Blessings in disguise

Blessings in disguise

To the anti-gay peeps, don’t disappear for you played your part brilliantly, the victory was not yours but at least you forced many to stand up for their rights and to proud to be who they are.

 

This has been an interesting week for me, turns out it is all about standing for equality:

 Monday I was with a group after work discussing creating a work environment that will give minorities an equal playing field to get to the top.

Tuesday, I was working on ideas to help people develop their leadership skill which should help them get to the top at their respective careers

Wednesday I was in the audience where panelists spoke about their experiences being gay.  Also on Wednesday I went to our company meeting where ideas were zipping through my head regarding getting services to people who can’t otherwise afford it, and about getting congress to give CMS and FDA the authority to negotiate for cheap drug prices.

Thursday – It was about being clear of what I want to accomplish professional and what I need to do to get their especially as a women courtesy of Women in Health Management and Cheryl Ellis (guest speaker)

Friday- I feel joy and happiness. I also learn the hard time we go through can turn into a blessing in disguise especially when we stay grounded and true to ourselves and our path.

 

US. Supreme court ruling. I love Justice Kennedy's reason for his vote: https://www.yahoo.com/politics/supreme-court-affirms-right-to-gay-marriage-122495807066.html

 

#scotus #women #career #equality

Recording breaking Medicare Fraud takedown

From HHS NEWS BULLETIN: http://www.hhs.gov/news/press/2015pres/06/20150618a.html

 

243 individuals have been charged in the largest health care fraud takedown in history, for billing Medicare for unnecessary services and equipments to the tune of $712 million. The charges were handed out to some Doctors, Nurses, Patient Recruiters, Home Healthcare Providers and Pharmacy Owners for health care fraud-related crime including the following:

·         Conspiracy to commit health care fraud

·         Violations of the anti-kickback statues

·         Money laundering

·         And aggravated identity theft

For access to beneficiaries’ information, cash kickbacks were to patient recruiters, Medicare beneficiaries and other co-conspirators.  

 

 

 

*** Bravo to the 17 districts Medicare Strike Force that carried out this operation. According to the report, since 2007 the strike force have charged over 2,300 defendants who have collectively billed Medicare fraudulently for more than $2.5 billion.

 

Personal Branding in progress

Now that the move to NYC is over,  and I have signed a year lease.. It is time to review my life plans and first on the list is my career.
I went to a Professional branding seminar at work courtesy of one my organization's employee resource network, where I seat on the steering-committee and I learned a great deal.

Couple takeaways from the seminar that I want to implement are managing my social and professional brand and having professional purpose.

As of today, I have created the new summary below for my professional pages.

"Moriyina has spent more than 15 years working in the healthcare industry. She started out in various roles in patient care including patient sitter, rehabilitation aide, and nursing aide.  After completing her B.S. in Chemistry at Western Michigan University, she worked as a Research Scientist doing drug discovery research at AMRI Global, in Albany, NY.  She then obtained a MBA in Healthcare Management from Union Graduate College and subsequently worked as an Operations Analyst and Manager for a firm in Albany, NY, that provides strategic cost containment solutions to commercial healthcare programs and government agencies.

She then joined MSKCC in 2014 and is currently a Budget Associate in the Department of Medicine.

 Ms. Cole is a member of two professional organizations, Women in Health Management (WHM), where she serves on the program committee, and American College of Healthcare Executives (ACHE).  She is member two employee resource networks here at MSK; BLAM (Black, Latino, Asia, Mixed) where she serves as an ambassador and MHM (MSK Women on the move), where is serves in the steering committee. "

 

Stay tuned. Next on the list is my professional purpose...

A successful relocation

After four years, my things are out of storage from my last permanent residence, Albany, NY, though part of me remained in the form of my friendships,  and my kitchen things and car at the Beauregard. Woohoo, NYC is a now my permanent home.

 The move went better than expected even with the rain on the Sunday while loading my stuff from the Queens apartment and the unloading the next day in Manhattan. I took the rain as a help from God, washing away the debris and bad energy of the past.

I drove the truck myself and the only part I did not like was driving around looking for parking when I got to Manhattan.. The next moves.. will be done by MOVERS. Oh yeah, moving to a 5 floor walk up is not scary as it sounds. Thank you God!! Thank you to the Movers and My friends that help load and secure.

Link to Yina's world blog.. Two blogs become one.

http://inyinasworld.blogspot.com/

Managing my career

Being back in the professional arena feels wonderful, being part of an organization whose mission, vision and goals I can help bring to fruition is a career dream come true. As a work to finish each tasks, I am also taking step to enhance my career.
My plan for this year calls for me to focus on three things: Building my professional skills including communication and analysis; Networking internally and externally as a way to stay inform; Considering every opportunity that comes my way; Reading to keep up with industry trends and to be inspired.

The 3 R's for insurers

When I hear about catastrophic medical costs and the difficulty with finding employment (this I can testify to) I am glad provisions like the '3 Rs' exists in the Affordable care act.

Here is an article on the '3 Rs' by Kaiser's Mary Agnes Carey. It is an informative read.

First reponder suffers PTSD mentioned CNN outfront

I just twitter CNN that people handle traumatic events different and there must be help available for those who need it.. Outfront was reporting on a story about one of the office who responded to the sandy hook massacre, not getting long term cover for his PTSD.. This world need to take a close look at how mental health issues are handled, all the latest shootings in the state have been done by people with some kind of mental health issue..

In New York State, parent can keep offspring up to age 30 on their health plan

I just found out something interesting today and I wondered how many people in New York State knows about this.  This article about Emblem Health agreeing to reinstate coverage of enrollee's offspring mentioned that in NY state insurer are required to offer continuous coverage to children of enrollee up to the age of 30.

I think this is great for the same conditions the article highlighted, plus it is difficult  economically for many people today especially those starting out; This is leading many to take the chance that they will not become sick and spend their money (that is they have any, or if there is any leftover after paying bills and debt) on what is actually needed instead of health insurance premium.

Great start for access to mental health services.

According to PBS news, Vice president Biden has announced a $100 million Mental Health Services plan. I am excited for this and very curious to see how this is implemented.

http://www.pbs.org/newshour/rundown/2013/12/vp-biden-announces-100-million-mental-health-services-plan.html

Schedule

Increased and better behavioral health service is a must.

After the Sandy Hook Shooting I wrote this in my personal blog: "This latest mass shooting should be taken as a wake up call, to remind us that we are in this world together. Today, a woman was killed by her one of her sons who then went on to kill the kids  she taught. As the nation focus on gun control and people hug their kids tighter, we must not forget the kids or adults  that are struggling and lost . We must get to them before they hurt others and themselves."- http://inyinasworld.blogspot.com/2012/12/another-mass-shooting.html

Through out this year I have noticed that most of the suspects in the shootings  covered by the national media have been reported to have mental health issues. As I wrote last year, these incidents must be viewed as a wake up call to us to exam the entire behavioral health system from diagnosis to treatment and after treatment support.

Today, I was happy to see in this article  from CMS summarizing a study they did that found that there is an increased need for behavioral health in the Medicaid population in the six States involved in the study. I hope this issue will be investigated by the other States and something can be done to improve the system.

http://www.latimes.com/news/local/la-me-clinic-mental-health-20130610,0,7272329,full.story

The financial loses associated with hospital acquired infections are forcing hospitals to find ways to increase the hand washing rates of its providers. According to the New York Times, video monitoring, hand washing coaches, radio-frequency chips, are being used to get providers to wash their hands. Rewards are giving to those that comply and  warnings are giving to those that do not. In one of the hospital when the provides knew they were being monitored, the rate of hand washing increased by 88 percent.

here.

The Obama Administration considers giving Home Health care aides a better wage

If this goes through it will be welcomed with much jubilation by all those who will benefit as the Home Health care aides jobs is one of the toughest out there; it much demands strength, patience, empathy, compassion, skill.  So much is demanded from those in this field and the wages they get in return in most cases is not a livable wage. Most of the people I know in this field work 12 hour days because of the low wages and have a second job to earn enough money to make ends meet.

Please read the article about the new proposal here.

A new study finds that emergency department of For profit out performs non-profit in treating certain occurances

Read the summary of the study here.
http://www.news-medical.net/news/20130402/New-study-finds-for-profit-hospitals-outscore-other-hospitals-on-performance-measures.aspx

Getting people to enroll in the Federally funded Health Exchange

On October 1st of this year, the federally funded health exchange will start accepting applicants and concerns are already being raised regarding getting enough people to enroll to make the program successful and financially viable.. In an article in Kaiser Health news today, several points were mentioned as potential barrier to getting consumers enroll.

One of  the barrier includes money as the states and federal government will need to find ways to get the word as to those eligible for the program as many are not aware of the program. Several state are forming partnerships with nonprofit community groups to help get the work out.  The law does provide funds to the state to help enroll consumers but in case where a State have opted out, it will be the responsibility of the federal government to set up exchanges in the State and to get the message out.

Another barrier is getting people who are healthy to enroll as most people want insurance when they are sick not healthy. This program is counting on the premium of the healthy people to help offset the cost of ensuring the sick and also to help keep premium cost affordable..

Read the full article here

Interesting tidbit about the Medical Loss Ratio regulations

The Medical Loss Ratio (MLR) regulations which is part of the affordable care act, states that insurer must spend 80 to 85 percent of premium on medical claims and quality improvement initiatives, and that if they spend less the money should be returned to premium holders as rebate. What I find interesting about this is the quality improvement piece as I did not know this what part of the law. Though insurers are not required to report  the type of quality measures taken, they must report the amount of money spent on the following initiatives: reducing re-admission, reducing medical errors, patient safety improvement, increase wellness and promotions.
The Common Wealth fund, has published a report that looks at the median amount insurers spent on quality improvement initiative and MLR,  they found  that insurers spent less than one percent of premium on MLR or quality improvement activities.The study found that the amount spent on quality initiatives and paid out as rebate depends on corporate structure. They found  that provider-sponsored insurers spent more on quality improvement measures and paid out less rebate on average  than  non-provider-sponsored insurer, non-profit provider spent more on quality initiatives and paid out less rebate than for profit and publicly traded company also spent more on quality initiatives and paid out less rebate than non-publicly traded company
In 2011 according to the study, insurers spend 11 percent on Administrative cost, 3.9 percent on operating profits, 0.7 percent on quality improvement initiatives, 84 percent on medical expenses and 0.5 percent on rebate.

Please read the Study  here: The Common Wealth Fund.

Planned Parenthood received record support from Tax payers

Good job tax payers. If the opposition to Plan Parenthood knows about fractions and percentages, they will realized the majority of it services is not for abortion.
Via Kaiser news: http://www.kaiserhealthnews.org/Daily-Reports/2013/January/09/cap-hill-watch.aspx

HHS letter to healthcare providers regarding billing fraud

 Recently the Obama administration sent a letter warning the hospital industry that committing billing fraud is illegal. The letter was sent out because the administration had indications that some providers are using Electronic Health Record (EHR) to game the system.

Read the letter http://www.nytimes.com/interactive/2012/09/25/business/25medicare-doc.html?smid=li-share.

A shot of optimism for this job seek

Healthcare finance news posted this article below on twitter, that gave this job seeker a shot full of optimism for her future in the healthcare industry.  I am grateful for this, as this job hunting has been going on for far too long. But I know it will be over soon, I feel like I am ready now and I have so much to bring to the table. Perseverance is the name of this game.

http://www.healthcarefinancenews.com/news/healthcare-employees-concerned-about-economy-not-employability