Saturday, March 04, 2017

TeamHealth: Medicine's "Big Short"

Remember Bob Wachter, MD, America's Most Influential Physician Executive in 2015?

Remember how he played Elvis and sang "Your Hospitalist Song" at Mandalay Casino while serving on the board of  IPC The Hospitalist Company in 2014?

Remember how Dr Wachter pivoted to "love" as a quality measure in the New York Times after leaving the American Board of Internal Medicine (ABIM) and after he quietly earned $210,586 in income, stock, and options with IPC Hospitalist Company in 2014, a portion of which was shared with his institution?

Remember how IPC Hospitalist was being investigated by the DOJ for Medicare fraud?

Remember how IPC Hospitalist Company was acquired by TeamHealth for a hefty profit anyway?

The DOJ's investigation completed and TeamHealth had a $60M judgement levied against it.

I went to look what happened to TeamHealth's stock price at the time of that announcement, but was surprised to see that TeamHealth had disappeared from the New York Stock Exchange.

It seems TeamHealth had been purchased by The Blackstone Group and became a private company just before the judgement was handed down.

* poof *

IPC Hospitalist Company. TeamHealth. All gone. All forgotten.

Welcome to US Medicine's mini-version of "The Big Short."

-Wes

More here: http://fortune.com/2016/10/31/blackstone-teamhealth-merger/

17 comments:

Thank you very much! said...

To be long on MOC is to be short on love.

Anonymous said...

I looked at the SEC filings for Wachter's company IPC, the Hospitalist. The amount of money that executives and board made was gross. And a lot of their personal wealth depended on production bonuses paid in cash and shares of stock. The executives and Bob Wachter's "safety committees" trained and incentivised the hosptitalists to get the most productivity out of their day. The trouble was the amount billed could not possibly add up to the number of hours in a day.

Anonymous said...

Sounds like they shorted safety too.

Anonymous said...

One hand washes another Bob

Remembering San Antonio said...

This DOJ whistleblower lawsuit was neutered by a Chicago judge rendering its scope limited to seven states, which essentially suppressed a nationwide discovery process to find similar systematic up-coding by IPC hospitalists in other regions. The case did not investigate nor did it address any alleged harm to patients (increases in morbidity/death) caused by IPC during the seven year period in question. The court/DOJ avoided naming company executives and board members as well, which only encourages "poof politics" to reneder guilty executives harmless and interferes with the pursuit of justice for those harmed and those who still grieve for their loved ones lost.

"In February 2017, the company paid $60 million to settle the False Claims Act qui tam lawsuit in the Northern District of Illinois.The suit alleged that IPC encouraged and trained physicians in upcoding and utilized incentive compensation schemes linked to billing performance, which in some cases led to incentive compensation exceeding the physician's base salary.

In 2011, the company was the subject of an investigative report looking at the use of hospitalists in San Antonio area hospitals and at the death of a patient under an IPC physician's care. A 2013 article published by JAMA raised concerns about the quality of care provided by hospitalists with excessive workloads."

https://en.wikipedia.org/wiki/IPC_Healthcare

Ed Rico said...

And for the next financial coincidence, McKesson will merge their IT business with Blackstone Group-owned Change Healthcare to form a $3.4MM business with plan for IPO. These guys make Iowa-to-Pennsylvania cash laundering look like child's play.

Ed Rico said...

Sorry, the combined McKesson-Change Healthcare unit will have anticipated annual revenue of $3.4 BILLION.

What about the "digital doctor" and the NHS spending spree for EHR said...

Speaking of San Francisco . . . debt-strapped, outmaneuvered and needing a cash infusion

McKesson and Change Healthcare --formerly Emdeon--(WebMD) will merge seeking megabucks from the public (in an IPO) after blowing it in the UK markets

You (we)just need more time and money says Bob Wachter on UK's NHS EHR implementation plans
https://www.gov.uk/government/publications/using-information-technology-to-improve-the-nhs/making-it-work-harnessing-the-power-of-health-information-technology-to-improve-care-in-england

Change Healthcare
https://en.wikipedia.org/wiki/Change_Healthcare

Emdeon was formerly known as Web MD.
https://en.wikipedia.org/wiki/Emdeon

**US lawsuit against McKesson and HBOC executives for conspiracy to commit securities fraud
This balance sheet padding is similar to what Christine Cassel and Premier did to strengthen Cecity's balance sheet, except the contracts/payments from ABIM to Cecity were real (as far as we know)
https://www.justice.gov/archive/dag/cftf/chargingdocs/mckesson.pdf

**McKesson settles class action lawsuit for $960 million
http://www.nytimes.com/2005/01/13/business/mckesson-agrees-to-pay-960-million-in-fraud-suit.html?_r=0

Further references see Arthur Anderson, MCI and Enron scandals

Bob Wachter @ The Doctors Company said...

TDC BoD Grandfathered but "NOT PARTICIPATING IN MOC" @ The Doctors Company

Bob Wachter has teamed up with the largest "physician-owned" malpractice insurance corporation, "The Doctors Company". They do many diverse types of insurance as well and even bought out a "HOLDING COMPANY", along with other strategic acquisitions over a period of several years. https://en.wikipedia.org/wiki/The_Doctors_Company

What is Dr. Wachter doing hanging out with certified physicians who do not participate in MOC? Not one of the prestigious docs chooses to participate in MOC. Will Bob be the next to drop out of MOC? Or help the medical industry and payers to change the onerous MOC requirements and mandates? Or will the states do it first.

How much did Wachter get paid by the Doctor's Company for his "featured presentation" at their Executive Advisory Board meeting? And how much are they paying Wachter to make videos for them? https://www.youtube.com/watch?v=DyXMAFmLb0I

"Robert M. Wachter, MD, Chief of the Division of Hospital Medicine and Chair, Department of Medicine at University of California, San Francisco, and author of New York Times bestseller The Digital Doctor and a featured speaker at The Doctors Company’s 2016 Executive Advisory Board meeting, outlines the importance of EHR improvements in this video. The Executive Advisory Board meeting is a forum where dynamic thought leaders explore topics of importance to modern medical practices in the evolving healthcare environment. The Doctors Company is proud to present diverse viewpoints from world-renowned experts."

Here are Dr. Wachter's new friends who believe in voluntary participation in MOC and not forced maintenance of certification tied to employment and insurance. They unanimously choose to not participate in MOC and waste their time. The Doctors Company is in the insurance business, so does this mean the mandates will change once the word gets out that none of Wachter's MD business buddies TDC are meeting MOC.

Here is a list of the current board members. It is worth reading the prestigious backgrounds of each and institutions they have associated with. http://www.thedoctors.com/TDC/OurLeadership/leadership#11

Richard Anderson MD (NOT PARTICIPATING IN MOC)
http://www.abim.org/verify-physician/Anderson-Richard-d_sUWatnCno=.aspx

Charles Kossman MD (NOT PARTICIPATING IN MOC)
http://www.abim.org/verify-physician/Kossman-Charles-LMgYUxpvMxw=.aspx

David M Charles MD (NOT PARTICIPATING IN MOC)
https://www.abplasticsurgery.org/ModDefault?section=SurgeonSearch#searching

Re: William Joseph Gallagher, M.D. (NOT PARTICIPATING IN MOC)
According to the ABS: Not Meeting MOC Requirements

Re: Donald Jerome Palmisano, M.D. (NOT PARTICIPATING IN MOC)
Verified with the Americian Board of Surgery: Not Required to Participate in MOC

William C. Rupp, MD (NOT PARTICIPATING IN MOC)
http://www.abim.org/verify-physician/Rupp-William-EHJqQm8H_UA=.aspx

David B. Troxel, MD, (NOT PATICIPATING IN MOC)
(verified through ABMS for American Board of Pathology - clinical and atomic)

Ronald Wender, MD (NOT REQUIRED TO PARTICIPATE IN MOC)
http://directory.theaba.org/Searchdetail.aspx?id=35850065
(verified with ABA by phone)

ABMS MOC: Verifying the Real Value said...

The Founder of the American Board of Internal Medicine Foundation is not KEEPING UP!

Christine K Cassel, former CEO/President of the ABIM and ABIMF, does not participate in MOC.

Dr. Cassel, an ACP Master, is now the FOUNDING DEAN of the new Kaiser Permanente Medical School.

According to the ABMS Verification Service Christine Cassel is "certified" in internal medicine, but she is NOT KEEPING UP with MOC! "NOT PARTICIPATING IN MOC," they say!

If a clever DEAN and exemplar to the nation wiggles out of paying the ABMS MOC tax and does not do the onerous busywork, why shouldn't we just stop participating in MOC too?

A Conspiracy to Commit Fraud? said...

No thinking physician in the US (or anywhere in the world) believes that ABMS MOC has any merit or real educational value. But yet MOC is required by insurers and employers if you want to work. Why?

ABMS' Untold Story: Catching the ABIM's Lies As They Fly said...

We have caught the ABIM in a series of robust lies. We have learned of their financial obfuscation, etc. For example, it has been pointed out here about the secretive creation of the ABIM Foundation, its wrong date of registration, false place of domicile written repeatedly on IRS forms. We know of the pattern of lying about lobbying, and the list goes on--so many things falsely documented. Why?

Then ABIM/ABMS brought in, bought themselves a bona-fide felon, a dirty ex-cop to defend them. The felon moved up the rungs in the testing security industry after destroying companies and the lives of physicians with his felonious testimony. He even became a subject matter expert while he and the executives skimmed off the corporate teat.

Why would the ABIM need protection? Because they were cheaters scamming with their business partners in the quality assurance system.

It is clear that the ABIM executives were involved in money laundering and risky investment schemes. They were involved in the ABMS price fixing for certification and MOC that no one dares accuse them of, but what's worse the ABIM executives skimmed from the surfeit of cash they transferred to the ABIM Foundation. They did it then in 1989 and continue to skim cash from the ABIM Foundation--padding their paychecks, without regard for the appearances and brows that are raised from such audacious pecuniary transfers. They are only now coming into the light, but the status quo does not know how to respond to the discovery of impropriety and crime and the admission of such guilty parties within their elite ranks.

The misconduct was not sporadic, it was systematic and continuous. The money transfers spanned nearly two decades involving staggering amounts of money deposited in a totally hidden "Foundation" account. That is remarkable in itself, but the money went not into money market accounts, which had a high rate of return at the time, but straight into high-risk investment accounts, with some of the top Wall Street scammers of the time. Some of their peers went to prison for their crimes and paid huge fines. But others escaped prosecution. No one knows why some were prosecuted and others were not.

1838 Investment Advisers/Drexel, Burnham, Lambert (defunct brokerages) took their heavy management fee and trading commissions from the ABIM and ABIM Foundation accounts. Fast trades and easy money in the high-turnover accounts.

Or so the ABIM executives and board thought--that is, until the losses in the early 2000's gave ABIM mega-millions in cash painfully flying out the window. They must have panicked. How would they explain or hide this negligence and fiduciary irresponsibility and the skimming of cash from the public? NO SWEAT, THE TAX FILINGS WERE PROPRIETARY PROPERTY. Hopefully the IRS would not notice the falsely registered records of the ABIM Foundation. And then came a few thin publications from the Foundation, but not before the secret investments in proving MOCK science with an equally obscure scandalous ABIM Foundation spin-off of cash into psychometricians' pockets. It was another secret "Foundation piggy bank", this one called ICE.

The ABIM Foundation and ABIM investments were hemorrhaging due to the increases in negative trades. I mean their stock positions were eroding so fast they could not believe it. 1838 played the market like a stock jockey or Las Vegas casino junky--a drunkard in a losers downward spiral. 1838 was slow to respond like a deer in headlights. No 10% safety rule or stop-loss orders. They were way beyond that in percentages of losses and hoped the market would recover, but it did not recover in time for them and they went out of business.

If the ABIM were a publicly traded stock without a steady influx of physicians fees, so too would they have gone belly up. And they should have.

The ABIM's Official ABMS Handbook on Racketeering, Money Laundering and Extortion said...

Just the facts, Ma'am.

"Have you ever watched invested money pour out of your financial accounts like fine sand running through the gaping fingers of your hands." The ABIM lost big money in more than two investment accounts with the dot.com bubble. They watched the sand pouring through their fingers as the political and economic conditions changed at the beginning of the new millennium.

No one knows the facts. The ABIM gambled with physicians' money and lost big. There were no regulators stepping in to protect the public from these gambling drunkards at the ABIM, because they were and still are accountable to no one.

And why should the public trust them to be their safety net when they are guilty of such negligence and financial malfeasance. How can the public trust them when they cover it up. So they published things like "To Err is Human". Or they go to press with a couple of thin cover-up PR magazines, which hypothesized on the real nature of "professionalism". The main trouble with their manifesto was it was filled with disinformation--mostly about who the ABIM really was and what their aims were. They hid behind the mask of their own phony professionalism, which was little more than social and political agenda, and an attitude of entitlement and underlying plans of continuing to get rich off pliable and gullible physicians driving it all.

They put a mask on the truth to put it in the minds of the public that these elitist medical politicians in charge of the ABIM/ABMS and crony affiliates were the authors and analogue of professionalism. The true masters of ethics in the new millennium. If you only knew the real story behind the curtain, behind the props and changing scenes.

Pulling back the curtain to see the real ABIM

The truth is the ABIM executives transferred money like crazy to hide the losses in the dot.com crash. They even liquidated their nice pseudo-research ICE machine that could only turn out intellectual slush. How the CFO expensed it--all the mind-blowing losses--on the tax returns is a mystery to many. But most in the public do not even know of the big ABIM/ABMS physician heist, and we must tally in with that the theft of billions by the ABMS boards and how the misconduct and scamming continues.

The Floridian, Lynn Langdon and Harry Kimball's mess; then in walks Dr. Cassel. (Or was she always there? She was the mother of the ABIMF and the Floridian its father.)

The ABIM's CFO, Mr. Floridian, soon retired in 2004 after a great deal of money was lost in the headlights. He sold off almost everything from the previous decade in the portfolio to hide the tremendous losses with a decade of solid gains. Still the losses far overshadowed the gains, but were mitigated somewhat. All this was happening as 1838 Investment Advisers went belly up. But the owners/managers of 1838 kept their personal wealth; huge personal gains from their investors who lost big.
The ABIM's deer drove off psychologically limping, but with his and the other executives' pensions and investment accounts intact.

http://drwes.blogspot.com/2015/02/why-abim-foundation-wants-us-to-ignore.html

Anonymous said...

Don't you know? MOC is only for the "little people".
Christine "Leona Helmsley" Cassel.

Mindy said...

Do you mean the ABIM's "queen of mean" and the "Kaiser Medical Palace's" new founding "dean"?

If so, that would infer that Dr. Cassel and other ABMS executives abused their organizations' non-profit status and tax boons for growing personal wealth and gaining power by means of extortion and evading federal, state and local income taxes.

Flashbacks from just a few years ago.

Former "Queen of NQF" Chris Cassel caught with her pantsuit/skirt down over conflicts of interest and fraud in her organization. An important investigation by ProPublica and DOJ. Cassel has recently left the NQF to become founding dean of Kaiser Permanente's new medical school. KP was the source of contreversial payments to Cassel while working for the NQF. The DOJ imo did not go far enough or probe deeply enough into the entire quality assurance racket and how it operates. This needs to be done now.

https://www.propublica.org/article/payments-to-ceo-raise-new-conflicts-at-top-health-quality-group

NQF/TMI kickback artist Chuck Denham caught defrauding the government. Was he really acting alone? Or was it par for the course? Christine Cassel said Chuck Denham clearly lied by not speaking about his financial contracts to the committee (in an archival transcript) and relationships with hospital suppliers and their products/services did not get disclosed to the committee. Christine Cassel, Bob Wachter, Helen Darling, and Rich Baron's crony, Chuck, says he did nothing wrong. So quoth, the NQF safety committee chair, Chuck Denham who never had a chance to take the stand. Christine Cassel's policy advisor at the ABIM/NQF tried to make it all go away and Helen Darling refused to be interviewed. No one went to trial or testified. The investigation was shut down and isolated to one individual, one company. But the corruption was systemic and they knew it. Why did they settle for a 40 million dollar fine. Will someone in the DOJ pick up the trail and look at the evidence that got shelved.

https://www.propublica.org/article/hidden-financial-ties-rattle-top-health-quality-group
CMS and NQF


Federal money opens the door to investigate the entire quality assurance racket and how it operates. The cartel consists of many NGO like the ABMS, NQF, NCQA, etc. Federally supported NQF needs grants and stakeholder membership dues to survive. Executives outnumber staff and execs get a big chunk of the federal pie.

https://www.fbo.gov/index?s=opportunity&mode=form&tab=core&id=bf9a9aa4529a19bab87c7c2c09ce2c9f&_cview=0

Voluntary certification with volunteer officers and board. said...

What does non-pecuniary mean as stated in the ABIM's 1936 bylaws? The organization was intended to be offering a voluntary lifetime certificate and the board and officers had term limits and worked for free.

How far has the ABIM fallen from its intended purpose and 50-year mission.

Harry Kimball the President of the ABIM when he retired walked out the door with $1.26 million in 2004 with his annual compensation and deferred compensation combined. His deferred compensation was nearly $1 million. What was in his ABIM retirement accounts is a mystery.

CEO/President Christine Cassel's stand-alone deferred compensation was $1.7 million when she left in 2013. Her salary was over $.8 million. Ditto on her retirement account?

This is way beyond what the IRS calls self-inurement, it is gross violation of the meanings the ABIM founding physicians associated with voluntary service and non-pecuniary giving. Christine Cassel should give her compensation back to the failing ABIM. She was seldom there working anyway.

Who is going to restore the good name and mission of the ABIM if it is still possible? Or dissolve it as they wished from the start. Mission accomplished. Now it serves only a corrupt group of elite executives.

Singer of praises: Ignoring allegations of Medicare fraud for a fistful of money! said...

Most disturbing about Bob Wachter and the Department of Justice investigation. He clearly lied about what he knew and when he knew it. Bob let himself down more than a few times by not listening to that inner voice inside.

But what about Dr. Wachter's employer, the University of California. Didn't UCSF get money directly from IPC Health for administering Dr. Wachter's IPC Hospitalist training/fellowship program?

Was the whole relationship false. ICP was hiding behind the screen of a great university's name - a show to distract from the scandalous billing fraud and patient safety issues associated with pushing your hospitalists to the brink of exhaustion, so your share price can keep rising and get the executive bonuses. The SEC filings are damning, because the money is unbelievable that Adam Singer and his executives scores of millions they all walked away with. Bob Wachter seems like a water boy in comparison with his few hundred thousand dollars he cashed in and probably invested in something else. Dr. Wachter cheapened the name of academic physician by involving himself in their scam. He knew what he was doing.

Dr. Wachter has never once admonished Adam Singer for the Medicare fraud and what was really going on. Instead Wachter reinforced fraud and coverup in our society, eschewing the ideal of honest transactions/exchanges among human beings. I have a moral sense and so does Dr. Wacther. It is never that buried or too late that we cannot address publicly our mistakes. That seems to be something that is called for now. The silence is disturbing and they all knew about what was going on. I presume even UCSF.

It takes a lot of money to run a fellowship program. Didn't Wachter and his medical school essentially just take a bribe for keeping quiet. Wachter should have done the right thing and spoken out about the systematic pressure and incentives that created the fraudulent IPC nightmare? It puts a dark cloud over the hospitalist movement.

A lot of money was on the line and once again we see an ABIM chairman doing the wrong thing for patients. He went for the money rather than speaking out publicly in defense of the patient. It is no different than Thomas Brem stumping for big Tobacco. Both Brem and Wachter sold out to Wall Street. History keeps repeating itself at the ABIM. Is this the tradition they teach. To take money and defraud the public?

The silence is deafening. The issues will not go away. The fact that ABMS MOC is also a "high stakes" fraudulent 'up-billing' (a violation of code to do no harm). This truth will not go away. Nobody with a thought in their head will let the profession of medicine be sullied by the appetites of Wall Street or greedy medical boards that refuse to play fair ball. Or men and women who succumb to the lure of money and political rank.

It's all there in the DoJ's whistle-blower lawsuit. Adam Singer and Bob Wachter are both innovators and entrepreneurs. They are experts in digital healthcare technology. The novel tracking software that monitored/followed each of the several thousand IPC hospitialists was instantaneously relayed to the executives and team leaders. Dr. Wachter was fascinated in the innovative monitoring systems that Adam had in place. The lawsuit, which paints a vivid picture, may have gone away through the payment of 60 million dollars, but the truth of what they all knew and when they knew it was immediate.

Defrauding Medicare and Medicaid, as well as the TRICARE Program, the Federal Employee Health Benefits Program, and the Railroad Retirement Medicare Program.

https://www.justice.gov/usao-ndil/pr/us-files-lawsuit-against-ipc-hospitalist-company-alleges-overbilling-federal-health