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Minggu, 18 September 2011

Steward Healthcare Outlines New Insurance Plan Called the Community Choice Plan Limiting Most Care to Their Owned Hospitals

It’s all turning out to be about contracts as to where consumers can get care today and we have this here in Massachusetts and there’s a bit of this too in California with the HMO managed programs.  The pricing is quoted as being 30% less than other policies so we have a hospital system now selling insurance.  We have seen quite a bit of this with Prime Healthcare in California relative to “contracts” and they run Cadillac ER rooms for the most part.  In addition, Steward, owned by Cerberus bought a hospitals in Florida and recently they stated they intend to go national.

Caritas Hospital Owner Steward States They Aim to Go National Under Management from Private Equity Firm Cerberus Capital

What I found interesting too is the name of the administrator of the plan, Tenet Health Plans?  Is this part of Tenet Healthcare hospital systems, a good guess might say there’s a very familiar ring here.   The insured will also be able to go to Mass General or Brigham & Woman’s for more complicated care if the services needed are beyond those offered in the Steward System.  Now if you go back to January of this year, Blue Cross has their offering which encourages consumers to avoid what they determined to be 15 high costs hospitals and their agreement left out Mass General and Brigham and Woman’s as they were part of the 15 member group high priced hospitals. 

Blue Cross Launching New Health Coverage Option in Massachusetts-Encourages Consumers Via Employer Plans to Avoid 15 Named High Cost Hospitals

When you are sick, you want care so again who knows how this will end up shaking out as all are marketing and contending for business.  Contracts get signed and it’s tossed out to consumers to make heads or tails of what each plan offered and which would be the best choice…complicated and getting more so every day. 

So the next step here for consumers, someone is going to make some money writing another algorithm on a website to make the complication easier for you to wade and select the plan that may work best for you.   Software just works this way and keeps building on itself. 

HHS has their hospital compare website for looking at both prices and quality of care and I might guess they are challenged as well to keep up with the the formulas and prices.  I read somewhere on the web that someone from Steward said they are happy to be the “Filene’s” of hospitals.  BD 

Right now, health insurers and hospitals are separate entities. This is something different: a hospital selling coverage, with the restriction that  you only seek care at its locations. The hospital chain is Steward, a Massachusetts-based business that has been buying up community-based hospitals for more than a year now. And the gamble it made was rolling out a health insurance plan that almost-exclusively serve its hospitals (there are a few exceptions). The plan, administered through Tenet Health Plans, is called Steward Community Choice.

The Community Choice plan, as outlined Friday, is targeted at small businesses in Massachusetts. It offers them a trade-off. Premiums will be 20 to 30 percent less than what other Massachusetts insurers charge. In return, subscribers will by-and-large be limited to treatment at Steward locations (there are some exceptions to this, helpfully outlined in this report from WBUR’s Martha Bebinger).

“A lot of what health reform is is a public finance problem,” he told me. “As we’ve done health reform in Massachusetts, it’s been a lot about how do we pay for coverage. A lot of these small businesses are really struggling as premiums keep going up. This is about making insurance affordable for them.”

That could create more of a space for a less expensive, more limited insurance product. As de la Torre described Steward’s strategy to investors recently, “In a world of Neiman Marcuses, we’re OK being Filene’s. “ Now that we have a hospital that wants to be the Filene’s of health insurance, we’re about to find out whether Americans are willing to shop there.

http://www.washingtonpost.com/blogs/ezra-klein/post/when-the-hospital-becomes-the-health-insurer/2011/09/16/gIQAUYXLYK_blog.html

Europe Gives Mesoblast Approval for Clinical Trials of “Off the Shelf” Stem Cell Treatments for Major Heart Attack Victims

To treat heart failure, Mesoblast’s Revascor treatment uses stem-cell technology to rebuild blood vessels and heart muscles. Mesoblast is located in Australia and the stem cell treatment does not use embryonic stem cells.  Revascor is based on stem cells in bone marrow and the miraculous finding here is that it does not set off any immune responses.  225 patients in Europe will be enrolled who have suffered severe heart attacks.  There have already been some other clinical trial results reported back in January.

Mesoblast's Heart Stem Cell Treatment to Rebuild Blood Vessels and Heart Muscles Has Positive Results–Regenerative Medicineimage

In addition there are US FDA trials for treating chronic back pain

Mesoblast Gets FDA Approval to Begin Advanced Clinical Trials Using Stem Cells to Treat Chronic Lower Back Pain

MPCs from unrelated donors have the unique ability of not stimulating an immune reaction when introduced into the patient. MPCs from donors can be grown in large numbers and made available for treatment in much the same way as a drug. Mesoblast’s MPCs have a strong safety profile with no cell-related adverse events to date.

This look very exciting for those who have had a major heart attack for sure.  In addition the company is also working on stem cell solutions for cancer.  BD 

An “off-the-shelf” stem cell treatment for heart attacks is now a step closer, following the go-ahead for an early-stage clinical trial in Europe, writes Jonathan Wood.

Many proposed treatments using stem cells to help repair the damaged heart are hampered by the need to use the patient’s own cells to avoid any immune reaction. Such an individual approach can be time-consuming, involving the growing of the patient’s cells, and multiple visits to the doctor.

But Australian company Mesoblast is developing adult stem cell therapies that are ready to use when needed for any patient, much as a standard drug. (It does not use embryonic stem cells, which are more controversial.)

Its Revascor product is based on a particular type of stem cell in bone marrow that does not set off an immune response. The “mesenchymal precursor cells” can be isolated from bone marrow donated by a healthy adult and grown to provide treatments for many patients without fear of rejection.

http://www.ft.com/intl/cms/s/2/0cd62b6c-de79-11e0-a2c0-00144feabdc0.html

Man in the UK Who Severed His Thumb Gets His Own Big Toe As A Replacement

We are hearing more and more about these types of surgery and in this case it imagemakes sense as you need your thumb and that’s not to say you don’t need your big toe but without the thumb, it’s hard to grasp and pick things up. 

Doctors Reattach Leg Backwards On Purpose-Reconstructive Surgery for Cancer

The man is a plant operator and he will be able to go back and make a decent living.  He won’t be able to run like he did before, but walking and moving around without the toe will not be a a problem.  They tried to re-attach the thumb bit it didn’t work so the next option was the big toe.  BD   

James Byrne, 29, from Fishponds severed the thumb on his left hand last December while sawing through wood.

After an attempt to re-attach his damaged thumb failed, plastic surgeons at Frenchay Hospital transplanted his left big toe to his hand.

Surgeon Umraz Khan said the gain outweighed the loss as losing a toe "is not as disabling as losing a thumb."

Mr Byrne said: "Mr Khan re-attached my thumb but it had been badly damaged and although we tried everything, including leeches, to get the blood flowing again it didn't take.

http://www.bbc.co.uk/news/uk-england-bristol-14903846

Florida Man Who Owned Largest Community Mental Health Center Gets 50 years for Medicare Fraud and A Fine of $87 Million–Subsidiary Watch

This is good to see the law finally catching up with these folks and the article elaborates on how “subsidiaries” add to the fraudulent actions taken by some imagecompanies and I focus on this quite a bit as the big corporate office may not be able to work in certain areas, but the subsidiaries can and nobody seems to do enough questioning in these areas today, but they should, especially with buying and selling data and how it is used and potentially abused as well. 

Guess what, this guy had a major lobbying effort going on too, so surprise there you might say.  50 years is a long time and I am guessing that when the case broke, the lobbying efforts may have had some influence on the long sentence given.  In addition in this scheme, patients benefited too with giving out their information for false billings, although their benefits were small compared to what the company did to benefit.  Records were manipulated so patients would have to stay longer and some patients had no clue what they were doing there at all and again only the patients who were coherent enough mentally were the ones who may have made a couple of bucks with divulging their Medicare numbers. 

Just think of it folks, this is the shape of some of the folks lobbying Congress today.  This is where analytics can really help HHS and Medicare with tracking suspicious activities outside the normal parameters found with most claims too.

CMS Announces Anti-Fraud Algorithms Will Begin Auditing Claims on July 1, 2011 Just As Insurance Companies Have Done For Years

It’s all about those algorithms and that’s why that word hold center stage at this blog and those who have been reading here for a while are already in tune with what all this means.  We hear of one case after another coming forward and how everyone worked the numbers for years and here’s one more example. 

Med Solutions and Blue Cross Caught On the Stress Test Denial Algorithm (video)

It seems like the cast of characters in fraud takes on many faces so it can be internal, or it can be those who are awarded contracts, but one thing for sure, getting smarter with analytics ahead of starting an investigation is going to pay off and catch many.  BD 

MIAMI — A federal judge on Friday sentenced a Miami man who had owned the nation’s largest community mental health center chain to 50 years in prison for his role in a $205 million Medicare fraud scam.

The sentence is the longest ever for a case brought under a Medicare fraud strike force.

Federal authorities said Lawrence Duran, 49, preyed on patients with Alzheimer’s disease and severe dementia, orchestrating an elaborate scam where staff forged patient charts to bill Medicare for therapy sessions and other services it never delivered.

Prosecutors said doctors and employees at American Therapeutic Corp. and its sister companies were instructed to alter diagnoses and medications to make it seem that they qualified for expensive sleep studies and mental health treatments. Patients suffering acute mental illness and on the verge of hospitalization were supposed to get intensive counseling, but federal officials said ATC didn’t provide any.

ATC also paid the owners of assisted living facilities and halfway houses to round up patients for their seven mental health centers in south and central Florida for therapy sessions that were never held. In some cases, elderly and infirm patients were left in rooms for hours and weren’t cognizant of where they were or what was happening around them, authorities said.

http://www.washingtonpost.com/national/fla-man-gets-50-years-for-medicare-fraud-owned-major-us-community-mental-health-center-chain/2011/09/16/gIQAblzTYK_story.html

Rabu, 14 September 2011

Eel Removed From Man’s Bladder–Entered Via His Penis While He Was At A Beauty Spa for an Exotic Dry Skin Treatment With Fish

Ok if you have not seen this on the web already today, here it is and this happened in China where the spa let’s the eels nibble away at your dry skin.  Next time wear underwear is what I would say, a nice pair of speedos would keep the eels away.  The surgery took 3 hours and to remove from the 56 year old man’s bladder.

It didn’t live though, it died in the bladder, no air.  The eel being a slippery character allowed it to swim right up through the man’s penis.  I guess from the story the man tried to stop it when it was about half way in, but again was too slippery and it got away from him.  BD 

Zhang Nan was bathing with live eels to cleanse his skiimagen when one rogue serpent took a liking to his manhood.

Foreign object: The dead eel is placed next to the surgical tool used to remove it from Zhang Nan's bladder (Picture: CEN)

The eel treatment in question is a similar concept to the popular London spas that offer fish pedicures.

Thinking that the eels would make him look ten years younger, Nan dived into the water and let them feast upon layers of dead skin.

But after laying in the spa bath, Nan felt a sharp pain and realized a small eel was working its way up his urethra and into his bladder

http://www.metro.co.uk/weird/875317-eel-removed-from-mans-bladder-after-entering-penis-during-beauty-spa

Joint Commission Grades Prime HealthCare Hospitals at Top Performers-Cadillac ER Rooms

If you read in the news, the hospital chain has had their other issues outside of the JACO standards in California in the last couple of years. I live and drive by one in Huntington Beach and the parking lot usually has no more than about a half a dozen cars in the lot, unlike how it used to be before the acquisition.  On the other side of the coin if Prime has not bought it, the hospital may not have been there today.  Kaiser and Prime went around and around on billing too for a number of years for patients seen out of network for balance due billing, but I guess JACO focuses only on the facility and patient care itself.  It’s kind of strange that way as you don’t maybe get the full picture from all aspects. 

Prime Healthcare Billing Processes Under Question as 25% of Medicare Patients are Showing Malnutrition- Profit Algorithms?

Prime Healthcare Under Investigation for High Infection Rates in California in Four Hospitals

Perhaps if I had these above issues along with a lawsuit from the state of California I too would probably want to focus on something done right.  As I understand they are beginning to negotiate with insurance carriers which was something they did not do for a number of years and thus the ER room hospitals were created.  No doubt though it would not be as easy to meet the same standards for a big busier facility though.  BD

ONTARIO, Calif., Sept. 14, 2011 /PRNewswire/ -- The Joint Commission on Wednesday Recognized Nine Hospitals Either Owned or Operated by Prime Healthcare Services as Top National Performers on Key Quality Measures

Out of more than 3,000 hospitals across the country, these hospitals – Garden Grove Hospital Medical Center, Huntington Beach Hospital, La Palma Intercommunity Hospital, Paradise Valley Medical Center, San Dimas Community Hospital, Shasta Regional Medical Center, West Anaheim Medical Center, Encino Hospital Medical Center and Montclair Hospital Medical Center – were recognized based on data reported about evidence-based clinical processes that are shown to improve care for certain conditions, including heart attack, heart failure, pneumonia, surgical care and children's asthma.

"Today the public expects transparency in the reporting of performance at the hospitals where they receive care, and the Joint Commission is shining a light on the top-performing hospitals that have achieved excellence on a number of vital measures of quality of care," said Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president, The Joint Commission.

http://ca.finance.yahoo.com/news/Prime-Healthcare-Services-prnews-1285618136.html

Thief Steals Woman’s Diamond-Captured by Police and Sent to Have X-Ray & Was Found in the Stomach

With modern day technology, swallowing something you stole just doesn’t work anymore.  This happened in Spain and lucky that one officer notices the motions of the man putting his hand up to his mouth.  Now the fun part, recovery of the jewelry.  BD  image

A thief in Spain who stole a diamond from a British woman -- and then swallowed it -- was caught when police stopped him at a checkpoint and forced him to undergo an X-ray.

The theft occurred when two British women entered a restaurant in the luxury southern resort of Marbella and one of them left her handbag on the floor by her chair, police said in a statement.

"Two well-dressed men came in, one sitting at the bar and the other next to the woman," it said.

"This gesture and the fact that they had found the pendant without the diamond made the police think he may have swallowed it.

"To find the stone, those arrested were taken to a medical center where they underwent X-rays, and the diamond was located inside the stomach of one of them, who admitted swallowing it."

http://news.yahoo.com/thief-swallowed-diamond-caught-x-ray-114841934.html

Ohio Valley Hospitals Currently Millions In Debt to Pay $3.8 Million to Settle Fraud Allegations for Billing False Claims to Medicare and Medicaid

In reading the article it also states that the government is actually going to pursue imagethe physicians as well, simply due to the nature of the fraudulent billing.  In addition the former CEO of the Ohio Valley hospital was sued for draining endowment funds and hid information from the board while also making illegal payments to the doctors so it sounds like he was right in all of this.  BD 

Ohio Valley Medical Center, East Ohio Regional Hospital and the parent corporation of both will pay $3.8 million to settle allegations of health care fraud, U.S. Attorney William Ihlenfeld said Monday.

The deal ends an investigation into allegations that the hospitals submitted false claims to Medicaid and Medicare from January 2005 to August 2010. Both hospitals are owned by Ohio Valley Health Education & Services Corporation. OVMC is in Wheeling, and East Ohio is in Martins Ferry, Ohio.

Ihlenfeld said the penalty is severe because the compensation agreements the hospitals had with local physicians were improper under federal law and involved significant amounts of money.

Together, the two Ohio Valley hospitals have 340 beds and more than 1,800 employees.

The company also said it will work with the U.S. Attorney and the Office of Inspector General in the U.S. Department of Health and Human Services on a compliance program that ensures the hospitals exceed federal guidelines and expectations.

The administration has publicly said it's tens of millions of dollars in debt.

http://www.businessweek.com/ap/financialnews/D9PN5LBO1.htm

Selasa, 13 September 2011

Former FDA Chemist Charged by SEC With Insider Trading, Case Gets Another Charge of Child Pornography Against His Son Who Was a Co-conspirator

I guess the son didn’t think twice about combining inside trading efforts and child pornography on the same computer as that’s when it was found by authorities who confiscated his MAC.  Child pornography doesn’t mix with any kind of business for sure, so as the article states he will also have to register as a sex offender if proven guilty.  BD 

SEC Files Lawsuit Against FDA Chemist for Insider Trading Violations

Liang was charged today in federal court in Maryland with one count of possessing child pornography. The government asked that Liang forfeit a MacBook laptop computer seized at his Gaithersburg, Maryland home during raids by the Federal Bureau of Investigation in March and April.

Prosecutors charged the Liangs in March with conspiracy, wire fraud and securities fraud. The maximum penalty for the fraud charges is 20 years in prison.

The insider-trading case has been postponed because “the parties are near resolution of this matter,” David Salem, assistant U.S. attorney, said in an Aug. 29 filing.

http://www.businessweek.com/news/2011-09-13/fda-insider-trading-defendant-charged-with-child-pornography.html

Senin, 12 September 2011

Walgreens Sued for Firing 18 Year Loyal Employee Who Ate A Bag of Chips During Diabetic Attack

This is not good and the employee had worked for the company for 18 years and one has to wonder if this is a way of weeding out employees with chronic healthcare conditions as it costs them more to insure such employees?  This is pretty bad that if you are a diabetic and having an attack that you can’t reach for a bag of chips to keep yourself from going into a diabetic coma or something along imagethat line.  We hear of such tales and my own mother in her 80s has had some issues with Walgreens.

She’s also a diabetic and has been for years and takes her blood sugar twice a day.  Well the pharmacist at Walgreens came along when it was time to refill her prescription one time and said that she was all wrong that she needed to do this 3 times a day.  The bottom line of this whole store is that she even checked with her insurers who said twice a day was fine and so did her doctor, but the pharmacists at Walgreens was almost relentless.  What’s the deal?  Mom didn’t want to have extra strips around going to waste and was doing the right thing, but perhaps Walgreens was more concerned about the sale numbers here?  Turns out they could not do the auto refill for a number that equates out to 2 times a day and were forcing the 3x a day number.  After a lot of hassle, even with her insurer calling and saying the smaller number was ok, they finally begged off.  You can read more about it at the link below.

Compliance Police Out In Force for Seniors–Health Plans and Drug Stores Making Phone Calls-Business Models & Caller Behavior Sucks -A Result of Pay for Performance Efforts?

At any rate this is pretty cold if all the facts line up correctly and the fact that 18 years of service go down the tube over trying to perhaps save costs on insurance benefits, which is what it is starting to look like.  It was probably some policy that she violated while having her attack as not paying for the chips first or something along that line as that’s what companies do today with legal interpretations and splitting fine hairs and making bad guys out of people with health conditions.  As  a side note, the company says it’s data selling business is worth just under $800 million so are we in to drugs or data?  BD   

The sacking of a Walgreens cashier who ate a $1.39 bag of chips during a diabetic attack in 2008 and paid for them later has drawn a lawsuit from the U.S. Equal Employment Opportunity Commission.

Josefina Hernandez of San Francisco had a clean record in nearly 18 years of service to the drugstore giant. Her supervisors knew she had diabetes, a disease that calls for careful monitoring and regulation of blood sugar levels.

“I almost always carry a piece of candy in my pocket for situations when I feel my blood sugar getting low, but I didn’t have anything on me this time,” Hernandez said in a statement on the EEOC website. “I knew I needed to do something quickly, so I reached for a bag of chips and paid for them as soon as I could. I worked for Walgreens with no problems almost two decades, so I am very upset to lose my job over this.”

http://abcnews.go.com/blogs/health/2011/09/12/walgreens-sued-for-firing-hungry-diabetic/

Minggu, 11 September 2011

Doctors in India Go on Strike To Demand Better Security at Hospitals

Talks are scheduled to resume but in some instances, surgeries had to be rescheduled or postponed.  As I read here this involves government hospitals for the most part and with recent incidents in the news the doctors probably have very good reason to want better security.  I’m sure some of these sentiments could be shared by doctors in the US too as we seem to be seeing more incidents happening imageat our hospitals here in the US as well.  Doctors do need to be able to feel secure when treating patients for sure no matter where you are.  The NHS over the last number of years has also been busy recruiting doctors from India as well so does this leave the country short handed? 

India is not the only area where doctors are protesting as in July doctors were also protesting and striking in Israel with wanting better working conditions and signed petitions to wanting better working conditions. 

Medical Students and Doctors Protest in Israel Demanding Improvements in the Healthcare System

Back in 2009 doctors went on strike in India after being attacked by family members in some hospitals so it sounds like security issues still need attention with this recent strike.

Doctors attacked in India Hospital – Threatened to Go On Strike after violent attack by Patient family Members

Also worth a note is that if access is not available, many have had to rely on the unreliable services offered by roadside street doctors who may or may not be of help as they may suggest herbs and other types of home remedies when in fact that’s not what a patient needs when critically ill. 

Roadside Street Doctors Are A Thriving Business in India

Nobody loses greater than the patient having access but again it appears to be the point that this is the last resort on getting attention so action can be taken to provide secure environments for doctors to practice in India.  BD 

Mumbai: Medical services in Maharashtra were severely hit on Saturday as over 3,000 resident doctors in government hospitals across the state went on an indefinite strike to press for enhanced security at hospitals, even as talks with authorities proved unsuccessful, doctors said.
Patients at various hospitals were hard pressed to find a doctor. Department heads at various hospitals said that more than 50 percent of their scheduled surgeries had to be postponed.

"We had two meetings today - one with the Mumbai's Municipal Commissioner Subodh Kumar and the other with the director of DMER (Directorate of Medical Education and Research) Dr P.S. Shingare. While the municipal commissioner has agreed to most of our demands, Shingare has asked for some time to look into the matter," said Pankaj Nalawade of Maharashtra Association of Resident Doctors (MARD) from KEM Hospital.
Nalawade said three government hospitals in Mumbai that come under the municipal corporation have major security issues. He also identified 11 government hospitals across the state which do not have adequate security for doctors.

"We have scheduled a meeting with Shingare Sunday and are awaiting a positive outcome. Till then, we continue to strike work," Nalawade said.

Around 400 doctors from Nagpur's government hospitals also joined Saturday's strike. "Manhandling and assault of doctors should stop. Authorities have to see to it that doctors are provided with proper security," said Bhausaheb Munde of MARD, Nagpur.
This is the ninth such incident this year, Nalawade said, while reiterating MARD's demand for better CCTV surveillance and security in hospitals. "We keep voicing our concerns but they fall on deaf ears."

http://www.ndtv.com/article/india/doctors-strike-hits-maharashtra-talks-fail-132805

Sabtu, 10 September 2011

Are Target Stores Now Selling Data Too? California Store Scanned My Driver’s License When I Bought One Bottle of Wine–How Much Business in the US Is Living Off of Data and Algorithms, Partly Why We Have Job Issues

I about flipped out on this one and if there wasn’t a big long line behind me I would walked but ok so now there’s one bottle of wine listed that I purchased that connects back to data on my driver’s license.  When the clerk asked for my driver’s license, being a person in my mid 50s, we all take as a back door compliment but when she scanned it…oh boy wait a minute.  I talk about the misuse and abuse of data analytics all the time here and it happens and you don’t need to look any further for that than the Governor of Arizona if you want a glaring example of digital illiterates that couldn’t find that small amount of dollars relatively speaking for transplant patients.  Anyway, being I research this all the time, it’s the data selling game as Target has pharmacies and we all know the ton of money made selling our prescription data.   This is a full on rant here, so you are warned.image

I WILL NEVER BUY ANOTHER BOTTLE OF WINE AT TARGET AGAIN. 

The article clip below talks about how Walmart is now going back to selling data back to Nielsen again, selling it.  They don’t give it away, nobody gives any data away today, so Target’s probably right in there too. Walgreens recently stated their data selling business was valued at just short of $800 million.  No wonder Silicon Valley’s economy sits so well, most of this stuff is coming from that direction with software.  I’m not picking on the folks up there as there’s a lot of good stuff that comes out of there too, but the value?  The banks jump in there and push that button too.  Even when you listen to our US CTO, he talks about “getting rich” writing code, not necessarily to help and create better ways of life. 

Now this is a goldmine as I have said before we can’t control the data but we could certainly begin requiring resellers licenses and start taxing it.  This would give law enforcement a leg to stand on as well for those who either don’t pay taxes or sell data without paying a hefty licensing fee.

Privacy Wanted–So Let’s Require Those Who Sell Web Data to Register and Tax the Transactions and Publicly Disclose Who They Sell To With a Federal Registry

If you have not watched it, this video is excellent from Stanford and they also lightly touch on the digital illiterates too with speaking of the “internet tubes’…tubes??  It’s worth the watch!

You are the Product…

Even HHS is a bit off their rocker with a Facebook contest…do we talk privacy and Facebook in the same sentence here? 

HHS Seems To Be Confused on Social Networks–Facebook for Disaster Support Contest, Give Me a Break

I did read all over the web and I am not the first one who became alarmed over this process at Target, and an IT guy in Texas beat me to it and he said the same things I say here with privacy and selling data almost to the tee.

So somewhere along the line someone is going to compare data they get from the connection of my driver’s license and I’m going to end up being some degenerate in some digital illiterates analytic process.  I’m telling you we have illiterates that DO NOT know how to use data and instead of perhaps coming up with community type numbers, they get it down to an individual level and misconstrue and this is where you and I as consumers get fleeced and screwed.  I know a few high tech folks that will jump right in here with me on this as they work with data too.  When you work with it and know the processes, you flat out see it for what it is. 

The problem is not so much the data being collected but it’s rather two other factors, the digital illiterates that mis use the information and have no clue how they judge and hurt others needlessly with stupidity and the other side of the very smart elite that use it to profit buy hiring the digital illiterates and telling them to run such analysis processes.  What do you think the high frequency folks do on Wall Street with their algorithms and it’s going to get worse now as the hardware side of profiting is getting close to an end so the next move is more algorithms to fragment and reformulate faster to get yet one more edge on the next guy.

I read on Forbes the other day (thanks to a tweet that alerted me) where a woman who worked at a drug store in San Francisco was fired as she was a diabetic and was having a low blood sugar attack and grabbed a bag of chips to keep from passing out.  Now was she wrong in the fact that she ate the chips before paying for them and should she have passed on the floor first?  Is this yet one more way to get rid of employees who cost the companies money with health insurance by getting rid of the employees with chronic conditions by catching them on this fine line of eating the chips before she paid for them?  I don’t know all the details but that’s exactly what it sounds like as she was quoted as having a perfect employee record for 18 years.

Why in the heck did Target need to scan my driver’ license?  How much are they making selling their data?  Some states even sell their DMV data too, so you know this is going on.  The governments had to resort to this practice due to lack of money, so I guess this is everyone’s excuse somewhere along the line!  Here’s Rite Aid doing it in the video…these average folks got it with analytics and the potential damage it can and will do. 

Here’s more with banks competing with Groupon and LivingSocial and selling your data…again how long can an economy last on the primary business of selling data with their highly inflated algorithmic processes? 

"Banks plan to compete with Groupon and LivingSocial by targeting coupons and deals at credit card holders based on their shopping habits. They found a way to do it without violating financial privacy laws: 'They're "selling" shopping habits the same way Facebook "sells" personal data about its users: in-network. It's a clever privacy work-around. Just as Facebook allows advertisers to specifically target certain kinds of users based on their profile information (without actually providing that profile information to the advertisers), banks plan to allow advertisers to send deals and coupons to their customers based on what they've bought before. That way, no user data actually leaves the network — instead, deals just enter the network. Each time a customer cashes in on one of those deals, the bank gets a commission.'"

This has become just a huge market and just think some of this money used to go to pay for employees to work at companies.  So let's go back to another post I made about a year ago…it’s been a big hit and well read here…let’s start finding some of those who are addicted and have to analyze every spec of data they can sniff..

Data Addiction and Abuse –The Up and Coming Next 12 Step Program Is On the Horizon–Side Effects Include Lack Of Data Quality, Integrity And Spasmodic Algorithms

BEWARE OF THE DATA ADDICT AND THEIR CO-HORTS THAT SUPPORT THEIR HABITS.  WE NEED GOOD SOUND DATA FOR IMPORTANT BUSINESS DECIIONS BUT NOT A BUNCH OF QUERIES COMPOUNDED INTO WHAT APPEARS TO BE A BIG PRESS RELEASE RELATED REPORT AND BOY DO WE SEE THIS IN THE NEWS TODAY.   Nobody has done squat to help engage the consumer so far as they are so wrapped up in analytics, the consumer is still left out in the cold and heck we don’t even see any leaders using any technology themselves, just search on Google and you see very few leaders with even so much as a cell phone in hand.

After this big event of discovery here with even more data being sold, I’m going to do the right thing the next time I want a bottle of wine, Target will not get my money for the 4-6 bottles of wine I may buy in a year, but instead the owner who runs an independent convenience store near my house is going to get my business and I can go else where for groceries as that’s what I went to Target for anyway.

Who knows where this data ends up and let’s hope it doesn’t end up at some place like FICO that runs mis matched “marketed” data.  I like technology and work with data bases to create answers and solutions and that is also how data base developers can also smell a rat at the same time and I wish more would speak out when issues as such occur.  Read up on the link below and you can see this is only to sell more data and will be totally inconclusive with the results they promise with being able to predict if you will take your medications. This is flat out math marketing fleecing the public and anyone else they can sell their analytics too who will buy in here. 

FICO Analytics Press Release Marketing Credit Scoring Algorithms to Predict Medication Adherence–Update (Opinion)

So I guess in a few year I’ll maybe find out who connected to my driver’s license purchase connected with the one bottle of wine that is now connected.  Some of this has been going on a very long time with retailers and their collecting and selling data.  I used to do some training for Intel and one day while doing a gig at Best Buy talked an employee into doing something he was not supposed to do and that was to let me see on the screen all the data they had on me, and this was about 4 years ago.  Their data went back around 4 years or so and I could plainly see a couple bags of M & Ms I bought in the store on a couple occasions, so they had it all down to the last munchie purchased as well as all my other items bought, so they must be selling some data too:)image

So again, what’s next, scanning my driver’s license when I buy a pack of M & Ms too?  Is is going to get this bad to where my entire purchase anywhere I go will be tied to my driver’s license as it’s bad enough already with all the stores and their “savings cards and coupons”.  Those are all data mongers and I can live with a certain amount of that even though I don’t like it, but come on, driver’s license for one bottle of wine?   License and tax these folks as with all the mergers and acquisitions out there we do not know what they are doing with the data, flat out and some may not be truthful about it either.  As you cans see regulatory agencies are wanting those “ those algorithms” and perhaps they should be asking a few more industries.  I suggested something like a Department of Algorithms in an archived post way back 2 years ago, again a coder’s insight or fear.  BD

FINRA and SEC Asking High Frequency Trading Firms To Hand Over the Algorithms of Their Trading Strategies And Code–Time for That Department of Algorithms?

Walmart says it wants to better understand its customers. That's why the company has reversed its position and agreed to share its scan data with outside research firms. The company has already reached a deal with Nielsen and is reported to be very close on a similar deal with SymphonyIRI.

Since Walmart first made the decision not to share its data, suppliers to the company have been able to see how well their products sold, but not competitors. Having this additional information is seen by many as critical to fully understanding the market.

http://www.retailwire.com/discussion/15396/walmart-to-share-scan-data

Jumat, 09 September 2011

LA-ABC News Anchor Gets a Stress Test from Dr. Oz–And As the Show Moves to Channel 7

I am busy working all the time so I don’t have much opportunity to catch his show but in Los Angeles his show will be now seen at 3 pm.  We all watch David Ono here and he had his visit with Dr. Oz.  The Race for the Cure is coming soon in Orange County and this year Dr. Oz will be attending that event as well that begins at Fashion Island in Newport Beach.  Back in December I actually had the opportunity to participate in a phone interview along with a few others from the press and was able to ask a question or two about his 11 week diet plan that began at the beginning of the year.  You can use the link below to read more. 

Dr. Oz “11 Weeks to Move It and Lose It” Revolutionary Weight Loss Challenge to Launching Jan. 3, 2011

Our new anchor got a good report so he doesn’t have any current worries according to the video below.  It was kind of nice to see Dr. Oz back in MD format and he may do more of that on the show but I’m working when his show is on the air.  BD

My story is a snapshot of what America has become, a country whose families are torn apart prematurely because of heart disease, our number-one killer.

More than anything else, my job as a father is to change my genetic course, to buck the trend. You do it through diet and exercise and Dr. Oz helped me gauge if I was, in fact, doing it right.

I took an echocardiogram. It basically looks at the rhythm of your heart and detects any abnormalities. The news was good: Mine was normal.

Finally, level seven. I was 18 and a half minutes in. My breathing was getting shorter and my heart rate was at a stressed 171.

It's time to stop the treadmill so doctors can take a good look at it.

After that, the doctors re-imaged my heart. The ultrasound allowed them to see all the chambers. If any part of the heart wasn't pumping properly, they'd see it.

"What's the verdict? It's perfect. It really is wonderful," Dr. Oz said.

The news was good, but it was just a reminder that I'm on the right track. If I stop my healthy habits tomorrow, my good health goes away with it.

http://abclocal.go.com/kabc/story?section=news/health&id=8345688

Kamis, 08 September 2011

Volunteer, Sponsors And Supplies Needed for The Largest Ever “Free Clinic” At the Los Angeles Sports Arena October 20-23, 2011

We have another free clinic coming up in October in Los Angeles and CareNow is looking for volunteers, professions, food, and more.  There are already quite a few sponsors and one worth a note is Bill Maher, the comedian.  Most sponsors are in imagethe healthcare business, but not all, and you don’t have to be a healthcare related business to contribute.  Los Angeles over the last couple of years is becoming a regular host to the free clinics for those who can’t afford care and do not have health insurance.  RAM has put on a couple clinics in LA and even more in other cities in California, the last was in Sacramento and CareNow coordinated with their efforts. 

All the details are listed below in the press release and as of tonight, the website appears to have more updates coming soon.  If you can donate time or can volunteer, all the information is included below.  Feel free to refer this post on to anyone in the Los Angeles area as well.  BD 

Press Release:

LOS ANGELES, Sept. 8, 2011 /PRNewswire/ -- CareNow, a local nonprofit organization formed to bring help and hope to the uninsured and underserved in America's urban centers, will transform the Los imageAngeles Sports Arena into a giant clinic to provide free healthcare services to men, women and children needing medical, dental and vision care. CareNow is looking for healthcare professionals (dental, vision and medical) to volunteer for the event. Volunteers may sign up for half day or full day shifts. CareNow/LA will take place on October 20 to 23 from 7:00 a.m. to 5:00 p.m. at the Sports Arena located at 3939 S. Figueroa Street in Los Angeles.

"Los Angeles is an epicenter of healthcare need, but there is much we can accomplish together to meet that need. There are vast healthcare resources in our community eager to help, and we're expanding our services with every event, providing not only quality care but continuing care for those who need it," said Don Manelli, president of CareNow. "Our success depends on medical professionals who are willing to donate their time."

Last October, CareNow partnered with Maria Shriver to produce the Modern House Call – a massive free clinic in Long Beach that ran in conjunction with the Women's Conference. Prior to that, the same team of local providers and organizers collaborated with Remote Area Medical (Knoxville, Tennessee based) to produce two large free clinics in Los Angeles. Together, these three events served 15,330 Angelenos and provided 36,120 medical, dental and vision services – free care valued at more than $7.1 million. This year, the same group of dedicated community stakeholders and CareNow team of volunteers will undertake yet another groundbreaking effort.

CareNow is looking for the following healthcare provider volunteers:

image

"As a returning sponsor of the country's largest free health clinic, we've seen firsthand the difference this clinic will make in peoples' lives," said Howard Kahn, CEO of L.A. Care Health Plan, the nation's largest public health plan. "We're proud to be a part of the LA healthcare community that has been inspired to continue the event."

In addition to professionally trained medical specialists, CareNow is looking for non-medical volunteers to help register patients, manage patient flow and assist professional staff. For more information or to register as a medical or non-medical volunteer please visit www.CareNowUSA.org.

image

"The Los Angeles medical, vision and dental communities have shown an amazing level of commitment, from our local medical and dental schools and businesses, to individual volunteers and the entertainment community, we have received overwhelming support," said Manelli.

To date, CareNow has confirmed the following sponsors and partners: Bill Maher, Mark Gordon, Jason Flom, Tzu Chi Medical Foundation, L.A. Care Health Plan, Keck School of Medicine of USC, Geffen School of Medicine of UCLA, VSP Vision Care, Marisa Foundation, Live Nation, Molina Healthcare, Southside Coalition of Community Clinics, Los Angeles Dental Society, VOSH, Loma Linda University School of Dentistry, Henry Schein Dental, Western Reserve University, Southern California School of Optometry, and more than fifty other healthcare organizations, manufacturers and suppliers.

CareNow is also seeking in-kind donations, including bottled water/refreshments, food, pharmaceuticals (excluding narcotics) ultrasound equipment, dental, vision and medical supplies.

For more information on sponsorship opportunities or to provide an in-kind donation, please contact Adrian Marquez at 323.202.1453 or adrian.marquez@edelman.com

While most supplies and equipment are donated, there are significant expenses in putting on an event of this magnitude and contributions are still needed. 

For more information about CareNow/LA, please visit the event page on Facebook at www.facebook.com/CareNowUSA or follow CareNow on Twitter at www.twitter.com/CareNowUSA.

About CareNow

CareNow brings help and hope to the uninsured and underserved in America's urban centers. The organization works with local community resources and volunteers to produce free clinics providing comprehensive medical, dental, and vision care to individuals and families who are without access to the healthcare they need. There is no cost to the patient for the services provided. Clinics are staffed by professional and general volunteers, and supported by donations – both financial and in-kind – from local and national supporters. To learn more about CareNow and this year's clinic, please visit the organization's website at www.carenowusa.org.

http://www.prnewswire.com/news-releases/volunteers-and-sponsors-needed-for-largest-ever-free-clinic-at-la-sports-arena-129474573.html

World Economic Forum Rankings–US Falling Again in Most Categories–5th in Global Competitiveness and 90th in Macro Economics (Math)

In trust with politicians we are ranked at 50th place, and not a big secret there with digital illiteracy running rampant through our Lawmakers at every level including Washing ton.  In macro economics (this includes math) the US is in 90th place.  There are others of course worse than the US, but when you think back to just a few years ago, the US was at the top of almost all the categories.  We hear this from companies who operate in the US and have international interests as well, Intel is one example.  Bill Gates too has testified year after year in front of Congress trying to get a stir going as well, folks that code predict but many have not figured out this bit of wisdom yet. 

Intel CEO States the US Faces Decline in Tech Jobs–Announces Purchase of German Wireless Chip Company Infineon

Intel CFO – US Not Taking High Tech Job Creation Serious Enough – A Reminder That We Are Falling Behind

in 2010 at Berkeley, Bill Gates said asked “are the brightest minds working on the most important issues”.  Well one look at Washington and that answers that with many that work on the Hill but still live in the 70s.  BD 

Bill Gates speaks at UC Berkeley Global Health, Education and Thoughts on Philanthropy

The US has fallen in the World Economic Forum's competitiveness rankings for the third year running. "The United States used to be very much in first place. Now it has dropped to fifth. Some elements suggest it may fall further in the future," Robert Greenhill, chief business officer of the World Economic Forum, told CNBC.

http://video.cnbc.com/gallery/?video=3000043936

Rabu, 07 September 2011

Audit Finds Dead Consumers Still Getting Social Security Checks

Wait a minute, this is the most relied upon data base in the US that everyone uses, right?  Well when you look at it though we still have clerical input errors and some part of the data chain that may not flow together correctly, but we are getting better with transparency in data.  The audit came up with 6000 folks that need to be identified and when you look at Social Security as a whole and how many collect, that’s not a big percentage and some were noted going back to the 90s.  By contrast though, paying health insurance on dead employees is to me much worse and someone was asleep at the wheel.  Didn’t anybody who worked with these folks look for them?  Obviously it was the paper and/or data trail here with an HR department who stressed out in their own words and as I understand it, they have to take the insurers who collected premium payments (no medical claims here free and bottom line profit) to court. 

City of Buffalo Has Paid Over $2 Million to Provide Health Insurance for Hundreds of Dead People-Some as Many as 4 Years

Probe finds dead doctors used in Medicare scams

Then of course we have all these online doctor referral sites who have their share of dead doctors, retired doctors and just flat out flawed information out there too.

Dead Doctors and Inaccurate MD Listings On the Web Can Be a Real Hunting Ground of Information to Mine For Crooks Relative to Fraudulent Medical Billing

Again, if it came down to 6000 individuals, that’s not a bad percentage at all for all the claims they handle on their old, but still steady as a rock COBOL data system.  BD

Pundits and policymakers love to brawl over who should be receiving Social Security benefits--but it's hard to imagine any of them vying for deceased Aunt Edna.

According to a Social Security Inspector General report, $40.3 million in social security benefits have been paid to the dead since 2008. Typically, family members or funeral homes are supposed to notify the Social Security Administration (SSA) that a person has died, at which point the information is put in the SSA’s Death Master File. However, people sometimes fail to report this information and even when they do—the SSA continues to make erroneous payments.

The report finds that the SSA has made payments to more than 6,000 beneficiaries for months or even years after receiving notice that the person has died. The IG estimates that about 1,760 of these people are actually dead—the rest of the entries are mistakes. According to the IG, these erroneous death entries can also lead to “severe financial hardship and distress to affected individuals.”

Selasa, 06 September 2011

Unemployed Man With No Health Insurance Dies When Tooth Infection Spread to His Brain–Couldn’t Afford the Antibiotics

This is a sad story indeed as he went to the ER and was given both pain tablets and antibiotics and he couldn’t afford both.  Gosh you wonder why this happened and someone could have given him the antibiotics and in some areas of the country they imageare free at certain drug stores for a limited amount.  Needless to say $4.00 at Target or WalMart would have probably done the trick and someone I’m sure would have lent him the few dollars.  Also this comes back around to which medications he chose and if he had a brain infection and was in really bad pain he maybe couldn’t get away from himself, again due to the pain.  A trip to a dentist of course was the first call that could have been made, but again when there’ s no insurance, perhaps people just don’t think clearly.  This is a sad story indeed as it played out.  BD

An unemployed Cincinnati man with no health insurance died after a tooth infection spread to his brain because he couldn't afford treatment, relatives said.

Kyle Willis, 24, came down with a toothache two weeks ago and was told he needed to have one of his wisdom teeth removed.

But Willis - whose uncle is famed bass player Bootsy Collins - decided to tough it out because he was out of work and couldn't afford the treatment.

Soon after, he began getting headaches and his face swelled, so he went to an emergency room. He was told an infection was in danger of spreading to his brain.

"The [doctors] gave him antibiotic and pain medication, but he couldn't afford to pay for the antibiotic, so he chose the pain meds, which was not what he needed," Willis' aunt Patti Collins told WLWT-TV.

While Willis' discomfort subsided, the infection continued to spread, causing lethal swelling in his brain.

Willis died Wednesday, Collins said.

http://www.nydailynews.com/news/national/2011/09/05/2011-09-05_unemployed_man_with_no_health_insurance_dies_after_minor_tooth_infection_spreads.html?r=news

Minggu, 04 September 2011

Paintball Pops Breast Implant in the UK–Female Competitors Now Required to Sign a Waiver–Protect Those Breasts While Playing

This makes sense obviously as you protect your eyes and other body parts but I guess the chest area for women here was not something anyone though about much until one paintball shot hit the bulls eye.  Its either that or don’t play Paintball if you have artificial boobs is what common sense tells me here.  Just the thought of an implant covered with paint is not particularly something anyone might want to see. 

Interesting too here in the article too about a doctor working on “adjustable” implants with an implanted port that allows for adding or removing saline, so if you have a hot date and want that “extra” affect, just pump in some saline it appears:)  Back in September of 2009 there was a real popular clinical trial for saline implants and I don’t know what the results are or if this is still ongoing or not, but gee enough about this topic already and if you have implants and play Paintball better use some common sense and protect them.  I guess if the technology advances to where you can adjust, you could just drain them before going to a Paintball match maybe?  BD   

Paintball ruptures British woman’s breast implant: The 190-mph impact of a paintball recently ruptured a British woman’s breast implant. In response, the UK Paintball company began asking female competitors to disclose whether they have implants and to sign a waiver.

Plastic surgeon Dr. Jennifer Walden of New York told ABC News that implants can withstand 20 times the pressure exerted by a mammogram machine, but a speeding paintball can “damage not only implants, but bodily structures such as eyeballs, breasts without implants, cheekbones, etc.” She recommended that women protect that “assets” by wearing protective vests.

Doctor develops adjustable implant: Plastic surgeon Dr. Jeffrey Weinzweig of Chicago has created a saline breast implant that can be enlarged or shrunk from three to six months after it is placed in a woman’s body.

During the original operation, the patient’s implants are connected to medical ports, about the size of a dime, which are placed under her skin.  If a woman wants to expand or reduce the implants’ size, Weinzweig inserts a needle through the ports to add or remove saline from the implants, he says.

The ports are then removed from the patient’s body.

Sabtu, 03 September 2011

Stanford Hospitals and Clinics No Longer Accepting Blue Cross Health Insurance–Contract Expire-Patients Have to Go Elsewhere While the Cost Algorithms Churn With Contract Negotiations

Here we go again, it’s the contracts and the costing algorithms of the insurance companies that are their business models that determine what reimbursement will be.  The article states that now they are “close’ to agreement so maybe this won’t imagelast too long, but in the meantime you can’t go there as of Setember1st and letters went out back in February that this would come around, and it did.  See how long it takes to negotiate insurer contracts today?   This means for right now you can’t go there or visit some of their physicians to get care where Steve Jobs reported went for some of his care.  About a year ago they opened a premier medial school. 

Stanford University Opens State of the Art Medical School

It’s complicated and their algorithmic business models have to allow for the projections they have analyzed and determined with their predictive software. Blue Cross has an entire IT infrastructure for this to calculate and sell to clients too, have had it for a while.  Now Stanford is pretty advanced with everything they do all over and I would expect nothing less here so in essence we may have this with the contract negotiations…as a matter of fact Stanford is probably giving them a real run for their money:)

The battle of algorithms…that’s what contracts pretty much amount to anymore.

The care given relative to Catheterization is very superior and you should read about their advanced MDs and procedures and outpatient procedures.  Sounds like Blue Cross though says we don’t want to pay that much for it maybe?  image

At Stanford Hospital Coronary Stent Processes Are Done On As an Outpatient Procedure–Using the Radial Artery in the Wrist
Stanford Hospital Gives Ipads To Patients in the Catheterization and Angiography Labs

And they have the very much anticipated clinical trials for stem cell treatment of the spinal cord.

Stanford Joins Geron Spinal Cord Clinical Trials Program as the 3rd Location in the US

Anthem filed a letter of transition with the State Department of Managed Care and as I read here access to the doctors will be extended until September 16th.  One nice plus though here is that transplant patients don’t have to make a change, thank goodness and the ER rooms don’t require pre-authorization so maybe Stanford ER rooms might be a little busier.  They have been going at this since before February on a new contract.  It further states that Blue Cross HMO has the right to send patients to another doctor.  If one is PPO you might face higher co-pays since I would maybe guess you could be subject to out of network charges.  Just a couple months ago HP committed $25 Million to the Children’s Hospital and Intel has kicked millions to the University as well.  image

HP Commits To Invest $25 Million To Stanford’s Lucille Packard Children’s Hospital To Include HP Labs Collaboration

All of this with medical care today just really stands to strengthen the need for a Public Option for sure.  Contracts leave peoples lives, and in the case of the doctors, their livelihoods up in the air. 

Again Stanford is world known for their technology with healthcare, but we are like I said, back to those costing algorithms and with Blue Cross figuring out how to maximize share holder dividends.  Insurers can’t negotiate a contract in a years' time so its time for inconveniencing patients and consumers off in other directions as deadlines today seem to mean zero as far as getting that part of the job done.  BD 

Patients with Anthem Blue Cross health insurance stopped having coverage at Stanford Hospitals and Clinics on Thursday (Sept. 1) after contract negotiations were not resolved, according to an Anthem document Palo Alto Online received yesterday.
The contract termination means that Stanford University Hospital, Lucile Salter Packard Children's Hospital (LPCH) and Stanford Medical Group might not be in the Anthem insurance-plan network. Authorizations and copay amounts could change for patients with the HMO and PPO plans, Lucile Packard spokesman Robert Dicks said.
The hospitals sent Anthem a letter on Feb. 25 informing the insurance giant of the termination on the contract's Sept. 1 expiration date.

http://www.paloaltoonline.com/news/show_story.php?id=22374