Advisor role in exchanges causes clash | LifeHealthPro

Advisor role in exchanges causes clash | LifeHealthPro.


Impaired Drunk Driving Enforcement

Impaired enforcement

By Editorial Board, Washington Post, Published: May 11

OFFICIALS IN the administration of D.C. Mayor Vincent C. Gray are quick to point out that the issues with faulty equipment used in arresting suspected drunk drivers surfaced during the prior administration. But that was two years ago. It’s a bit unsettling that the city is still without breath-test machines. Surely it shouldn’t be that hard to get equipment that is a standard tool for law enforcement everywhere.

This week the District announced settlement agreements in cases of drivers who challenged their drunken-driving convictions because of unreliable, and in some cases false, test results. The Post’s Mary Pat Flaherty reported that the city will pay a total of $20,000 plus attorneys’ fees to four drivers; 16 similar cases are pending. Failure to calibrate and regularly check the equipment resulted in a driver’s blood-alcohol level being reported as higher than it actually was in cases that stretched back to 2008.

It’s good that D.C. Attorney General Irvin B. Nathan is working to clear up these lawsuits, but why hasn’t more progress been made in replacing the equipment? Officials said they first thought they could resolve the problems with new machines, but a panel of outside experts said last fall that an overhaul of the program was needed. There also seems to have been somewhat of a standoff between the Metropolitan Police Department and the Office of the Chief Medical Examiner in how to best approach the issue, but that has been resolved. Now the city hopes to phase in new equipment in July or August.

Officials assured us that the city has not slacked off its pursuit and prosecutions of impaired drivers, using roadside observations and urinalysis results. Arrests of impaired drivers this year as of April 30 totaled 435, compared with 431 for the same time period in 2011 and 447 in 2010. So serious is the administration about this issue that Mr. Nathan told us it would soon introduce legislation that will update the laws on drunken driving to include tougher requirements and increased penalties. We hope the city soon has the appropriate technology and procedures to match.

Scaffold Industry Insurance Company Risk Retention Group, Inc., Placed in Liquidation

This notice and proof of claim were released by DC DISB last week. See details at the links below.

May 1, 2012
Scaffold Industry Insurance Company Risk Retention Group, Inc., Placed in Liquidation
Cover Letter* | Proof of Claim Form*

Kevin Wrege, Esq.

Founder & President

Pulse Issues & Advocacy LLC

Office: 202-625-1787

Mobile: 202-253-4929

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

GEICO: Choosing to Break Up Monotony With Variety

March 15, 2012

Choosing to Break Up Monotony With Variety


HE is traveling “from sea to shining sea,” he declares, at a prodigious pace, visiting states with lots of electoral votes like California, New York and Texas as well as states with just a few like Nevada. And what he calls his “journey of epic proportions” is the subject of advertising worth tens of millions of dollars, on television and radio and on social media like Facebook and YouTube.

But no, he is not running for president. For one thing, his accent suggests he is not a natural-born American citizen. For another, he is not even human.

The “he” in question is the Geico gecko brand character, who is appearing in a campaign devised around a . The campaign is joining at least five others that are currently promoting the insurance sold by the Geico Corporation, part of Berkshire Hathaway.

Geico likes to run several types of campaigns at the same time, each with a different theme. Its approach has inspired other insurers — among them Allstate, Progressive and State Farm — to pursue a similar strategy.

“We do have more than one arrow in the quiver, that’s for sure,” said Ted Ward, vice president and chief marketing officer at Geico.

“The common thread is the little green guy is ever-present in the mix,” he added, as the Geico “brand ambassador.”

The intent of the multiple campaigns is “trying to keep things fresh for the consumer,” Mr. Ward said.

“We do some research,” he added, which finds that “people have some likes and dislikes” among the campaigns.

In addition to the gecko’s journey, they now include commercials that carry the theme “There’s an easier way to save”; ads that depict the Geico cavemen characters playing golf and tennis; commercials featuring an anthropomorphic pig that likes car, zip line and street luge rides; straightforward ads for motorcycle insurance; and magazine ads, tailored to the publications in which they appear, meant to remind readers that “it only takes 15 minutes to see how much you could save with Geico.”

Each campaign “has a purpose,” Mr. Ward said. “As long as each accomplishes its purpose, we’re comfortable with running more than one at a time.”

“And we have some more coming,” he added.

The variety of campaigns is a tactic intended to offset fatigue that may set in among consumers who encounter the enormous amount of Geico ads that fill traditional and new media.

Geico spent $772.5 million on advertising last year, according to the Kantar Media unit of WPP, up 3.8 percent from the $743.9 million spent in 2010 and up 25.2 percent from the $617 million spent in 2009.

“The Gecko’s Journey Across America,” as the peripatetic campaign is called, began in the fall and is to continue for a year. The starting point in the initial commercial was the Geico headquarters in Chevy Chase, Md., a Washington suburb, and the final commercial will be set in Washington, Mr. Ward said.

The campaign stemmed from discussions between Mr. Ward and the creative team at the Martin Agency, the longtime Geico agency, that were inspired, he said, by a bit of gecko biography: he had never been “on the road” because he is always “behind the desk.”

After leaving the parking lot of the Geico headquarters, the gecko’s next stop on video was the , followed by , and, most recently, . There are also “Gecko Cam” video clips appearing on YouTube, such as one in which the lizard meets in Times Square.

The trip can also be followed on Facebook, at, where there are videos, photographs and comments, and on Twitter, where the gecko’s feed includes remarks like this: “I felt guilty today because I haven’t visited the gym in ages. Then I remembered, ‘Oh yes, I’m walking across the entirety of America.’ ”

(If he walked on four legs rather than two, perhaps he could lose twice the weight.)

“As if he were an actual person traveling across the country, he posts everything he does,” said Anne Marie Hite, a creative director and copywriter at Martin in Richmond, Va., part of the Interpublic Group of Companies.

Although the journey’s timing with a presidential election year is a coincidence, she said, her partner on the campaign, Adam Stockton, a senior art director at Martin, said it does provide “a unique point of view of America.”

And “as most tourists experience, he may get into a little bit of trouble,” Mr. Stockton said. Indeed, the Las Vegas spot evokes “The Hangover” with the tiger and Mike Tyson from the movie replaced by a kangaroo and Richard Simmons.

Unlike the travelers in a current , the gecko has so far not had to ask Siri for directions to “the best barbecue in Kansas City” or Santa Cruz, Calif.

“We’ll have to do that” in a future spot, Ms. Hite, said, laughing.

Ms. Hite and Mr. Stockton praised the work on the campaign by the Framestore New York unit of Framestore, a visual effects company that, he said, “integrated the gecko into the environments” faithfully enough that “he doesn’t look composited.”

Ms. Hite noted how, in the commercial set on the Brooklyn Bridge, the gecko “interacts with the cracks as he walks across” and even, at one point, “stumbles a bit.”

But not too much. After all, restaurants in Brooklyn are far more likely to serve gizzard than lizard.

CareFirst to give $8.5 million in grants to safety-net clinics

CareFirst to give $8.5 million in grants to safety-net clinics
By Lena H. Sun, Washington Post, February 28

CareFirst BlueCross Blue­Shield, the largest private insurer in the Washington region, plans to announce Tuesday that it will give $8.5 million to a dozen safety-net clinics to help them use a coordinated primary-care approach to treat their most vulnerable patients, executives said.

Over the next three years, the funded programs are expected to treat as many as 66,000 patients with costly chronic illnesses such as diabetes, heart disease and high blood pressure. The clinics are in Maryland, Virginia and the District.

The initiative expands on an approach known as the patient-centered medical home, which is being tested in dozens of public and private experiments across the country as part of the health-care overhaul. Federal policymakers are watching closely to see whether the strategy can improve care and reduce costs.

Instead of doctors waiting to see patients mostly when they have a specific problem, a team of doctors, nurses and other staff members aims to take care of the whole person on a continuing basis, with an emphasis on prevention and comprehensive care, often targeting the sickest patients. The strategy is expected to translate into better care and fewer emergency visits, hospital stays and trips to specialists, clinic officials said.

Many of the experiments are taking place in privately insured networks. CareFirst, with 3.4 million members, has been conducting one of the largest of its kind in the Washington area since January 2011. About 3,100 doctors, or 81 percent of the region’s actively practicing primary-care physicians, are participating in the program, according to Chet Burrell, CareFirst’s chief executive.

The program uses a team approach and relies on a host of financial incentives to encourage doctors to increase the emphasis on helping their sickest patients. Doctors who join the program receive a 12 percent increase in their insurance reimbursements, $200 for each detailed care plan they set up for a patient, and additional fees for improving quality and reducing overall cost.

In the initiative to be announced Tuesday, CareFirst will provide grants to the safety-net clinics to jump-start their own programs. CareFirst will also give technical support and guidance on electronic health record systems, clinic officials said.

Clinics were asked to submit proposals and were chosen based on how well they could coordinate care for the most needy patients.

“We’re not paying for the care, we’re paying for the coordination,” Burrell said.

One of the recipients is the Arlington Free Clinic, which provides free health care to about 1,600 low-income, uninsured residents. The clinic will receive about $350,000 over three years, roughly a third of the total cost of the program, said Nancy Sanger Palleson, the clinic’s chief executive.

The clinic will use the money to hire additional personnel and upgrade electronic medical records to allow the staff to better track the care of “the sickest of the sick” — about 160 people — she said.

For example, medical assistants could make sure the necessary bloodwork is completed before a patient’s appointment with a specialist, Palleson said. “Otherwise it would be a wasted trip for her and for the physician, who could be seeing someone else.”

With 140 affiliated doctors providing their services free, she said, “the more efficiently we can use them, the more people we will be able to see down the road.”

And the need appears to be growing. The clinic takes new patients through a monthly lottery system. Typically, about 120 show up for the lottery, and the clinic takes 25 of them, Palleson said — but last week, for the first time, 220 people showed up. “We could only take 25,” she said.

The other clinics include Mary’s Center and Unity Health Care in the District, the Spanish Catholic Center in D.C. and Maryland, and Community Clinic Inc. and partner Greater Baden Medical Services in Montgomery County and Prince George’s County.

Experts say the key will be whether the clinics can sustain the programs over time. “The kind of people who have complex medical problems as well as social and economic issues might be the people who would benefit most by this kind of initiative,” said Judy Feder, a health-care expert at the Urban Institute.

Those patients are most likely to “fall prey to the inappropriate use of health care, whether on the back end with preventable high-cost hospital admissions or on the front end with insufficient primary care,” she said.

Leveling the playing field will be even more important in the run-up to 2014, when primary-care doctors will be in greater demand as insurance coverage expands to millions more Americans, experts said.

Maryland hospitals to share patient data

Maryland hospitals to share patient data

By Lena H. Sun, Washington Post, Published: February 16

Maryland’s 46 acute-care hospitals will soon be able to share basic patient information among themselves and with credentialed doctors, a key step that health officials and clinicians say will improve patient care and cut costs.

The development, announced at a news conference Friday at Holy Cross Hospital in Silver Spring, is being led by the Maryland’s health information exchange, a statewide system that is working to promote the secure electronic sharing of health information among approved doctors’ offices, hospitals and other health organizations.

Maryland officials have been among the most aggressive in pushing for the sharing of health information, an important piece of the federal health-care overhaul. Patients have long been frustrated by the inability of doctors at one facility to access records about a visit to another hospital. But changing the process has been slow for a variety of reasons, including reluctance by hospitals and others to exchange information with competitors.

The goal is to “help ensure that providers have the right information about the right patient at the right time so we can reduce costs and improve care for all Marylanders,” Lt. Gov. Anthony G. Brown (D) said in a statement.

The level of data available for sharing is rolling out in stages.

All of Maryland’s acute-care hospitals are providing basic patient demographic information in real time to the exchange. But it will be 18 to 24 months before the hospitals’ users are fully trained to use the shared data. This includes when any patient in the state is admitted, discharged or transferred, officials said.

Eventually, all hospitals would share much more detailed clinical data, such as lab reports, radiology reports (but not images), and clinical documents such as hospital discharge summaries and specialist reports, said Scott Afzal, who heads the arm of the nonprofit Chesapeake Regional Information System for Our Patients (CRISP) that is in charge of running the state’s health information exchange.

Four of the five hospitals in Montgomery County already provide the most detailed clinical data to the exchange. But only two — Suburban and Holy Cross — have received the extensive training to allow their users to access patient data from other hospitals, he said.

At Suburban, emergency room doctors say the additional information has allowed doctors to improve care.

In an interview posted on the CRISP Web site, Barton Leonard, who heads Suburban’s emergency department, said doctors can even access the operation notes from a surgery that took place two hours earlier.

“No more waiting on faxes or sitting on the phone waiting to talk to someone in medical records,” Leonard said.

In one case in December, Leonard said he was treating a patient with a severe infection and was able to look up his previous blood and urine cultures at another hospital and quickly get him on the right antibiotic.

Efforts in the District and Northern Virginia have lagged farther behind that of Maryland. In the District, an effort to create a health information exchange by the D.C. Primary Care Association, a private group, was suspended because of a lack of funding. The District government is working to create another exchange. In Northern Virginia, a coordinating organization exists, but an exchange has not been set up.

Kevin Wrege, Esq.

Founder & President

Pulse Issues & Advocacy LLC

Office: 202-625-1787

Mobile: 202-253-4929

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

United Medical Center seeks $15 million from the D.C. government

United Medical Center seeks $15 million from the D.C. government

By Tim Craig, Washington Post, Thursday, February 16, 8:47 PM

United Medical Center is requesting an additional $15 million from D.C. taxpayers to help finance a turnaround, likely renewing debate about whether the city should own a cash-starved hospital.

After its previous owners defaulted on its obligations to the city, the District took over the Ward 8 hospital in December 2010 until a new operator could be found. But the city government is divided over whether the city should try to quickly unload the hospital to a private buyer or keep it to try to bolster its quality — and its price tag.

With the latter camp prevailing so far, the hospital’s board of directors wrote Mayor Vincent C. Gray (D), requesting additional funds to help United Medical rebrand its mission by shifting to “ambulatory and physician-centric care.’’ The hospital, formerly known as Greater Southeast Medical Center, specializes in traditional acute care.

The board is asking the District for an additional $9 million in direct funding, as well as to forgive a $6 million loan. The board will also seek $5 million in federal funds.

“The Board, hospital management, and [the Office of the Chief Financial Officer] leadership met to collaboratively determine the financial support needed to maintain hospital operations and fund the restructuring effort,” wrote Bishop C. Matthews Hudson, chairman of the board. “We came to a consensus that $15 million will be required.”

Gray said in a statement that he would “carefully review” the request “to determine the best response for the benefit of UMC, the District residents it services, and the city as a whole.”

Serving a limited number of clients with private insurance, the hospital has been plagued by financial problems for years. But as the only hospital east of the Anacostia River, D.C. Council member David A. Catania (I-At Large) and other city leaders have repeatedly stepped in to prevent it from closing.

The District invested $79 million in the hospital in 2007 as part of a deal to keep it from closing by selling it to Specialty Hospitals of America, a for-profit company. Specialty struggled to make it payments, citing low Medicare reimbursement rates. In 2010, the District took over the hospital after Specialty defaulted.

Catania, chairman of the health committee, has become a chief advocate for keeping the hospital under public control.

Chief Financial Officer Natwar M. Gandhi has suggested a quick sale. Although Gray agrees broadly with Gandhi’s concerns, he has signaled that he is willing to give the hospital time to stabilize its finances.

In October, a report by the Department of Health Care Finance recommended that the hospital readjust its mission so it can compete better. Citing the report, Gray then requested that the hospital focus more on ambulatory care before it is put up for sale.

Hudson said in his letter that additional money is needed to work toward Gray’s suggestion, including the hiring of a “turnaround consultant.”

“We are not just asking for money,” Hudson said in a brief interview. “There is a purpose to move the hospital forward.”

Hospital officials note that the facility’s finances have improved since the city takeover, including an estimated $2.5 million profit in the fiscal year that ended Sept. 30.

“If you want to make improvements, you have to invest in capital and . . . this proposal appears to do that,” Catania said through a spokesman, Brendan Williams-Kief.

But the hospital’s request could spark a fierce debate on the D.C. Council.

On Tuesday, Catania got into a profanity-laced shouting match with council member Marion Barry (D-Ward 8) when Barry tried to question Gandhi on the hospital’s finances.

Barry, however, endorsed the turnaround plan on Thursday. “We are not going to let the hospital fail,” he said.