Journalist; OB Story Wrong

So, I’m innocently reading the news and find myself researching a reporters comment.

Okay, so I’m conflicted. Either the reporter misquoted, misunderstood or is intentionally quoting incorrectly. Screen Shot 2015-09-17 at 8.32.09 AM

This is an unusually long post, but it has a number of good points. I didn’t wake up today planning on writing this post. But, it’s a good chance to write about things I’m passionate about that most people don’t spend their day thinking about.

  1. journalist integrity
  2. healthcare rules and how Universities shape our physicians
  3. how rules and word smithing is important
  4. how abortion is learned
  5. how insurance companies rely upon this training
  6. how us as Americans pay for this
  7. that rationing exists in our system today, this is an example
  8. the inconsistency in thinking that is soooooo costly

For those doctors and healthcare professionals who follow me, please engage with me on this note.

The reporter writes about, “The decades-old relationship between MU and Planned Parenthood,” says of medical school education;

Nursing and medical students were never required to work at any Planned Parenthood clinic, work at the clinic was not part of the core curriculum in either the nursing or medical schools and the placement was an optional…

Columbia Missourian, Elise Schmelzer, Sep 15, 2015; “State investigation focuses on decades-old relationship between MU, Planned Parenthood”

http://www.columbiamissourian.com/news/local/state-investigation-focuses-on-decades-old-relationship-between-mu-planned/article_de825b18-5bd9-11e5-b5d3-8b294f78e0ba.html

A small amount of digging

But, in doing a small amount of digging, I found the association responsible for setting out the rules for residence in training for OB work are required to train on abortions. My brain is a word smith brain which means I can’t reconcile what the journalist wrote with what I found in a quick look at her own link on the topic. I didn’t perform any further analysis but I’m sure the topic has much more detail.Screen Shot 2015-09-17 at 7.47.29 AM

When I read a journalists article that might be misleading I have to look for the detail. I want to know why does this not sound correct to me. I have an advantage over a young journalist with 29 years in healthcare finance. In this case, I wondered if the reporter intentionally left out an important fact, or skewed a statement. You decide. I think if they asked a few more questions they may have blown open a different discussion. And, an important one at that. They may have discovered the school is training residence on abortion, just not at planned parenthood. Makes you wonder if they use the tissue like planned parenthood, but they use it for University research. It is universities that use the tissue. The article and title make it sound like the university isn’t using planned parenthood clinic and are innocent of any relationship with the abortion business. Innocent enough I suppose on the surface, but what is the rule for OB’s? Where do the residence at this University get their required training?

A very small misquote, or misstatement changes the flavor of the article completely, upon close inspection, the phrase, “at a student’s request” conflicts with the written rule for the Universities accreditation.  Here is the authors quote, it’s there in bold.

The agreement with the medical school was required to meet Accreditation Council for Graduate Medical Education requirements that mandated schools provide training on abortion procedures at a student’s request, MU Chancellor R. Bowen Loftin said in a letter to Schaefer.

Columbia Missourian, Elise Schmelzer, Sep 15, 2015; “State investigation focuses on decades-old relationship between MU, Planned Parenthood”

http://www.columbiamissourian.com/news/local/state-investigation-focuses-on-decades-old-relationship-between-mu-planned/article_de825b18-5bd9-11e5-b5d3-8b294f78e0ba.html

It might seem silly but I live in a world of insurance where rules guide how our medical system works including how much it costs. Think about it this way, our educational institutions work because they have many rules to guide education. They are the one’s who write the rules, and these rules are used to train your favorite doctor. These rules make it possible for insurance companies to pay claims.

So, here’s my word smith problem. The quote below is a rule from a body that gives accreditation to medical education programs and this quote says it is mandatory for University programs, to be accredited, they must provide abortion training. It does not say, what the journalist wrote, “at a student’s request.” The rule as quoted says, they must train residence in abortion.

See, it says it right below in bold.

It’s on page 15 of the ACGME instructions, rules and guide (the journalist provided this link in their article). These rules are used by insurance companies to make sure doctors are properly accredited by properly accredited university training delivering the best care to the insurance company patience. These things, these rules, matter.

Screen Shot 2015-09-17 at 8.31.30 AM

“IV.A.6.d) Family Planning and Contraception IV.A.6.d).(1) Programs must provide training or access to training in the provision of abortions, and this must be part of the planned curriculum. (Core) IV.A.6.d).(2) Residents who have a religious or moral objection may opt-out, and must not be required to participate in training in or performing induced abortions. (Core) IV.A.6.d).(3) Residents must have experience in managing complications of abortions and training in all forms of contraception, including reversible methods and sterilization.”

ACGME Program Requirements for Graduate Medical Education in Obstetrics and Gynecology, ACGME approved major revision: September 28, 2014; effective: July 1, 2015, Page 15.

https://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/220_obstetrics_and_gynecology_07012015.pdf

This quote is current, the document doesn’t dictate any specific place for the training, it doesn’t even mention planned parenthood.

Rationing is a phrase I use and when I do most people do one of two things; their eyes glaze over in confusion, or they object out of ignorance because they incorrectly believe rationing will never happen in America. In fact, this article, this misquote or misstatement by the person quoted leads to rationing.

Let me try a different tact.

You’ve been to school and you know from the office of the registrar to commencement day policies, paperwork and rules are required before you get your diploma. It shouldn’t surprise anyone then, that there’s rules for medical school.

Ever wonder where the rules come from?  Who writes them, why they write them a certain way? Ever wonder why these rules are important? Did you ever consider these rules influence the healthcare you pay for? Do you understand how this simple language has an evil twist for medical students? Ironically, what the author wrote would be the logical way most people would write the rule, “students have the choice if they want the training.” But, the fact is, the training is required and students at that University are getting it. I haven’t researched this, maybe, the University is outside the norm and their doing it as quoted. Then, the national standards for OB’s is not being followed and this is not a good thing….

It leaves me in this article examining the person in the article who the journalist quoted as not telling the truth, or answering the journalists question about planned parenthood with a strictly narrow answer. And, the unknowing journalist innocently took them at their word. Or, the journalist intentionally wrote an untruth.

The point? The point is OB residence are mandated to take abortion training, it’s not optional. They can opt out for religous beliefs. This is opposite what the journalist wrote. She wrote, students can opt in for that training. This would be how most Americans would assume it’s taught, as an option for medical students. It is a small, razor thin edge isn’t it.

Okay, shift for a minute with me to the actual topic of abortion

Consider that our country makes physicians learn how to perform induced abortions and kill babies. They are in fact babies because this same system pays million upon millions to keep alive babies at the exact age. The contrast to me, originally a claim payor is almost too much to bare. Why, how, as a country did our healthcare system get to a point where this contrast is so great.

It’s because the masses follow what they read from journalists, because they’re not word smiths, because they don’t have time, blah, blah, blah.

This is where the problem starts, it’s where the evil begins. It’s where medical students, in the hallowed halls of educational institutions are provided the means to promote abortion, to agree with them as a course of study and health for a women. You have promoted this behavior by paying for the medical school education, by paying insurers premium, by having policies that promote the idea this is healthcare, that new physicians are mandated to learn about and accept abortion as care. The societal endorsement for doing abortions is trained, it is a medical school endorsed practice.

For the baby, for the voice of the babies, for increased medical premiums, for rules that don’t provide health but death we need to change our methods in the US.

Editing needed

If you’ve slugged through my poor grammar today I hope the overall point was worth it. I’ll return to edit grammar and such but for now, this should suffice.

Looking for other visionaries, leaders, partners, investors

Moving away from systems of record to systems of Engagement

Watch for less than 2 minutes. I’ve marked it to start at about the 30 second mark, if you watch 2:00 minutes mark you’ll capture what I’ve quoted below.

Geoffrey Moore, author of Crossing the Chasm, writes and talks in an understandable way. He is clear about the challenges facing institutions and legacy systems. Slow to happen for a reason, says Mr. Moore:

“unfortunately, it’s not happening nearly as fast as anyone wants because there’s a lot of complications with bringing consumer technologies into the enterprise…”

“… it’s not as actionable yet as we want it to be, we’re so good at doing the system of record actions because we’ve been doing them for decades. This is newer, there’s legal issues such as privacy issues, there’s lots of technical issues as well and so I think people feel a little bit like, my God, there’s such a big hill to climb, where do we start…”

Automation of the Decoder is next for this reason:

I see the automation looking like what Mr Moore calls, “moment of engagement.”

“moments of engagement, which are the critical strategic moments where your strategy wins or loses, and see if you can’t get the technology involved there because that would really change the performance of your company.”

Today insurance and in particular healthcare processes are rooted in “systems of record.” These are legacy systems and processes still require a fax machine to communicate. It’s human intervention in many places. There is a lot of work to do and it won’t be easy but the rewards will be significant. This video clip underlines the fact that moving out of systems of record and into systems of engagement will be hard work and difficult because of the complexities.

I’m hopeful that others who want to enter this space can find their way, marrying underwriting, technical, compliance and operational histories with the latest technology are whats needed.

Uncompensated care is now the providers problem

Changing plan deductibles is not lowering the cost curve.

Bending the cost curve will not happen because we’ve increased deductibles and coinsurance. What’s happened is we’re shifting uncompensated care to providers.

Obamacare Health Spending Surge? Not So Fast

“There’s still no guarantee that it won’t, even though many suspect that increasingly higher out-of-pocket expenses for consumers and the health law’s cost-control measures will help “bend the cost curve” for medicine over the longer term.”

http://capsules.kaiserhealthnews.org/index.php/2014/06/obamacare-health-spending-surge-not-so-fast/?utm_campaign=KHN%3A+First+Edition&utm_source=hs_email&utm_medium=email&utm_content=13163528&_hsenc=p2ANqtz–nqe_sb10526eRaJuiJhNkI-gGncUq9wqsgRLovqqE0i2Cf0-0Du0cFbeFwYt7xgHxwWMYTrwZhjBTjTStxnUC68yWEQ&_hsmi=13163528

The Owners Health Initiative targets the latest, innovative and visionary thinking from the BenStaff team. Stop thinking cost shifting to employees is a solution.

BCBSM Value partnerships for hospitals

Reimbursement model changes but who is getting the incentives?

Healthcare reform initiated a new payment model that has not widely been discussed. The ACO model in reform allows a hospital, just a for instance, to take a single payment to cover thousands of lives in a geographic area. The management of that population is up to the hospital. ACO is an acronym for “accountable care organization.” You should learn what this means to you.

The Michigan Blue Cross plan is working toward a model to provide “population management” by pulling together new contracts with providers. Providers interested in the “rest of the story” should consider an independent evaluation of these agreements.

Blues Perspective, Four more hospitals agree to BCBSM value-based reimbursement model _ MIBluesPerspectives. From the following BCBSM site link; http://www.mibluesperspectives.com/2014/05/22/four-more-hospitals-agree-to-bcbsm-value-based-reimbursement-model/?utm_source=LinkedIn&utm_medium=BCBSM&utm_campaign=blog

Blues Value Partnership, Hospital Pay For Value _ Value Partnerships. From the following BCBSM site link; http://www.valuepartnerships.com/hospital-pay-for-performance/

 

A calculator for employers to estimate their cost of smoking and overweight.

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Alere Health Calculator for Tobacco

For the first time there is a company whose providing end-to-end health services in a single system. They’re able to research and create products across 100 diagnosis groupings, offer instant diagnosis and testing improving results and speed to diagnosing. This includes at home testing that’s fed directly to physicians and hospitals.

Screen Shot 2014-08-28 at 6.06.25 AM
Alere Health Tobacco calculator

But, what’s really exciting is their entrance recently into the informatics and population management environment with services connecting the health of tested populations at home with science based, legitimate research based incentives for engaging health.

Calculator link