Healthcare/PBM

This one is for you NIK..
OSHA puts 'new sheriff in town'
http://www.lvrj.com/business/osha-increasing-oversight-in-nevada-102886554.html?ref=554

Business owners need to prepare front-line managers and supervisors for unscheduled visits from OSHA inspectors, especially since the federal agency opened an office in Las Vegas, an attorney who specializes in labor laws said Tuesday.

OSHA has intensified regulatory enforcement after a string of construction deaths on the Strip and in the general industry around Las Vegas, opening a local office with area director Joy Flack.

A string of deaths..more like few decades..LOL

"Is there a new sheriff in town? Absolutely," said Ken Atha, administrator for OSHA's regional office in San Francisco that covers most of the Western states. "Secretary (of Labor Hilda) Solis wants to make a point. She wants people to know we're an enforcement agency. That's where that slogan came from."

When the Feds want to stimulate the economy, they "deregulate"..But if they want to depress the economy, they "regulate"..

OSHA will use a $14 million budget increase to hire another 130 officers, strengthen oversight of 27 state plans and step up site-specific targeting programs for repeat violators, Atha said.

What can I say ?? Apply for an OSHA job I guess..

Great info Ian...thanks
More money ....more compliance....

Stop paying crooks: Get tough on health-care fraud
By Newt Gingrich & A.Barry Rand

Health-care fraud is enough to make you sick: kickbacks, money laundering, identity theft, criminals peddling Medicare numbers for profit, bills for home-health services that never happened, HIV drugs, make-believe medical equipment, you name it.

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This is an epidemic, and we want to stop it.

We all have a responsibility to use the power that comes with standing together to battle health-care fraud. All stakeholders can take these steps:

-Advocating for much wider use of technologies that enhance our ability to detect scams before bills are paid, ensuring that criminals, once identified, can never defraud again. Health care is well behind such industries as banking and credit cards in embracing modern tools that flag and prevent misconduct in real time. We have to get better at using data to uncover questionable transactions and trends.

-Calling on private and government insurers — Medicare and Medicaid — to do more. Consumers need easy-to-read information, along with greater security for their medical records. Forms such as insurers’ Explanation of Benefits should be simplified. Consumer complaints should be acknowledged and acted on promptly.

-Offering guidance on how to recognize and report fraud. Medical bills can be complex. Our organizations help people recognize what to look for and, if they find something fishy, where to report it. We urge Americans to protect their Medicare and Medicaid identification numbers as carefully as they do their Social Security cards.

We salute efforts by the federal government’s Medicare Fraud Strike Force, which has uncovered more than $1.85billion in alleged fraud since its inception in March 2007. But law enforcement can’t do this job alone. Indeed, we agree with Health Secretary Kathleen Sebelius who said at the first National Summit on Health Care Fraud in January, “We believe the problem of health-care fraud is bigger than government, law enforcement or private industry can handle alone.”

Our two organizations, AARP and the Center for Health Transformation, are working to shine a light on health-care fraud and its impact on all Americans.
http://www.orlandosentinel.com/news/opinion/os-ed-medicare-fraud-gingrich-093010-20100929,0,6372824.story

Newt is going to take on healthcare fraud….LOL…I’m sure he has a scheme or two of his own goin on…
“wider use of technologies”….wonder what Newt has invested in?

genome + wifi + black ops

Healthcare through cellphone comes at Rs 45

NEW DELHI, INDIA: Aircel and Apollo Hospitals, which announced on Wednesday the launch of their round-the-clock healthcare facility through mobile phone, called Tele Triage, said the service would be available for Rs 45 per consultation. This service will become operable in all circles where Aircel has operation around the first week of this November.

“Most of the people hesitate to even wake up people at home in the wee hours of the day to take them to the doctor. Tele Triage will end this issue. Through this service, the patient will be able to access immediate consultation of Apollo health experts even at the wee hours. The service will be available round the clock,” said Dr. Prathap C Reddy, chairman, Apollo Hospitals Group, on the occasion of launching the service.

The payment will be made by deduction of Rs 45 from the balance of the Aircel pre-paid customer and in case of post-paid customers, the amount will be charged in the bill.

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HealthNet Global will also be involved in developing and facilitating medical applications on tele medicine and Tele Triage platform.

“We have plans to take health care to the doorstep of the people. Soon there will be smartphones that can measure the patient’s blood pressure and other vital health profile, which will be transmitted to the health expert online and help him make precise diagnosis,” said Charles Antony, CEO, HealthNet Global.
http://news.ciol.com/News/News/News-Reports/Healthcare-through-cellphone-comes-at-Rs-45/141807/0/

Apollo is HUGE!!! I have done extensive research on them.
Looks like healthcare of the future...maybe an investment opportunity.

A related article : The company had won spectrum for 13 new circles across India. These include Delhi (Metro), Mumbai (Metro), Andhra Pradesh, Gujarat, Haryana, Karnataka, Kerala, Madhya Pradesh, Maharashtra & Goa, Rajasthan, Punjab, UP (West) and UP (East).
http://economictimes.indiatimes.com/news/news-by-industry/telecom/Aircel-to-launch-3G-services-in-Q1-next-yearinvest-500-mn/articleshow/6651502.cms

Tennessee’s bold leap in care for the aged and disabled

NASHVILLE, Tenn. — After lagging behind the rest of the country for years, Tennessee is catching up fast when it comes to changes in its health care system aimed at elderly and disabled residents. More of them are getting the assistance they need in their homes — at a much lower cost than at a nursing home. A lot of this change is the direct result of efforts by Governor Phil Bredesen.

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Like every other state, Tennessee is bracing for an avalanche in demand for long-term care as the biggest generation in American history — 77 million so-called Baby Boomers born between 1946 and 1964 — begins to hit retirement age next year.

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In 2008, the Legislature unanimously approved a bill that would make Tennessee one of just a few states to contract out its long-term care program to managed health care organizations. The federal government took a full year to approve it.
Like laws in Arizona and New Mexico, Tennessee’s new law counts on private companies to ensure that a broad array of services — from so-called personal services such as meal preparation, bathing and dressing to home improvements, including wheel chair ramps and even pest control — are provided without additional cost.
Two months ago, TennCare CHOICES, opened its doors statewide with the goal of helping 11,000 people remain at home or return to their homes in the first year — all for the same amount the state paid in 2009. “The change is like night and day,” says Wilo Clarke, a caseworker for a managed care company in central Tennessee where the program started as a pilot earlier this year. “More and more, people in the nursing facilities are hearing about this program. They want to do whatever it takes to go home.”

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For the managed care organizations, the financing structure is straightforward. The state gives them a flat monthly fee for each eligible long-term care recipient — whether in a nursing facility or living at home. Some patients will cost more and others will cost less. It’s the company’s job to ensure that the average cost for all enrollees does not exceed a specified level.

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The new federal health care law — the Patient Protection and Affordable Care Act — has a chance of changing that. It includes financial incentives for states to spend at least 50 percent of their long-term care dollars on non-institutional services and offers a grant for every person who leaves a nursing home to receive services in the community. Still, experts say the federal dollars may not be enough to persuade some states to make the changes.
In Tennessee, both supporters and critics of the CHOICES program say only time will tell whether the managed care organizations will be able to keep a lid on costs. Bredesen says his greatest worry is keeping “fly-by-night” operators out of the system. “A lot of people can play. You don’t have to be a doctor or build a hospital.” But for those directly affected, Tennessee’s experiment is already offering hope.
http://www.stateline.org/live/details/story?contentId=520026

Tennessee’s new law counts on private companies to ensure that a broad array of services — from so-called personal services such as meal preparation, bathing and dressing to home improvements, including wheel chair ramps and even pest control — are provided without additional cost.
FRAUD!

Express Scripts, Other PBMs Go Data-Diving to Predict Health Problems

Pharmacy benefit managers and insurers are going all “Minority Report” — they’re attempting to predict when people will stop taking their meds or develop medical problems before they even do so.

As the WSJ reports, Express Scripts is announcing a new initiative that will analyze factors including prescription history, whether the patient has kids living at home, the amount of the co-pay and disease-specific issues to predict who’s likely to skip doses or stop taking their meds. (No word on whether, like Tom Cruise’s crime-predicting team in the movie, they’ve also got three psychics in a swimming pool helping them out.)

Once those folks are identified, the PBM will reach out to them via phone or letter to offer them ways to stick to the medication plan, say, by ordering via mail.

And other PBMs and insurers are also data-diving in order to figure out who’s likely to skip meds or develop complications or new problems down the line, the paper says. UnitedHealth’s Ingenix unit sells a diabetes-prediction service; among other things, it uses mole-removal stats to pinpoint people who spend time outdoors and therefore who aren’t likely sedentary. CVS Caremark is preparing to launch its own predictive prescription adherence efforts.
http://blogs.wsj.com/health/2010/10/11/express-scripts-other-pbms-go-data-diving-to-predict-health-problems/

thanks for that..

AT&T* and WellDoc(R), a healthcare company that develops technology solutions to improve the lives of people with chronic diseases, today announced a strategic alliance to market and sell WellDoc's mobile health (mHealth) solution in the United States to facilitate improved patient outcomes and reduce the spiraling costs of managing chronic diseases.

AT&T plans to deploy the WellDoc technology through an internal initiative with a select number of employees, using WellDoc DiabetesManager(R) System in 2011. AT&T will potentially expand to other disease areas (upon U.S. Food and Drug Administration (FDA) clearance), including: heart disease, asthma, chronic obstructive pulmonary disease and oncology. AT&T has a vested interest to help improve our employees' health and quality of life and reduce healthcare expenditures.

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According to the Deloitte Center for Health Solutions, approximately 50 percent of consumers have expressed interest in home monitoring devices to check their condition and communicate the results to their doctor. Mobile technology, through the use of messaging and feedback via mHealth can play a key role in helping individuals with a chronic disease like diabetes make the appropriate lifestyle choices. The WellDoc DiabetesManager(R) System's Web-based enterprise tools also enable providers and disease management organizations to more effectively oversee larger patient populations as the system automates and increases patient engagement.

"The alliance between AT&T and WellDoc is a landmark catalyst for the field of wireless health," said Donald Casey, Chief Executive Officer at the West Wireless Health Institute.
http://www.marketwatch.com/story/att-selects-welldocr-mobile-health-solution-for-management-of-chronic-diseases-2010-10-13?reflink=MW_news_stmp

It wont be long and instead of asking "who is our doc?" we will be asking "what app do you use"

Good post Nik..Very soon we don't even a "on-site" doctor anymore..

ianadds wrote:Good post Nik..Very soon we don't even a "on-site" doctor anymore..

and another...

MedHelp and GE Announce New Mobile App to Help Track Sleep Habits


MedHelp, the world’s largest online health community, has partnered with GE to create and introduce a new, mobile app, Sleep On It, that helps improve users’ sleep quality and impact overall health. The app is available as a free download on iTunes for the iPhone and iPod Touch

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“GE has committed to helping people achieve better health through our healthymagination initiative by combining innovation with the latest technology,” said Beth Comstock, senior vice president and CMO, GE. “By providing people with easy-to-use tools and readily available data, we can empower them to make better, more informed health decisions. The Sleep On It mobile app will help users get the rest they need to be healthier and more productive.”

Sleep On It is the second in a series of mobile applications being developed by MedHelp and GE. The first was the popular iPhone pregnancy app, I’m Expecting, which was released in July. I’m Expecting is the most comprehensive free pregnancy app available and allows women to track their pregnancy symptoms and share info with their doctors or other users, get weekly updates on their baby’s growth, upload photos of their growing baby bumps, send out birth announcements and more.

http://www.prweb.com/releases/2010/10/prweb4650164.htm

iPhone pregnancy app, I’m Expecting...and coming to your iphone soon I'm in labor..the midwife app

I feel sorry for those young graduates..They have no clue what the politicians have in store for them.

GEO is taking over the prison contract in Taft, CA..BUY..BUY..

ianadds wrote:Wise investors should also keep an eye on the completion dates of prisons:
2010/09/12
A sad day: Detention center to open in Pahrump Oct. 1
http://nevadaprisonwatch.blogspot.com/2010/09/sad-day-detention-center-to-open-in.html

Prison health services:

http://www.asgr.com/
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Parts of healthcare lawsuit can proceed


TALLAHASSEE, Fla., Oct. 15 (UPI) -- Portions of a lawsuit brought by 20 states challenging the healthcare reform law can move forward, a federal judge in Florida ruled.

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The merits of the case will be discussed at a summary judgment hearing Dec. 16.

Vinson ruled that states can challenge whether the law's mandate requiring nearly all Americans to buy health insurance exceeds Congress's constitutional authority to regulate commerce and make laws "necessary and proper" for carrying out its powers.

Vinson's ruling also allows the plaintiffs to argue whether the law's expansion of Medicaid to cover not only the very poor but also low-income people impinges on state sovereignty because the expansion could require states to spend billions more on the program.
http://www.upi.com/Top_News/US/2010/10/15/Parts-of-healthcare-lawsuit-can-proceed/UPI-35041287148543/

had to happen!

New Study: $3.5 Trillion Could Be Saved over 25 Years by Restructuring Medicare and Medicaid Fee-for-Service Model

Federal and state governments could save taxpayers about $3.5 trillion over the next 25 years by expanding the use of coordinated care programs in Medicare and Medicaid, according to new analysis by UnitedHealth Group's /quotes/comstock/13*!unh/quotes/nls/unh (UNH 36.01, +0.03, +0.08%) Center for Health Reform & Modernization. The report has been provided to the bipartisan National Commission on Fiscal Responsibility and Reform, known as the Deficit Commission.

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1.....Under this option, states would enroll most of their fee-for-service Medicaid population (who aren't also receiving Medicare) in coordinated care programs, including people with long-term care needs.

2.....Examples from the report's recommendations include wider use of home- and community-based care programs to allow individuals to live longer in their own homes, better coordination between Medicare and Medicaid, and full integration of Medicare and Medicaid benefits.

3....Examples include adding high-quality provider networks, care coordination, and disease management and wellness programs, as well as consumer incentives, treatment decision support and value-based benefit designs.
http://www.marketwatch.com/story/new-study-35-trillion-could-be-saved-over-25-years-by-restructuring-medicare-and-medicaid-fee-for-service-model-2010-10-15?reflink=MW_news_stmp

Summary
Bundled payments,
home health,
coordinated care,
wellness programs/disease management (sadly a lot of phone apps )