Wednesday, June 22, 2016

ABIM's Bedfellows

Right now, the Center for Medicare and Medicaid Services (CMS) has a comment period that extends through 27 Jun 2016 regarding MACRA, the new payment scheme created by the health care industry, to pay physicians on the front line of health care. I encourage every physicians to voice their  opinion about this plan,

Before you do, however, I'd like to remind you of the recent indifference by the AMA regarding the House of Delegates overwhelming vote to end Maintenance of Certification last Monday.  Needless to say, there's a reason why.

Remember those conflicts of interest with Christine Cassel, MD, former President and CEO of the American Board of Internal Medicine (ABIM) and, later, the National Quality Forum, the ABIM, and ABMS?  Remember the huge splash the announcement of those conflicts had when her conflicts were disclosed by Propublica, and Dr. Cassel quickly relinquished her ties to Premier and Kaiser Health Plan and Hospitals? Remember how Christine Cassel, MD pocketed a cool $230,000 ($100,000 of which was in Premier securities) just before Premier, Inc purchased CECity for $400 million?

Here's the image on the front page of the CECity website:

(Click to enlarge)
Look at all of the friends of the ABIM who welcome CECity's services: Johns Hopkins Medicine, the American Osteopathic Association (AOA), Merck, the American Medical Association (AMA), Aetna, The American College of Physicians (ACP), Premier, the ABIM, NextGen, Athenahealth, and Optum. These are just a few of ABIM's corporate bedfellows. The AMA has no interest in what doctors really want or need.  The AMA has no interest in ethics or what's best for patients.

The AMA and the ABIM only have interest in what's best for the AMA and the ABIM.

This is why the ABIM wants physicians to do Maintenance of Certification and enter all their demographic and survey data into the ABIM's database. It has nothing to do with maintaining physician skills but has everything to do with medicine's new digital party.

This is why physicians must act collectively to stop the tax fraud, violations of research ethics, and abuse of our civil rights that has occurred at the ABIM and the ABMS. Because like it or not, you're paying to have your right to practice medicine independently corrupted by these organizations that stand to earn billions from your work while being simultaneously coerced into paying ABIM's fees.



Dr. Vinod Sharma said...

Thank you for sharing

Anonymous said...

Nothing coming out of those old AMA lords and barons surprise me any more. It's disgusting

A. Patel - The Voice is the Vote said...

That suggests the AMA delegates have no voting power - just manikins on display.

There are conundrums in every democracy. Democracy today in the USA is getting further and further away. But our voice and vote must count. In order to accomplish that, we must be insistent, consistent, and persistent.
The AMA state delegations are a prime example of the conundrum we face in America. The Pennsylvania Medical Society has the right approach after not being heard for two years. A strong message. A vote of no confidence. And their strong action is now their voice. The only way to get ABIM's attention is through adversarial action. The PA Medical Society has retained a law firm. This shows us just how serious the situation is. The AMA delegates must represent the physicians and themselves not corporate power or cronyism.

The ABIM (ABMS) is not listening, because they are ignoring an orderly transition for "ending all mandatory MOC", immediately. That is the clear message from the delegates. Let's see how much real influence the people have in deciding who are voting in our democratic society. I vote to end mandatory MOC immediately. That means no ties to employment or insurers.

"What's the difference between a democracy and a dictatorship? In a democracy you vote first and take orders later. In a dictatorship you don't have to waste your time voting." - Charles Bukowski

The voiceless AMA delegates should heed the words of Franklin Delano Roosevelt.

"Nobody will ever deprive the American people of the right to vote except the American people themselves - and the only way they could do this is by not voting."

"Every citizen of this country should be guaranteed that their vote matters, that their vote is counted, and that in the voting booth, their vote has a much weight as that of any CEO, any member of Congress, or any President." - Barbara Boxer

"As a citizen, you need to know how to be a part of it, how to express yourself - and not just by voting." - Sandra Day O'Connor

Madhu said...

Circle of Money

Wes, that's what happens when you put Wall Street in charge of CMS. Acting head of CMS Andy Slavitt represents some conflicts of interest and got an unprecedented huge tax boon when he was given the position. Slavitt worked as CEO for Optum. (CECITY PARTNER) United Health is Slavitt's Company. Word on the street is that when Slavitt was put in charge of CMS United Health virtually bought out the CMS.

"Slavitt, who we’ve written about before, formerly served as group executive vice president at UnitedHealth’s Optum and was CEO of OptumInsight, Optum’s health information technology division. Don’t forget that it was Ingenix that became OptumInsight. Our article on Optum put the Ingenix fraud into perspective with Governor Andrew Cuomo, then New York’s Attorney General, describing Ingenix and UnitedHealth’s use of data as 'deception, manipulation of data and outright fraud.'"

Full disclosure: the AMA and ACP are the original parent "companies" of the ABIM. The AMA and ACP are the mother and father of the ABMS. NextGen is an affiliate of United Health--Slavitt's company. And on and on. It's a Wall Street digital party and ABIM's Christine Cassel, Rich Baron, and Bob Wachter are in on the digital info-flow party. Their are all lying at the poolside sipping drinks. Wachter even took Wall Street and the AMA with him to London to advise the UK National Health Service on how we could collaborate -- not much to do with technical knowledge, which Wachter has precious too little of.

Bob Wachter wrote the Digital Doctor and this was heavily subsidized and publicized by his publisher McGraw Hill--the test publishing giant. It goes full circle back to the power of the testing industry and how certification/recertification plays into the control and the cash flow. Bob's publisher also is active in influencing Wall Street via S&P Global, Formerly called McGraw Hill Financial.

Connection to the family of George W. Bush

The McGraws and the George W. Bush/George H. W. Bush family have close ties dating back several generations. According to McGraw-Hill, Barbara Bush is a member of its advisory board.[35] The California Test Bureau division has provided testing material integral to No Child Left Behind, a George W. Bush initiative.

No Child Left Behind has led to a great deal of revenue for the testing/security industry, which ABIM and the ABMS (all physicians globally) are a big part of.
Think Atlanta teachers and prison time. Think Caveon, forensic testing security industry. Think ABIM/Mannes/Kryterion/ABMS/Chris Cassel/Robert Wachter/Dr. Arora/Sarah von Muller/Salas-Rushford.
Laws are passed lobbyists. Publishing giants in testing make a great deal of money. Lives are stressed or destroyed for Wall Street greed. Think Andy Slavitt--head of the CMS. Who loses and suffers?

Georgia drops No Child Left Behind. "It is not the teachers who are at fault it is the corrupt educational system." All for money? Absolutely. Physicians are cash cows and political pawns - milked and played.

Sandeep Pandey said...

Seems like its going to add a lot of work for physician office to enter all those performance measures. Excerpt below from the proposed regulations.

Within each performance category, we propose some specific standards, including:
Quality: For most MIPS eligible clinicians, we propose to include a minimum of six measures with at least one cross-cutting measure (for patient-facing MIPS eligible clinicians) and an outcome measure if available; if an outcome measure is not available, then the eligible clinician would report one other high priority measure (appropriate use, patient safety, efficiency, patient experience, and care coordination measures) in lieu of an outcome measure. MIPS eligible clinicians can meet this criterion by selecting measures either individually or from a specialty-specific measure set.
Resource Use: Continuation of two measures from the VM: Total per costs capita for all attributed beneficiaries and Medicare Spending per Beneficiaries (MSPB) with minor technical adjustments. In addition, episode-based measures, as applicable to the MIPS eligible clinician.
CPIA: We generally encourage but are not requiring a minimum number of CPIAs.
Advancing Care Information: Assessment based on advancing care information measures and objectives."

Anonymous said...

Who is in charge at the ABIM? Really! Does Baron even work there anymore?
Or has he and many others decided to quietly exit with parachute in hand, like Wachter, Cassel, Holmboe and Langdon. Who is 'manning the walls' protecting the public?

Anonymous said...

In the most recent 990 tax filing the ABIM gave $1,260,000 to Cecity for services listed on page 8 (ABIM 2015).

Anonymous said...

Dr. Baron, you have the right to remain silent...but not forever.

Anonymous said...

What's next in the digital party that the ABIM Gestapo has in store for us?
The felon Mannes, ABIM's director of investigations has been the managing director for Caveon, which spies on kids online and sends teachers to prison--just for the money they make when they have a contract out on you. Caveon's CEO David Foster has been pushing his products at the ABMS for years and the fact that Mannes works for David Foster proves to be egregiously conflicted when we discovered that Kryterion is on the short list for the next generation MOC party. You will be offered something in place of 10-year MOC that is even worse and more onerous and more in violation of civil liberties and privacy because it is called online proctored testing--you pay for their K'COPS to come to take control of your computer and monitor you while you due your annual testing.

And it is not for free! It all comes with a hefty price tag. Money and loss of privacy, self-determination, and civil liberties are part of the fee. Big brother is what is in the pipeline for physicians. Unless physicians end MOC now it may be too late later--after the next election there may be no choice. Already Christine Cassel, who hired Ariel Benjamin Mannes to do her political dirty work at phycians expense, is working behind the scenes in Washington to make life and MOC even more onerous for physicians.

If you recall Cassel just gave up her day job at the NQF to work for Kaiser Permanente. NQF has government oversight whereas working for Kaiser does not. Cassel, no longer burdened with MOC requirements herself, is working behind the curtains in Washington using folks like Mannes to bring about further erosion of civil liberties and privacy and the right to choose for physicians. The beat and pulse of coi goes on for Cassel. She just found a different funding source with more freedom to move about. Cassel is a political leech. She has sucked money and blood out of physicians for years. Cassel, Baron and the corporate cronies are saboteurs of the healthcare system just to increase corporate bottom lines.

So if physicians don't get legislation in their favor in all fifty states to end mandatory MOC the end is near and the controlling mechanism of MOC will make it more an more difficult to extract oneself from it and the ruling fist of the ABMS.

Physicians will have Caveon/Kryterion online MOC tests with identity check and K'COPS (KCPs or E-COPS). Pledges with increasing liability that will put physicians in civil and criminal court. Physicians will go to jail--the ultimate fear mechanism of the ABMS Gestapo.

Every physician must make their voice heard. No more mandatory MOC. Not in my home or office? Not anywhere. No thanks. I will not submit to this kind of financial hooliganism and privacy abuse from any medical board. No more!

The ABIM and ABMS has gone way too far too many times. Nobody can trust any of their egregiously conflicted executives or alleged "fraudulent" partners.
Baron is all about the money. Cassel is all about the money. Wachter is all about the money. Cassel and Baron put their man Rich in place to keep control of physicians and control over the direction of healthcare. They do it through the ABMS, which one cannot leave ever. Just try to do it.