHpfsX56e4kW6K0lMI%2F0ER3fOvrPUfGjI4IRcVjI%2BSLDwEYGJlv6SgFQ7LHMbpszbgPUhM%3D</a></p>

CMS Medicare Part D Program With Medication Therapy Management–Here Comes the Flawed Medication Adherence Prediction Scores, Make Sure Jane Doe Gets the “Cheap Meds”..

You know they are going to use these flawed medication adherence scores to determine who gets what with medications. This is horrifically f...

Thursday, October 22, 2015

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