Day: March 30, 2010

MyHealthGuide Source: MultiPlan, 3/15/2010, www.multiplan.com and www.Viant.com

New York, NY – MultiPlan, Inc. announced that it has acquired Viant, Inc., bringing together the considerable expertise and complementary solutions of both companies to produce what MultiPlan believes will be the industry’s most comprehensive provider of healthcare cost management services.

“The timing couldn’t be better for Viant to join the MultiPlan family, as containment of healthcare costs has become the nation’s imperative,” said Mark Tabak, MultiPlan’s Chief Executive Officer. “Together, we plan to more effectively leverage our companies’ combined expertise and technology to improve efficiencies and patient flow for providers, driving significant savings for healthcare consumers and payers.”

Founded in 1980, MultiPlan is a provider of PPO network and related transaction-based solutions that reduce the per-unit costs of healthcare claims. MultiPlan contracts directly with over 5,000 hospitals, 115,000 ancillary care facilities and 625,000 practitioners who participate in the company’s national primary and complementary PPO networks.

Established in 1990 as Preferred Payment Systems, Inc., Viant today offers PPO networks, network management, pre-payment and post-payment services to commercial and government clients. Viant’s networks represent approximately 5,400 hospitals, 95,000 ancillary facilities and 600,000 practitioners.

Added Tabak, “With our combined product lines, MultiPlan has a solid foundation from which to develop new solutions as healthcare reforms take shape. We look forward to working with our new colleagues at Viant to meet the needs of this changing marketplace.”

Together, MultiPlan and Viant offer healthcare payers an end-to-end solution for managing healthcare unit costs on a pre- and post-payment basis.

About MultiPlan

MultiPlan, Inc. is the industry’s most comprehensive provider of healthcare cost management solutions. The company provides over 2,300 clients with a single gateway to a host of primary, complementary and out-of-network strategies for managing the financial risks associated with healthcare claims. Clients include large and mid-sized insurers, third party administrators, self-funded plans, HMOs and other entities that pay claims on behalf of health plans. Incorporated in 1980, MultiPlan is owned by a group of investors led by the Carlyle Group. Visit www.multiplan.com.

About Viant

Viant, Inc. (through its subsidiaries including Texas True Choice and national PPO network, Beech Street) provides healthcare payment solutions through primary and complementary networks, integrated network and contract management, non-network cost management services and post payment audit and recovery services to the U.S. commercial and public health insurance sectors. Viant’s comprehensive and effective cost management strategies focus on timely, accurate and fair payment for providers, payers and patients.  Visit www.Viant.com.

There are enough problems with reform – big, obvious, scary problems – that make lying about reform unnecessary. Yet opponents continue to resort to ludicrous, unsupportable, and completely false claims about the bill, with some of the leading detractors choosing to rewrite history in an effort to scare voters and score political points.

It is NOT socialized medicine, socialized healthcare, government-controlled health care, a violation of the US Constitution, or any of the other ridiculous charges leveled by people who should be more responsible. The reform law is:

– pretty centrist – no public option, utilizing private, for-profit insurers to deliver insurance

– without price controls on providers or insurers, and with no utilization controls to speak of

– based on a very weak mandate that is more accurately described as a fine for those who decide to forgo coverage

Among the demagogues who know better is Newt Gingrich the former House Speaker is outraged, outraged I say, at the Democrats’ passage of the insurance mandate. He’s obviously had a change of heart, as a few short years ago he not only called for an enforceable mandate in a speech, he did it in two of the books he wrote.

Newt’s flip-floppery came about just yesterday, when the following dialogue took place on that fair and balanced network:

HANNITY: Do you think any of these constitutional challenges that are out there about the employer mandate, individual mandate, or any of the other challenges — do you think as they work their way through the courts, that any of that will be effective?

[…]

GINGRICH: Then you have to appeal the president’s ruling and they’d probably lose that fight. But what my sense is — first of all, I’m glad to see that some 13 attorneys general around the country —

HANNITY: Are going to sue.

GINGRICH: Have sued. Based on a 1992 Supreme Court decision which said that the federal government cannot punish you for failure to do something, I think that there’s an outside chance the suit will hold up. And that that will stop the individual mandate at the federal level.

Hmmm, seems pretty unequivocal.

here’s what Newt said just two years ago: “According to a June 11, 2008 Associated Press article (accessed from the Nexis database), which ran under the headline, “Gingrich suggests insurance mandate for those who can afford,” Gingrich reportedly “outlined his strategy to combat rising health care costs a plan of attack that includes insurance mandates for people who earn more than $75,000 a year” at a visit to a Nebraska health system. The article went on to report that “Gingrich called it ‘fundamentally immoral’ for a person who can afford insurance to save money by going without, then show up at an emergency room and demand free care. He said those who can afford insurance and choose not to buy it should be required to post bonds to pay for care they may someday need… Gingrich said everyone should have insurance, but not provided by the federal government.” [emphasis added]

(from MediaMatters)

Is he so ignorant, or so ballsy, that he doesn’t think anyone will pay attention to what he said, or wrote, a few short months ago? Or is Gingrich so driven, so insanely desperate for power, that he’ll be blown by political winds like a feather in a gale? Gingrich’s patently false statements are prima facie evidence of the depths to which right-wing opponents will descend in pursuit of power and popularity.

It’s disgusting and abhorrent behavior, and ill serves the nation.

What does this mean for you?

The new law of the land is nowhere close to perfect, or even very good; as I’ve said repeatedly I’m deeply concerned about the law’s all-but-complete failure to address costs. There’s so much misinformation circulating about health reform it is impossible to keep track of it all, much less debunk it.

When you hear Romney, or Boehner, or McConnell, or their fellow wingnuts proclaim the end of America as we know it, ignore them, or better, marvel at the lengths they will go in pursuit of the votes of the ignorant.

Editor’s Note: This was written by Joe Paduda, nationally known expert on our health care delivery system.

In Mexico, they have a socialized healthcare system, it is known as IMSS. At IMSS people wait in a large, open room to get screened before seeing a doctor. But in many cases, after a long wait, they may not get the treatment that is needed. This is because IMSS is running out of money. People who have serious illnesses might get superficial treatments, while a person with a simple illness, like a sprained ankle, can get as much as a 7 day incapacity.

An incapacity is the official declaration from IMSS that you have been treated and are excused from work until the end of your incapacity. In one case of a sprained ankle, the incapacity was for 7 days. For seven days, a 20 year old man was not allowed to work, and only recieved 60% of his salary during the incapcity. The reason he was given the incapacity, and a seriously ill person was not, is simple. It costs IMSS nearly nothing to treat the man with the sprained ankle.

All corporations in Mexico pay taxes to IMSS, they are approximately 10% of payroll. But, because the care given by IMSS is so poor, most large corporations pay for a private major medical insurance for their employees in addition.

Amost all middle class citizens have their babies in private hospitals with private doctors, and go to private doctors when they are ill. If you are pregnant, and middle class, you will still need to go to IMSS which is required by law to grant a 90 day leave of absence from work. The leave is taken 45 days before the birth, and 45 days after. Even if you are able or willing to work, you cannot.

Medications are not supplied by IMSS, although they are prescribed. Blook is not provided, and must be purchased from the local blood bank.

It is not uncommon for employees to collect money from co-workers to help fund medical expenses, especially for lower income workers.

Furthermore, a person must be employeed to receive benefits from IMSS. A special program is available for unemployed people, but at a lower benefit level.

Many times ill employees need to miss work to go to IMSS for treatment, but they are turned away without an incapacity, even for the day they spent attempting to get treatment. In addition there is a transportation expense for the employee, as well as lost income for missing work. They may also have the absence counted as an unjustified absence on their attendance record. If the illness does not go away and the absenses mount, the employee may face disciplinary action by the employer. These types of problems have forced employers to reqrite their attendance policies to be more lenient in order to avoid having to discipline, or worse, terminate, an otherwise good employees.

While is it not completely clear what Congress in the US is proposing, there do appear to be many elements that are similar to IMSS. Is this what we want in the US healthcare system?

Editor’s Note: This article appeared in March 2010 issue of Freedom Today!. Their website is http://brownsville.rgvtp.com

This is one of the best we have seen in the past several days – HCR Timeline