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The Long War's Newcomers; Dracula's Trial: Twice In A Lifetime (Chapter 19)
2024.05.13 08:10 Gloomius The Long War's Newcomers; Dracula's Trial: Twice In A Lifetime (Chapter 19)
Sorry this took so long, kinda got caught up.
Don't have too much to say, other than Maple Whiskey is rapidly becoming one of my favorite drinks, and I'm sorry this took so long to come out. Real life kinda got in the way for a bit (I have one of those?), and I had to put stuff on the backburner. Sorry.
That about covers it.
Previous/Main/Discord/Next
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Fries limped his way down the ship’s hallways, using the wall to his right to support himself. Twisted metal and debris littered the hallways, but it had clearly not come from this sector. He was in the center of the ship, far enough away that nothing was dangerously damaged yet, but they were obviously putting stuff in the wide, CEVA-rated hallways for the time being. He gritted his teeth from the pain and was forced to take short, shallow breaths as he walked. He clutched his side as he shuffled along, almost wishing that he was in one of the suits to help support him.
“Fuck me.” He muttered, pausing for a moment outside of his room to breathe. He was about to type in his code to unlock the door when he realized that it was already unlocked. Not sure why and fearing the worst, he drew his personal pistol from the back of his suit’s waistband, keeping it close in to himself to make sure that it couldn’t get pulled away from him. Exhaling sharply as he brought his arm away from his chest to hit the button that opened the door.
It quickly slid open with a sharp hiss and allowed him into the room. The lights were on, and the room didn’t seem to be different, but he distinctly remembered having locked the room prior. He slowly walked in, trying to clear as much as possible while coming in. He took note of the new bag in the room, but couldn’t see anything else new in the room.
His attention was rapidly divided by a shipwide alert that the admiral had left the vessel, causing him to turn around suddenly.
“You alright?” a voice behind him asked, causing him to rapidly turn around to aim the gun, but wound up hurting him more and causing him to drop to one knee.
“What in the fuck are you doing in my room?” the ODST whispered, barely able to speak from pain.
“Got moved down here for safety, you can ask Donahue.” she stated, helping him up and taking the gun from him.
“Got it… he just left the ship?” he asked, immediately attempting to lay himself down on the bed.
“Yeah, he’s heading to see the Tikaqick.” Firdaus stated with a slight bit of disdain in her voice.
“You got a problem with them?” the ODST muttered, barely looking at her.
“Not as many as with my own people, but certainly a fair number of problems with them.” she hissed, helping the man move towards the bathroom.
“You’re going to need to explain, but in a bit. I have like six different bandages to switch.” Fries grunted, closing the door behind him.
_____
“Sir?” the lieutenant Marine beside him asked, racking a round into her rifle’s chamber, “You alright?”
“Hmm?” The man asked, his head quickly snapping up to look at her, “Oh, yes. I’m fine.”
“You’re sure?” she asked again, watching as the man sealed on his helmet.
“Yes.” He nodded, shooting a glance back at the ship they left from, “Yes… it’s not my first time doing this…”
The crew continued on in relative silence. The Marines and ODSTs were a mix of the two crews, one of each being from the old crew and one of each being the replacement crew. The Marine Lieutenant was one of the new crew, along with the ODST Sergeant. The Marine Sergeant and ODST Captain, however, were both well experienced in combat.
“We’re approaching the landing bay.” The pilot called out over radio, “Thirty seconds.”
“Copy that.” Donahue nodded, standing up and bracing himself against the roof to avoid floating around, “Well… Guess it’s that time again.”
“There’s no CIA on board and the ship isn’t a USS.” The Marine sergeant stated, unbuckling himself but not standing up, “It’ll be different this time.”
“Let’s hope not. Flu’ron’s still on board.” James Orwell, the xenobiologist muttered, attempting to raise his reflective visor, to little avail.
The Marine floated over and helped the man with his visor before floating towards the pilots’ cabin door and letting himself in, floating between the two so he could see out the front window.
“Siddown, Sergeant.” One of the pilots muttered, not looking back as he did minute adjustments to the ship’s trajectory as they approached.
“This whole damn thing could be made of gold…” The Marine muttered, magnetically locking himself to the floor and kneeling down as they approached.
“Crossing threshold, standby for turbulence.” One of the pilots radioed out, a hydraulic whine reverberating through the ship’s hull as they lowered the landing gear.
“Back and seal the hatch, Sergeant.” The other pilot snapped, barely looking back at the Marine, instead focusing on the windows and displays ahead of them.
“Copy that.” The Marine nodded, taking the time to check the two pilots’ weapons stowed behind their chairs before floating himself back into the crew compartment and sealing the hatch behind him.
“Ten seconds to landing. Artificial Gravity is off in the bay, disarming OMS.” A pilot called out, still keeping a smooth voice about him, “Threshold crossed, stand by.”
The ship seemed to do nothing for a moment before a very light shudder echoed through the hull, followed by a sharp, metallic ‘thud’.
“We have contact, maglocks engaged.” The first pilot informed.
“Gravity systems and harmonics coming online. Disengaging RCS.” the second pilot called out, likely talking to his partner over the crew in the back. After a few seconds of silence, the ship seemed to spool down and orange lights came on in the back of the crew compartment, showing up just over the CEVA-sized, round airlock doors at the sides of the craft and above the regularly-sized hexagonal door at the back of the craft. After a moment, a female robotic voice called out ‘Pressure stable’ and the lights switched to green.
“We’re down. Thank you for flying Air Peregrine, please take your bags from the overhead compartments and leave in an orderly fashion.” one of the pilots called out, putting on an extremely good and smooth ‘airline’ voice.
“You are aware that you’re talking to an Admiral, right.?” the Marine Lieutenant asked, seemingly disappointed at the pilot.
“Oh, I imagine he does.” Donahue smiled, motioning for the ODSTs to head out the door first.
The two armored figures were already moving towards the door, letting the ladder come out first before checking pressure one last time and opening the rear door. To their shock and horror, the void of space lay just outside the door, though nothing was losing pressure.
“Plasma barrier?” a Marine asked, his voice faltering slightly when he saw the smoking form of the Dracula in the distance.
“Something like that…” James muttered, waiting for the Admiral to head down the ladder after the ODSTs before following him down.
There were no aliens directly off their ship, which surprised them slightly, but gave the crew time to prepare themselves. They were supposed to form a ‘triangle’ with Donahue at the front, the two ODSTs behind him, and the two Marines on either side of James, behind the ODSTs. However, they had more than enough time to prepare, to the point of it becoming awkward. The team moved to the left side of the Ranger, and sat in waiting. The Marine Sergeant began to get skeptical and checked the chamber of his rifle while his reflective visor dropped into place, subtly preparing for a conflict.
However, before their thoughts could fester any further, a door off the left-side nose of the Ranger opened to reveal the creatures that owned the ship. They were around the same height as a Human, albeit seeming a little taller on average. They were obviously Avian-esque, with short, stubby, owl-like faces, in opposition to the long beaks of Afi’end. They had two large eyes just behind their beak, with what appeared to be two sets of closed eyelids underneath them. Their feathers were gray and black, with a small amount of crow-like iridescence in them. They had long wings which wrapped around their bodies, making a ‘cloak’ around them. Their legs were similar to that of an Afi’end’s, but seemed slightly thinner.
They wore thick, heavily stylized armor. It had gold plating with ivory and blue-diamond accents, glassy pauldrons, and other, seemingly glowing, lines and accents in it.
The rest of the ship looked similar; with gold, ivory, and blue-diamond glass seeming to come from all parts of the ship. The ship looked incredibly clean, with no smudging seeming to come from anything except the Humans. The flight deck they were on was made of some kind of ivory-esque compound as well, with the only scuffs on it being from the RCS thrusters the Ranger had used earlier. Against the gold, whites, and blues of the alien vessel, the greens, grays, and oranges of the Human suits contrasted hard;
Donahue’s suit was nothing special, nor was it too dirty, but it was not perfectly hermetic, like the rest of the ship seemed to be. James’ suit did seem to fit their criteria of cleanliness everywhere except his boots, where it was obvious that he hadn’t put hours of work into cleaning the dirt out of the fabric on the last surface mission he had done. The Marines’s suits were the most well-loved; boasting patches of stained mud, foliage, and other assorted junk all over the suit. The ODSTs were clearly battle-damaged, however: Cuts and scrapes into the plating could be seen around the arms and chest, with plasma burns etched into the metal of the helmet on the more experienced man.
Donahue almost wished he had been able to wash his suit now, but he hoped they would understand.
“Hey, we’re not the only ones to bring armed guards.” The ODST to his right stated.
“Oh thank Christ.” Donahue muttered, shifting his reflective faceplate up, “I would have felt awful if they trusted us that much.”
“Feel better, they don’t.” The ODST muttered back, standing up straighter as the aliens approached.
“Admiral Donahue?” the creature at the front of the group asked, looking at the admiral in the front of his own group.
“Captain Kinlykc?” Donahue asked, stepping towards the aliens. The creature seemed mildly amused at the Admiral’s suit, but went back to looking him in the eyes shortly after.
There was an awkward silence for a moment before the alien decided that it was likely in everyone’s best interests if something was said.
“Apologies for my awkwardness in this situation; it has been a long time since I’ve had the pleasure of doing a proper first-contact scenario.” it stated, clearly motioning for his own guards behind him to be less on-guard. The Humans were taken aback a bit, as the creature didn’t move his mouth to speak, but more seemed to emanate the words from itself.
Donahue nodded, but didn’t have to motion to his own men, as they had already come to stand down themselves.
“Entertainingly enough, I was still captaining that ship out there for our true first contact.” Donahue nodded, making sure that both his hands were visible in front of him.
“Really?” the avian asked, motioning for the admiral to follow him deeper into the ship, “Is your ship the only one in your fleet?”
Donahue paused for a moment before following the alien Captain, motioning for his team to follow shortly behind him.
“Negative, we’re just lucky.” The Admiral smiled, attempting to hide his trepidation through humor. The ODSTs were just as slow to follow behind, but eventually caught back up, seemingly worried about leaving the pilots alone. They were brought into a wide hallway. It had the same stylings as the docking bay had, but seemed to have ‘tiling’ instead of the solid piece that the other room had. James slowly pushed his way through the column of armored personnel and wound up beside the Admiral.
“Umm, excuse me, Captain Kinlykc?” He asked, fiddling with his suit to attempt to make sure the external speakers were working.
“Yes?” the avian asked, looking back at the scientist.
“How… are you talking?” He asked, not sure whether the question was to be considered rude or not, “As in, your mouth isn’t moving, how are you talking to us?”
After the scientist clarified himself, the avian seemed to understand the question.
“We do not breathe through our mouth, I’m assuming like you do then.” It nodded, tapping on its beak and unfolding its wings. It raised its arms and pointed at a set of openings under the creature’s armpits, “We breathe and vocalize through these.”
James was speechless for a moment, but the Admiral was relatively sure that was because he was deciding whether or not it was entirely wrong to lean in closer for a better look.
“If you do not mind me asking a question of my own, what are the clothes you’re wearing?” The avian asked, motioning to everybody except the ODSTs, “Are they your uniforms?”
“These?” James repeated, pulling at his suit, “These are pressure suits. To keep our own atmosphere in.”
“But why?” The bird asked, continuing down the path, “We scanned your vessel as the door opened to analyze what your atmosphere was to accommodate, and they were almost identical.”
"We pressurized our vessel to the bay’s atmosphere.” Donahue stated, nodding at the two, “Our atmospheres are similar, and very breathable, but not the same.”
“Why the pressurized suits then? We can breathe the same atmosphere, no?”
“Our people are not nearly as advanced as some others, who can do bacterial scans of atmospheres before they even land to make sure that neither side will infect the other. We cannot do that, so we hermetically seal off from everybody else to avoid infecting them.” James stated, finishing Donahue’s explanation.
That was an answer that seemed to sit well with the avian, who nodded at them and continued down the hallways.
_____
Kinsey practically dive-rolled out of her vessel’s docking port and into the Dracula’s gravity field, her helmetless RHEV suit’s bulk causing her to roll erratically to the side. She quickly got back up and started jogging her way to the other side of the ship, her quickly-moving, armored figure moving everybody out of her way. She wasn’t in any actual hurry, but the message did have to be delivered relatively quickly.
She quickly dog-legged down a side hallway and towards flight bay 3, near the primary medical bay. As soon as she was at the area, she started heading back towards the outer hull of the ship again, turning only when she was directly on a course with the med bay. After a few moments of running, she turned into the medbay, where Flu’ron was inspecting a rifle another Marine had given him.
“Feathers!” she called out, skidding to a halt outside the door.
“Oh Hells.” Flu’ron muttered as he looked up at her. He handed the rifle back to the Marine and walked towards her, “What do you need, Doctor?”
“Only us Marines can call him ‘Feathers’.” the Marine muttered, putting on a fake pout for her.
“Look!” She exclaimed, ignoring the Marine’s protest and shoving a datapad into the avian’s face.
After pulling back a bit, he took the pad from her and started reading the text on it. After a moment, during which the Marine came over to see what the commotion was, Flu’ron looked up from the pad and nodded at her.
“Well… Goddamn!” He smiled, handing the pad back and pulling out his own tablet, “One-hundred. Going your way.”
“Woah, hold on, I think I missed something. What’s going on?” the Marine asked, confused as to why the Afi’end was sending the scientist money.
“Her brother, who was listed KIA a month and a half ago, is not dead.” Flu’ron explained calmly, watching as the scientist practically bounced off the walls with excitement. He wasn’t sure whether it was because of the money or that Frost was still alive.
“And the fucker made it onto Xalantun before me!” Kinsey stated, calming down enough to get the words out.
“You saw the ‘sent’ date, right?” Flu’ron stated, making sure she knew how recently she had received it.
“Three hours, forty-five minutes ago!” she stated, nodding enthusiastically.
“If the round-trip time isn’t that long, why’d it take him nearly a month to respond?” Flu’ron asked, just sitting down to enjoy the show.
“I’ve got two theories; either he’s been too busy to respond, or this is the first time he’s gotten a data dump in months.” She stated, “Where’s Firdaus, she owes me money!”
Flu’ron shrugged, but the Marine perked up, “To my knowledge, she’s down in Deck 5, section 6, subsection 3, room 156. She’s keeping hidden from the alien ships around us.”
Kinsey perked up at that knowledge, suddenly looking concerned, “Hold on, what?”
“Yeah, she’s residing in an ODST’s room, to my knowledge. Not sure why she’s hiding though. I’m not saying anything to anybody who isn’t a crewmember on board this ship though, aside from you, doc; she wants to stay hidden, we’ll keep her that way.”
“In an ODST’s room?” Kinsey asked, looking immediately at Flu’ron.
“He’s got four broken ribs, you need to go stop her.” the avian stated, rolling his eyes, “I’ll prep the machines, just in case.”
“Ok, I gotta check on two things with her then.” Kinsey stated, nodding at the two before running out of the room and yelling “Carry on!” at the pair.
_____
“Peregrine, we’re going deeper into the vessel, think you can handle yourselves?” The Marine Sergeant asked, slinging his rifle onto his back.
“Hey! Keep that thing out!” the Lieutenant snapped, motioning to his gun again.
The man rolled his eyes, but unlimbered his rifle again.
“Copy that, Praetor. We’re good for the time being.”
“Understood. Keep us apprised, yeah?” the Marine radioed back, shifting his suit around to relieve a pinch he had created in his armpit.
“Copy that, Praetor. Out.” one of the pilots responded back, killing the communications network afterwards. The Marines and ODSTs walked alongside the Admiral and xenobiologist in silence, taking intrigued glances down hallways as they passed them, and receiving intrigued glances back from aliens as they passed them in the hallways. They weren’t entirely privy to the conversation that was happening ahead of them, but they weren’t looking to be part of it either. The two veterans were far more interested in getting a good look at the ship than having to talk to anybody, and the two newer members were still too paranoid to pay attention to anything other than their duties.
They were brought into an unoccupied room with a large window that looked out into the deep space just beyond, though the Dracula and other alien vessel blocked the view. The guards from both species gave a quick visual sweep of the room as they came in. Upon watching the Tikaqick guards sit down or generally relax, the veteran ODST and Marine slung their weapons and moved towards the back of the room, motioning for the other two to do so as well. Despite obvious hesitation to do so, they eventually moved to the back with the other two soldiers.
“So what, if you are able to tell me, are your people doing out here?” Captain Kinlykc asked, glancing back at the soldiers momentarily before returning his gaze to the Human ship.
“Sadly, I am not able to give you our reasoning for being out here. That’s not exactly something I can give away freely.” Donahue sighed, not even sure why he’d actually have to explain that, “What I can tell you is that we weren’t planning to be out this far.”
“Really?” the avian asked, looking at the man with surprise, “Scans have indicated that your vessel is prepared for long-range assignments, based on compartmentalization and areas theorized to be for food.”
Donahue raised an eyebrow at the statement, realizing that they likely had a near-perfect model of the interior of the ship if they could theorize about the ship’s rooms, even if they couldn’t entirely see the contents of the rooms. He was relatively concerned at the revelation, but didn’t let it show.
“Well, that ship is a modification of our first attempt at a long-range exploration ship, but the project was canceled five years before first contact.” Donahue explained, watching as a few suited figures climbed around the hull of his vessel, “There were only ever three of the ships created, all of which got converted to combat duty."
“Really? I know they got converted, but what became of the other vessels?” the avian asked, seemingly entranced by the same men on the hull.
“Well, the Armstrong-Class exploration vessels, named the AC-00 J.T.K., AC-01 J. Harker, and AC-02 M. Reynolds, were all brought back to our home planet as soon as possible, be that from assignment or construction, for retrofit.” Donahue explained, turning away from the window so he could better look at the avian, who saw the gesture and did the same, “The J.T.K. was a prototype, and was axed shortly thereafter. The Reynolds was renamed to Serenity and moved to be part of the United States Space Force, but was destroyed on assignment after the newly-fitted reactors went on runaway and melted half the ship off.”
“And the J. Harker?” it asked, indicating towards the window, clearly already knowing the answer.
Donahue nodded and motioned out the window, “Refused the new reactors, renamed to Dracula, joined the USSF, made first contact, made first contact negotiations, made first Human-to-alien combat, limped back to our space, received the first official ship-systems AI, became the first ship in the UNITF a year later, and still remains in combat as the oldest space combat ship in our service. As a species.”
The bird looked at the vessel with a new form of respect in its eyes, though whether for the crew or the vessel was unknown. It gave a shallow nod to the vessel before turning back to the man in front of him, “How old is it?”
Donahue had to pause to think for a moment, trying to remember everything he could about his ship.
“Well… the program to make them started nearly seventy years ago, and she was the first ‘production’ model. After decades of systems upgrades and additions, she’s the embodiment of Theseus’s ship, but her original christening would have been… forty-eight years ago.” He muttered, ignoring the confused look on the alien’s head when he mentioned Theseus, “I remember her first launch. I would have been around seven at the time.”
“How… Do you keep something like that running for that long? Especially if it’s a combat device.”
“Same way we keep the grandfather clock and jukebox in the primary lounge running; good care from a good crew.” Donahue nodded, watching as the blue sparks from a plasma cutter lit up a section of hull that was surrounded by CEVAs.
_____
“Watch it! Merde!” The Marine snapped out as Kinsey sprinted past him, intent on quickly making it to the room.
“Sorry! A life is at stake!” she called back, hearing another string of words in French that she didn’t care to translate yelled back at her.
The scientist slid to a halt in front of room 156, trying the door, then knocking on it rapidly. When nobody came to the door, she looked up and down the halls, locking eyes with the Marine, who was still watching her.
While still looking at him, she grabbed a tool out of her belt and started to plug it into a receptacle below the keypad.
“Code is two-five-four-eight.” The Marine called out, shaking his head and just walking away.
“Oh.” was all she could manage, pausing for a second to put the tool away before waving back at the Marine, “Thanks, Frenchie.”
“Je m'appelle Mauvieux…” he mumbled from down the hall, turning down another hall, seemingly to get away from her and the scene of the crime.
She ignored him entirely as she punched in the code and hit the button to open the door. The door had barely slid open entirely before she slipped inside and looked around for the snake.
“Firdaus, don’t! His ribs are-” She started, pausing when she realized that the snake was not doing anything other than sitting curled up in a corner of the room, a book in her hands. She looked surprised when she saw the suited Kinsey enter the room.
A door slid open to the scientist’s right, revealing the ODST she was looking for. Unfortunately, he was covered only by a towel around his waist, was clutching at his floating ribs with one arm, and had a pistol in his other hand, pointed directly at her head. As soon he recognized who he was looking at, he lowered the sidearm and leaned against the doorframe.
“Jesus Christ, Ev. What th’ fuck yeh doin’ in here?” He hissed, letting her take the gun from his hand and put it on a nearby desk, “And who th’ fuck gave you the emergency code to my door?”
“Someone who I forgot the name of.” Kinsey shrugged, stopping the man from bending over to pick up his clothes, which had been unceremoniously dumped onto the floor. She handed them to the ODST, who nodded at her and headed back into the bathroom, leaving the door open and hoping, or simply not caring, that the two women didn’t look into the room while he was dressing.
“Ok then, better question; and one I already asked you: Why the fuck are ya barging in here?” he wheezed out from the bathroom, obviously struggling a bit as he tried to dress himself.
“Making sure the thirty-odd foot long constrictor isn’t doing anything to the poor man with the four broken ribs.” She shrugged, shooting a shit-eating grin back at the snake, who flipped off the woman as she smiled back.
“Hey, don’t worry, I drew a gun on her as well.” Fries chuckled, grunting immediately afterwards. After a moment, he came out of the bathroom far more clothed than previous. He immediately went towards the scientist and gave her a quick, one-armed hug that leaned a fair deal of his weight on her, something that took her off-guard.
“Hey… you alright?” She asked, clearly realizing that something was wrong. She knew how the ODST usually acted, and he wasn’t generally the kind to hug without a stiff drink or three in him, let alone put weight on somebody else.
“Yeah, just… didn’t like what happened out there.” He sighed, pulling his weight off of her and going to lean against a wall.
“Didn’t hear what happened. You mind filling me in?” She muttered, moving to sit in a nearby chair. It creaked in protest to the woman’s suited 6’2” frame sitting down, but didn’t break.
“Thought I was going to die stranded out in the middle of fuck-off=nowhere space.” Fries wheezed, knocking his head on the wall behind him, “Kinda… put into perspective what I was told from day one was still a possibility.”
“Well, now I’m more interested in who told you what from the start.” She chuckled, clearly attempting to lighten the mood.
“Me mum always told me that I’d die alone in space, a billion and a half miles away from home.” He muttered somberly. He thought for a moment before his face twisted into a sad grin, “First time she’d shown concern for me in years.”
“Jesus, man. I’m sorry.” the woman muttered, feeling bad about her previous attempt at humor.
“Seriously; my condolences.” Firdaus piped up, simply sitting in her coils and watching the ODST sadly.
“Ehh… Whatever. That cunt never wanted to have me to begin with.” the man shrugged, grunting slightly as he sat down, “I did her a favor when I joined the forces.”
“That’s… not how you should look at that…” Kinsey muttered, standing up slightly when the man sat down, but sat back down when he waved her down.
“Ehh. Don’t care anymore. She’s six feet under an’ can’t bitch at me anymore.” He stated callously, rolling his eyes.
Kinsey quickly snapped to look at him, an expression of horror and sadness on her face. Firdaus seemed to share the same reaction as her, but was far less expressive in her movements.
“What the hell, dude?! Your mother died?! When! How?!” she exclaimed, getting out of her chair and motioning her arms out.
“Three years ago, MDMA overdose.” he muttered, clearly wanting the subject to change.
“Fuck…” the scientist muttered, picking up on the man’s clear reluctance to continue the conversation, “You could have said something.”
Fries paused for a moment, before simply shaking his head, “Nope.”
Kinsey paused for a heartbeat before nodding and stepping back towards the door, “Well, I’m sorry that there’s no better place to leave this at, but I’m going to head out.”
“Alright. Have a good time doc.” the ODST muttered, looking down at the floor for a moment before looking back up at her and nodding again, “Check in again sometime soon, yeah?”
“Yeah. Can do.” She nodded, opening his door and stepping out.
submitted by Gloomius to HFY [link] [comments]
Don't have too much to say, other than Maple Whiskey is rapidly becoming one of my favorite drinks, and I'm sorry this took so long to come out. Real life kinda got in the way for a bit (I have one of those?), and I had to put stuff on the backburner. Sorry.
That about covers it.
Previous/Main/Discord/Next
_________________________________
Fries limped his way down the ship’s hallways, using the wall to his right to support himself. Twisted metal and debris littered the hallways, but it had clearly not come from this sector. He was in the center of the ship, far enough away that nothing was dangerously damaged yet, but they were obviously putting stuff in the wide, CEVA-rated hallways for the time being. He gritted his teeth from the pain and was forced to take short, shallow breaths as he walked. He clutched his side as he shuffled along, almost wishing that he was in one of the suits to help support him.
“Fuck me.” He muttered, pausing for a moment outside of his room to breathe. He was about to type in his code to unlock the door when he realized that it was already unlocked. Not sure why and fearing the worst, he drew his personal pistol from the back of his suit’s waistband, keeping it close in to himself to make sure that it couldn’t get pulled away from him. Exhaling sharply as he brought his arm away from his chest to hit the button that opened the door.
It quickly slid open with a sharp hiss and allowed him into the room. The lights were on, and the room didn’t seem to be different, but he distinctly remembered having locked the room prior. He slowly walked in, trying to clear as much as possible while coming in. He took note of the new bag in the room, but couldn’t see anything else new in the room.
His attention was rapidly divided by a shipwide alert that the admiral had left the vessel, causing him to turn around suddenly.
“You alright?” a voice behind him asked, causing him to rapidly turn around to aim the gun, but wound up hurting him more and causing him to drop to one knee.
“What in the fuck are you doing in my room?” the ODST whispered, barely able to speak from pain.
“Got moved down here for safety, you can ask Donahue.” she stated, helping him up and taking the gun from him.
“Got it… he just left the ship?” he asked, immediately attempting to lay himself down on the bed.
“Yeah, he’s heading to see the Tikaqick.” Firdaus stated with a slight bit of disdain in her voice.
“You got a problem with them?” the ODST muttered, barely looking at her.
“Not as many as with my own people, but certainly a fair number of problems with them.” she hissed, helping the man move towards the bathroom.
“You’re going to need to explain, but in a bit. I have like six different bandages to switch.” Fries grunted, closing the door behind him.
_____
“Sir?” the lieutenant Marine beside him asked, racking a round into her rifle’s chamber, “You alright?”
“Hmm?” The man asked, his head quickly snapping up to look at her, “Oh, yes. I’m fine.”
“You’re sure?” she asked again, watching as the man sealed on his helmet.
“Yes.” He nodded, shooting a glance back at the ship they left from, “Yes… it’s not my first time doing this…”
The crew continued on in relative silence. The Marines and ODSTs were a mix of the two crews, one of each being from the old crew and one of each being the replacement crew. The Marine Lieutenant was one of the new crew, along with the ODST Sergeant. The Marine Sergeant and ODST Captain, however, were both well experienced in combat.
“We’re approaching the landing bay.” The pilot called out over radio, “Thirty seconds.”
“Copy that.” Donahue nodded, standing up and bracing himself against the roof to avoid floating around, “Well… Guess it’s that time again.”
“There’s no CIA on board and the ship isn’t a USS.” The Marine sergeant stated, unbuckling himself but not standing up, “It’ll be different this time.”
“Let’s hope not. Flu’ron’s still on board.” James Orwell, the xenobiologist muttered, attempting to raise his reflective visor, to little avail.
The Marine floated over and helped the man with his visor before floating towards the pilots’ cabin door and letting himself in, floating between the two so he could see out the front window.
“Siddown, Sergeant.” One of the pilots muttered, not looking back as he did minute adjustments to the ship’s trajectory as they approached.
“This whole damn thing could be made of gold…” The Marine muttered, magnetically locking himself to the floor and kneeling down as they approached.
“Crossing threshold, standby for turbulence.” One of the pilots radioed out, a hydraulic whine reverberating through the ship’s hull as they lowered the landing gear.
“Back and seal the hatch, Sergeant.” The other pilot snapped, barely looking back at the Marine, instead focusing on the windows and displays ahead of them.
“Copy that.” The Marine nodded, taking the time to check the two pilots’ weapons stowed behind their chairs before floating himself back into the crew compartment and sealing the hatch behind him.
“Ten seconds to landing. Artificial Gravity is off in the bay, disarming OMS.” A pilot called out, still keeping a smooth voice about him, “Threshold crossed, stand by.”
The ship seemed to do nothing for a moment before a very light shudder echoed through the hull, followed by a sharp, metallic ‘thud’.
“We have contact, maglocks engaged.” The first pilot informed.
“Gravity systems and harmonics coming online. Disengaging RCS.” the second pilot called out, likely talking to his partner over the crew in the back. After a few seconds of silence, the ship seemed to spool down and orange lights came on in the back of the crew compartment, showing up just over the CEVA-sized, round airlock doors at the sides of the craft and above the regularly-sized hexagonal door at the back of the craft. After a moment, a female robotic voice called out ‘Pressure stable’ and the lights switched to green.
“We’re down. Thank you for flying Air Peregrine, please take your bags from the overhead compartments and leave in an orderly fashion.” one of the pilots called out, putting on an extremely good and smooth ‘airline’ voice.
“You are aware that you’re talking to an Admiral, right.?” the Marine Lieutenant asked, seemingly disappointed at the pilot.
“Oh, I imagine he does.” Donahue smiled, motioning for the ODSTs to head out the door first.
The two armored figures were already moving towards the door, letting the ladder come out first before checking pressure one last time and opening the rear door. To their shock and horror, the void of space lay just outside the door, though nothing was losing pressure.
“Plasma barrier?” a Marine asked, his voice faltering slightly when he saw the smoking form of the Dracula in the distance.
“Something like that…” James muttered, waiting for the Admiral to head down the ladder after the ODSTs before following him down.
There were no aliens directly off their ship, which surprised them slightly, but gave the crew time to prepare themselves. They were supposed to form a ‘triangle’ with Donahue at the front, the two ODSTs behind him, and the two Marines on either side of James, behind the ODSTs. However, they had more than enough time to prepare, to the point of it becoming awkward. The team moved to the left side of the Ranger, and sat in waiting. The Marine Sergeant began to get skeptical and checked the chamber of his rifle while his reflective visor dropped into place, subtly preparing for a conflict.
However, before their thoughts could fester any further, a door off the left-side nose of the Ranger opened to reveal the creatures that owned the ship. They were around the same height as a Human, albeit seeming a little taller on average. They were obviously Avian-esque, with short, stubby, owl-like faces, in opposition to the long beaks of Afi’end. They had two large eyes just behind their beak, with what appeared to be two sets of closed eyelids underneath them. Their feathers were gray and black, with a small amount of crow-like iridescence in them. They had long wings which wrapped around their bodies, making a ‘cloak’ around them. Their legs were similar to that of an Afi’end’s, but seemed slightly thinner.
They wore thick, heavily stylized armor. It had gold plating with ivory and blue-diamond accents, glassy pauldrons, and other, seemingly glowing, lines and accents in it.
The rest of the ship looked similar; with gold, ivory, and blue-diamond glass seeming to come from all parts of the ship. The ship looked incredibly clean, with no smudging seeming to come from anything except the Humans. The flight deck they were on was made of some kind of ivory-esque compound as well, with the only scuffs on it being from the RCS thrusters the Ranger had used earlier. Against the gold, whites, and blues of the alien vessel, the greens, grays, and oranges of the Human suits contrasted hard;
Donahue’s suit was nothing special, nor was it too dirty, but it was not perfectly hermetic, like the rest of the ship seemed to be. James’ suit did seem to fit their criteria of cleanliness everywhere except his boots, where it was obvious that he hadn’t put hours of work into cleaning the dirt out of the fabric on the last surface mission he had done. The Marines’s suits were the most well-loved; boasting patches of stained mud, foliage, and other assorted junk all over the suit. The ODSTs were clearly battle-damaged, however: Cuts and scrapes into the plating could be seen around the arms and chest, with plasma burns etched into the metal of the helmet on the more experienced man.
Donahue almost wished he had been able to wash his suit now, but he hoped they would understand.
“Hey, we’re not the only ones to bring armed guards.” The ODST to his right stated.
“Oh thank Christ.” Donahue muttered, shifting his reflective faceplate up, “I would have felt awful if they trusted us that much.”
“Feel better, they don’t.” The ODST muttered back, standing up straighter as the aliens approached.
“Admiral Donahue?” the creature at the front of the group asked, looking at the admiral in the front of his own group.
“Captain Kinlykc?” Donahue asked, stepping towards the aliens. The creature seemed mildly amused at the Admiral’s suit, but went back to looking him in the eyes shortly after.
There was an awkward silence for a moment before the alien decided that it was likely in everyone’s best interests if something was said.
“Apologies for my awkwardness in this situation; it has been a long time since I’ve had the pleasure of doing a proper first-contact scenario.” it stated, clearly motioning for his own guards behind him to be less on-guard. The Humans were taken aback a bit, as the creature didn’t move his mouth to speak, but more seemed to emanate the words from itself.
Donahue nodded, but didn’t have to motion to his own men, as they had already come to stand down themselves.
“Entertainingly enough, I was still captaining that ship out there for our true first contact.” Donahue nodded, making sure that both his hands were visible in front of him.
“Really?” the avian asked, motioning for the admiral to follow him deeper into the ship, “Is your ship the only one in your fleet?”
Donahue paused for a moment before following the alien Captain, motioning for his team to follow shortly behind him.
“Negative, we’re just lucky.” The Admiral smiled, attempting to hide his trepidation through humor. The ODSTs were just as slow to follow behind, but eventually caught back up, seemingly worried about leaving the pilots alone. They were brought into a wide hallway. It had the same stylings as the docking bay had, but seemed to have ‘tiling’ instead of the solid piece that the other room had. James slowly pushed his way through the column of armored personnel and wound up beside the Admiral.
“Umm, excuse me, Captain Kinlykc?” He asked, fiddling with his suit to attempt to make sure the external speakers were working.
“Yes?” the avian asked, looking back at the scientist.
“How… are you talking?” He asked, not sure whether the question was to be considered rude or not, “As in, your mouth isn’t moving, how are you talking to us?”
After the scientist clarified himself, the avian seemed to understand the question.
“We do not breathe through our mouth, I’m assuming like you do then.” It nodded, tapping on its beak and unfolding its wings. It raised its arms and pointed at a set of openings under the creature’s armpits, “We breathe and vocalize through these.”
James was speechless for a moment, but the Admiral was relatively sure that was because he was deciding whether or not it was entirely wrong to lean in closer for a better look.
“If you do not mind me asking a question of my own, what are the clothes you’re wearing?” The avian asked, motioning to everybody except the ODSTs, “Are they your uniforms?”
“These?” James repeated, pulling at his suit, “These are pressure suits. To keep our own atmosphere in.”
“But why?” The bird asked, continuing down the path, “We scanned your vessel as the door opened to analyze what your atmosphere was to accommodate, and they were almost identical.”
"We pressurized our vessel to the bay’s atmosphere.” Donahue stated, nodding at the two, “Our atmospheres are similar, and very breathable, but not the same.”
“Why the pressurized suits then? We can breathe the same atmosphere, no?”
“Our people are not nearly as advanced as some others, who can do bacterial scans of atmospheres before they even land to make sure that neither side will infect the other. We cannot do that, so we hermetically seal off from everybody else to avoid infecting them.” James stated, finishing Donahue’s explanation.
That was an answer that seemed to sit well with the avian, who nodded at them and continued down the hallways.
_____
Kinsey practically dive-rolled out of her vessel’s docking port and into the Dracula’s gravity field, her helmetless RHEV suit’s bulk causing her to roll erratically to the side. She quickly got back up and started jogging her way to the other side of the ship, her quickly-moving, armored figure moving everybody out of her way. She wasn’t in any actual hurry, but the message did have to be delivered relatively quickly.
She quickly dog-legged down a side hallway and towards flight bay 3, near the primary medical bay. As soon as she was at the area, she started heading back towards the outer hull of the ship again, turning only when she was directly on a course with the med bay. After a few moments of running, she turned into the medbay, where Flu’ron was inspecting a rifle another Marine had given him.
“Feathers!” she called out, skidding to a halt outside the door.
“Oh Hells.” Flu’ron muttered as he looked up at her. He handed the rifle back to the Marine and walked towards her, “What do you need, Doctor?”
“Only us Marines can call him ‘Feathers’.” the Marine muttered, putting on a fake pout for her.
“Look!” She exclaimed, ignoring the Marine’s protest and shoving a datapad into the avian’s face.
After pulling back a bit, he took the pad from her and started reading the text on it. After a moment, during which the Marine came over to see what the commotion was, Flu’ron looked up from the pad and nodded at her.
“Well… Goddamn!” He smiled, handing the pad back and pulling out his own tablet, “One-hundred. Going your way.”
“Woah, hold on, I think I missed something. What’s going on?” the Marine asked, confused as to why the Afi’end was sending the scientist money.
“Her brother, who was listed KIA a month and a half ago, is not dead.” Flu’ron explained calmly, watching as the scientist practically bounced off the walls with excitement. He wasn’t sure whether it was because of the money or that Frost was still alive.
“And the fucker made it onto Xalantun before me!” Kinsey stated, calming down enough to get the words out.
“You saw the ‘sent’ date, right?” Flu’ron stated, making sure she knew how recently she had received it.
“Three hours, forty-five minutes ago!” she stated, nodding enthusiastically.
“If the round-trip time isn’t that long, why’d it take him nearly a month to respond?” Flu’ron asked, just sitting down to enjoy the show.
“I’ve got two theories; either he’s been too busy to respond, or this is the first time he’s gotten a data dump in months.” She stated, “Where’s Firdaus, she owes me money!”
Flu’ron shrugged, but the Marine perked up, “To my knowledge, she’s down in Deck 5, section 6, subsection 3, room 156. She’s keeping hidden from the alien ships around us.”
Kinsey perked up at that knowledge, suddenly looking concerned, “Hold on, what?”
“Yeah, she’s residing in an ODST’s room, to my knowledge. Not sure why she’s hiding though. I’m not saying anything to anybody who isn’t a crewmember on board this ship though, aside from you, doc; she wants to stay hidden, we’ll keep her that way.”
“In an ODST’s room?” Kinsey asked, looking immediately at Flu’ron.
“He’s got four broken ribs, you need to go stop her.” the avian stated, rolling his eyes, “I’ll prep the machines, just in case.”
“Ok, I gotta check on two things with her then.” Kinsey stated, nodding at the two before running out of the room and yelling “Carry on!” at the pair.
_____
“Peregrine, we’re going deeper into the vessel, think you can handle yourselves?” The Marine Sergeant asked, slinging his rifle onto his back.
“Hey! Keep that thing out!” the Lieutenant snapped, motioning to his gun again.
The man rolled his eyes, but unlimbered his rifle again.
“Copy that, Praetor. We’re good for the time being.”
“Understood. Keep us apprised, yeah?” the Marine radioed back, shifting his suit around to relieve a pinch he had created in his armpit.
“Copy that, Praetor. Out.” one of the pilots responded back, killing the communications network afterwards. The Marines and ODSTs walked alongside the Admiral and xenobiologist in silence, taking intrigued glances down hallways as they passed them, and receiving intrigued glances back from aliens as they passed them in the hallways. They weren’t entirely privy to the conversation that was happening ahead of them, but they weren’t looking to be part of it either. The two veterans were far more interested in getting a good look at the ship than having to talk to anybody, and the two newer members were still too paranoid to pay attention to anything other than their duties.
They were brought into an unoccupied room with a large window that looked out into the deep space just beyond, though the Dracula and other alien vessel blocked the view. The guards from both species gave a quick visual sweep of the room as they came in. Upon watching the Tikaqick guards sit down or generally relax, the veteran ODST and Marine slung their weapons and moved towards the back of the room, motioning for the other two to do so as well. Despite obvious hesitation to do so, they eventually moved to the back with the other two soldiers.
“So what, if you are able to tell me, are your people doing out here?” Captain Kinlykc asked, glancing back at the soldiers momentarily before returning his gaze to the Human ship.
“Sadly, I am not able to give you our reasoning for being out here. That’s not exactly something I can give away freely.” Donahue sighed, not even sure why he’d actually have to explain that, “What I can tell you is that we weren’t planning to be out this far.”
“Really?” the avian asked, looking at the man with surprise, “Scans have indicated that your vessel is prepared for long-range assignments, based on compartmentalization and areas theorized to be for food.”
Donahue raised an eyebrow at the statement, realizing that they likely had a near-perfect model of the interior of the ship if they could theorize about the ship’s rooms, even if they couldn’t entirely see the contents of the rooms. He was relatively concerned at the revelation, but didn’t let it show.
“Well, that ship is a modification of our first attempt at a long-range exploration ship, but the project was canceled five years before first contact.” Donahue explained, watching as a few suited figures climbed around the hull of his vessel, “There were only ever three of the ships created, all of which got converted to combat duty."
“Really? I know they got converted, but what became of the other vessels?” the avian asked, seemingly entranced by the same men on the hull.
“Well, the Armstrong-Class exploration vessels, named the AC-00 J.T.K., AC-01 J. Harker, and AC-02 M. Reynolds, were all brought back to our home planet as soon as possible, be that from assignment or construction, for retrofit.” Donahue explained, turning away from the window so he could better look at the avian, who saw the gesture and did the same, “The J.T.K. was a prototype, and was axed shortly thereafter. The Reynolds was renamed to Serenity and moved to be part of the United States Space Force, but was destroyed on assignment after the newly-fitted reactors went on runaway and melted half the ship off.”
“And the J. Harker?” it asked, indicating towards the window, clearly already knowing the answer.
Donahue nodded and motioned out the window, “Refused the new reactors, renamed to Dracula, joined the USSF, made first contact, made first contact negotiations, made first Human-to-alien combat, limped back to our space, received the first official ship-systems AI, became the first ship in the UNITF a year later, and still remains in combat as the oldest space combat ship in our service. As a species.”
The bird looked at the vessel with a new form of respect in its eyes, though whether for the crew or the vessel was unknown. It gave a shallow nod to the vessel before turning back to the man in front of him, “How old is it?”
Donahue had to pause to think for a moment, trying to remember everything he could about his ship.
“Well… the program to make them started nearly seventy years ago, and she was the first ‘production’ model. After decades of systems upgrades and additions, she’s the embodiment of Theseus’s ship, but her original christening would have been… forty-eight years ago.” He muttered, ignoring the confused look on the alien’s head when he mentioned Theseus, “I remember her first launch. I would have been around seven at the time.”
“How… Do you keep something like that running for that long? Especially if it’s a combat device.”
“Same way we keep the grandfather clock and jukebox in the primary lounge running; good care from a good crew.” Donahue nodded, watching as the blue sparks from a plasma cutter lit up a section of hull that was surrounded by CEVAs.
_____
“Watch it! Merde!” The Marine snapped out as Kinsey sprinted past him, intent on quickly making it to the room.
“Sorry! A life is at stake!” she called back, hearing another string of words in French that she didn’t care to translate yelled back at her.
The scientist slid to a halt in front of room 156, trying the door, then knocking on it rapidly. When nobody came to the door, she looked up and down the halls, locking eyes with the Marine, who was still watching her.
While still looking at him, she grabbed a tool out of her belt and started to plug it into a receptacle below the keypad.
“Code is two-five-four-eight.” The Marine called out, shaking his head and just walking away.
“Oh.” was all she could manage, pausing for a second to put the tool away before waving back at the Marine, “Thanks, Frenchie.”
“Je m'appelle Mauvieux…” he mumbled from down the hall, turning down another hall, seemingly to get away from her and the scene of the crime.
She ignored him entirely as she punched in the code and hit the button to open the door. The door had barely slid open entirely before she slipped inside and looked around for the snake.
“Firdaus, don’t! His ribs are-” She started, pausing when she realized that the snake was not doing anything other than sitting curled up in a corner of the room, a book in her hands. She looked surprised when she saw the suited Kinsey enter the room.
A door slid open to the scientist’s right, revealing the ODST she was looking for. Unfortunately, he was covered only by a towel around his waist, was clutching at his floating ribs with one arm, and had a pistol in his other hand, pointed directly at her head. As soon he recognized who he was looking at, he lowered the sidearm and leaned against the doorframe.
“Jesus Christ, Ev. What th’ fuck yeh doin’ in here?” He hissed, letting her take the gun from his hand and put it on a nearby desk, “And who th’ fuck gave you the emergency code to my door?”
“Someone who I forgot the name of.” Kinsey shrugged, stopping the man from bending over to pick up his clothes, which had been unceremoniously dumped onto the floor. She handed them to the ODST, who nodded at her and headed back into the bathroom, leaving the door open and hoping, or simply not caring, that the two women didn’t look into the room while he was dressing.
“Ok then, better question; and one I already asked you: Why the fuck are ya barging in here?” he wheezed out from the bathroom, obviously struggling a bit as he tried to dress himself.
“Making sure the thirty-odd foot long constrictor isn’t doing anything to the poor man with the four broken ribs.” She shrugged, shooting a shit-eating grin back at the snake, who flipped off the woman as she smiled back.
“Hey, don’t worry, I drew a gun on her as well.” Fries chuckled, grunting immediately afterwards. After a moment, he came out of the bathroom far more clothed than previous. He immediately went towards the scientist and gave her a quick, one-armed hug that leaned a fair deal of his weight on her, something that took her off-guard.
“Hey… you alright?” She asked, clearly realizing that something was wrong. She knew how the ODST usually acted, and he wasn’t generally the kind to hug without a stiff drink or three in him, let alone put weight on somebody else.
“Yeah, just… didn’t like what happened out there.” He sighed, pulling his weight off of her and going to lean against a wall.
“Didn’t hear what happened. You mind filling me in?” She muttered, moving to sit in a nearby chair. It creaked in protest to the woman’s suited 6’2” frame sitting down, but didn’t break.
“Thought I was going to die stranded out in the middle of fuck-off=nowhere space.” Fries wheezed, knocking his head on the wall behind him, “Kinda… put into perspective what I was told from day one was still a possibility.”
“Well, now I’m more interested in who told you what from the start.” She chuckled, clearly attempting to lighten the mood.
“Me mum always told me that I’d die alone in space, a billion and a half miles away from home.” He muttered somberly. He thought for a moment before his face twisted into a sad grin, “First time she’d shown concern for me in years.”
“Jesus, man. I’m sorry.” the woman muttered, feeling bad about her previous attempt at humor.
“Seriously; my condolences.” Firdaus piped up, simply sitting in her coils and watching the ODST sadly.
“Ehh… Whatever. That cunt never wanted to have me to begin with.” the man shrugged, grunting slightly as he sat down, “I did her a favor when I joined the forces.”
“That’s… not how you should look at that…” Kinsey muttered, standing up slightly when the man sat down, but sat back down when he waved her down.
“Ehh. Don’t care anymore. She’s six feet under an’ can’t bitch at me anymore.” He stated callously, rolling his eyes.
Kinsey quickly snapped to look at him, an expression of horror and sadness on her face. Firdaus seemed to share the same reaction as her, but was far less expressive in her movements.
“What the hell, dude?! Your mother died?! When! How?!” she exclaimed, getting out of her chair and motioning her arms out.
“Three years ago, MDMA overdose.” he muttered, clearly wanting the subject to change.
“Fuck…” the scientist muttered, picking up on the man’s clear reluctance to continue the conversation, “You could have said something.”
Fries paused for a moment, before simply shaking his head, “Nope.”
Kinsey paused for a heartbeat before nodding and stepping back towards the door, “Well, I’m sorry that there’s no better place to leave this at, but I’m going to head out.”
“Alright. Have a good time doc.” the ODST muttered, looking down at the floor for a moment before looking back up at her and nodding again, “Check in again sometime soon, yeah?”
“Yeah. Can do.” She nodded, opening his door and stepping out.
2024.05.13 02:44 Rainyfriedtofu Vertical consolidation of healthcare: the goods, the bads, and the might not work out. bahaha!
Hello Fellow Apes,
This is the only time that I have to write so I'm going to make anymore post regarding vertical consolidation since UNH is being sue like a catholic priest over its current monopoly of healthcare.
https://news.bloomberglaw.com/health-law-and-business/unitedhealth-faces-justice-department-antitrust-probe-wsj-says
With that said, let's get this show on the road. Vertical consolidation, often referred to as vertical integration, is a strategy used by companies to gain control over their entire supply chain. This approach involves a company expanding its business operations into different stages of production or distribution that are normally operated by separate businesses. We're going to use UNH as an example here, but on the surface, UNH is pitching their vertical integration in a positive light.
UnitedHealth Group, through its Optum division, is actively engaging in vertical consolidation within the healthcare sector. This strategy involves integrating various healthcare services under one corporate umbrella, which has been a significant trend in the industry. Optum encompasses a wide range of health services, including pharmacy benefits management, healthcare providers, clinics, and data analytics platforms. By consolidating these services, UnitedHealth aims to create a more integrated healthcare delivery system that can provide more coordinated and efficient care. We'll go more into this later.
This type of vertical integration allows UnitedHealth to manage both the provision of healthcare services and the insurance coverage aspects, leading to "potentially" lower healthcare costs and improved health outcomes. However, this consolidation also raises concerns about market competition, as it could limit choices for consumers and control more of the healthcare process within a single company's ecosystem.
This consolidation trend is not unique to UnitedHealth. It reflects a broader movement within the healthcare industry where large entities are increasingly integrating providers such as hospitals and physician groups to create comprehensive healthcare networks. This trend is expected to continue and possibly accelerate, influencing how healthcare services are delivered and accessed in the United States.
Health insurance companies have increasingly engaged in vertical consolidation as a strategy to streamline operations, reduce costs, and expand their market influence. There are several ways in which these companies are using vertical consolidation to funnel consumers into their health services business segments:
Vertical consolidation can also provide insurers with extensive data on consumer behavior, health outcomes, and cost efficiency. This information can be used to optimize their own services and pricing models further, strengthening their market position and making it harder for others to compete on the same level of efficiency or personalization. Large, vertically integrated companies often have greater resources to influence healthcare policy and regulations. This can lead to a regulatory environment that favors large, integrated entities over smaller competitors or new entrants. While crowding power can lead to increased efficiency and potentially lower costs for consumers, it also raises significant concerns about competition, consumer choice, and the overall health of the market. Regulators often scrutinize such consolidations closely to ensure they don't harm consumer interests, and this is why UnitedHealth is being sued by DOJ.
For Medicare Advantage (MA) plans, which are private plans offering Medicare-covered benefits, vertical consolidation can play a significant role in managing financial risks and costs, particularly in the face of changing policies from the Centers for Medicare and Medicaid Services (CMS). One of the primary ways vertical consolidation helps is through more direct control over costs. For Medicare Advantage plans, controlling healthcare costs is crucial since they receive a fixed payment per enrollee from CMS. By owning providers, MA plans can directly influence the cost of care, reducing overall expenses and potentially offsetting losses due to policy changes that might reduce reimbursement rates or impose new cost-sharing requirements. Vertical integration allows MA plans to streamline care delivery. For example, they can implement more effective care coordination and management practices across their owned networks, which can lead to better health outcomes and reduced hospitalizations—a significant cost factor. This efficiency can help balance out negative impacts from policy changes by keeping patients healthier and reducing expensive medical interventions. Owning a broader swath of the healthcare delivery system gives MA plans access to comprehensive data across the care continuum. This data can be used to identify cost-saving opportunities, manage chronic conditions more effectively, and tailor preventive measures. Such data-driven strategies can help MA plans stay financially viable even when CMS policies become less favorable. However, with the recent earnings, we are seeing many companies failing on their cost modeling.
The twist behind all of this is the whole process might not be all rainbow and butterflies. In a somewhat new findings in the JAMA health forum, vertical consolidation might actually drive higher utilization and spending. In the words of Moocao, "Integration of health systems allows PCP to refer to higher-level specialists if they can't solve something. Before integration, they have to think really hard before referral"
https://www.fiercehealthcare.com/providers/newly-integrated-pcps-steer-patients-toward-systems-higher-utilization-spending-study
Despite previous studies, vertical integration isn't beneficial for healthcare access or coordination. This is why the Biden administration and other lawmakers are scrutinizing mergers that lead to greater vertical integration and provider consolidation. This scrutiny includes proposed updates by the Federal Trade Commission and the Department of Justice to antitrust guidelines, specifically considering the impacts of vertical integration. There is ongoing debate, with some stakeholders arguing that consolidation can help providers survive economically challenging times, while others believe these mergers cause significant market harm without benefiting patients.
Anyway, I hope this helps explain to you why you are seeing so much consolidation, but the cost saving isn't showing up, and why these giant healthcare companies are being sued.
submitted by Rainyfriedtofu to Healthcare_Anon [link] [comments]
This is the only time that I have to write so I'm going to make anymore post regarding vertical consolidation since UNH is being sue like a catholic priest over its current monopoly of healthcare.
https://news.bloomberglaw.com/health-law-and-business/unitedhealth-faces-justice-department-antitrust-probe-wsj-says
With that said, let's get this show on the road. Vertical consolidation, often referred to as vertical integration, is a strategy used by companies to gain control over their entire supply chain. This approach involves a company expanding its business operations into different stages of production or distribution that are normally operated by separate businesses. We're going to use UNH as an example here, but on the surface, UNH is pitching their vertical integration in a positive light.
UnitedHealth Group, through its Optum division, is actively engaging in vertical consolidation within the healthcare sector. This strategy involves integrating various healthcare services under one corporate umbrella, which has been a significant trend in the industry. Optum encompasses a wide range of health services, including pharmacy benefits management, healthcare providers, clinics, and data analytics platforms. By consolidating these services, UnitedHealth aims to create a more integrated healthcare delivery system that can provide more coordinated and efficient care. We'll go more into this later.
This type of vertical integration allows UnitedHealth to manage both the provision of healthcare services and the insurance coverage aspects, leading to "potentially" lower healthcare costs and improved health outcomes. However, this consolidation also raises concerns about market competition, as it could limit choices for consumers and control more of the healthcare process within a single company's ecosystem.
This consolidation trend is not unique to UnitedHealth. It reflects a broader movement within the healthcare industry where large entities are increasingly integrating providers such as hospitals and physician groups to create comprehensive healthcare networks. This trend is expected to continue and possibly accelerate, influencing how healthcare services are delivered and accessed in the United States.
Health insurance companies have increasingly engaged in vertical consolidation as a strategy to streamline operations, reduce costs, and expand their market influence. There are several ways in which these companies are using vertical consolidation to funnel consumers into their health services business segments:
- Many insurers are buying or partnering with hospitals, specialist clinics, and primary care practices. By owning these providers, insurers can direct their policyholders to use these in-network services, which are often cheaper for the insurance company due to controlled pricing and streamlined services.
- Insurers are acquiring or creating their own Pharmacy Benefits Managers (PBMs). These entities manage prescription drug benefits on behalf of health plans. By controlling the PBMs, insurers can influence prescriptions and direct consumers to specific pharmacies or mail-order drug services, often owned by the insurer itself.
- Some insurers are integrating vertically by acquiring companies that provide specialty medical services, such as dialysis centers, mental health services, and rehabilitation facilities. This allows them to keep these often expensive and frequently used services within their network, potentially lowering costs and increasing the use of these services among their insured population.
- Insurance companies are also developing or acquiring digital health platforms that offer telemedicine services, health apps, and other digital health tools. These platforms often direct users to preferred providers or services that are part of the insurer’s network, promoting an integrated approach to healthcare that keeps all aspects of patient care within one system.
- Through vertical consolidation, insurers are pushing more into value-based care agreements where providers are paid based on patient outcomes rather than services rendered. By owning healthcare providers, insurers can better implement these programs, which aim to reduce unnecessary services and focus on preventive care.
Vertical consolidation can also provide insurers with extensive data on consumer behavior, health outcomes, and cost efficiency. This information can be used to optimize their own services and pricing models further, strengthening their market position and making it harder for others to compete on the same level of efficiency or personalization. Large, vertically integrated companies often have greater resources to influence healthcare policy and regulations. This can lead to a regulatory environment that favors large, integrated entities over smaller competitors or new entrants. While crowding power can lead to increased efficiency and potentially lower costs for consumers, it also raises significant concerns about competition, consumer choice, and the overall health of the market. Regulators often scrutinize such consolidations closely to ensure they don't harm consumer interests, and this is why UnitedHealth is being sued by DOJ.
For Medicare Advantage (MA) plans, which are private plans offering Medicare-covered benefits, vertical consolidation can play a significant role in managing financial risks and costs, particularly in the face of changing policies from the Centers for Medicare and Medicaid Services (CMS). One of the primary ways vertical consolidation helps is through more direct control over costs. For Medicare Advantage plans, controlling healthcare costs is crucial since they receive a fixed payment per enrollee from CMS. By owning providers, MA plans can directly influence the cost of care, reducing overall expenses and potentially offsetting losses due to policy changes that might reduce reimbursement rates or impose new cost-sharing requirements. Vertical integration allows MA plans to streamline care delivery. For example, they can implement more effective care coordination and management practices across their owned networks, which can lead to better health outcomes and reduced hospitalizations—a significant cost factor. This efficiency can help balance out negative impacts from policy changes by keeping patients healthier and reducing expensive medical interventions. Owning a broader swath of the healthcare delivery system gives MA plans access to comprehensive data across the care continuum. This data can be used to identify cost-saving opportunities, manage chronic conditions more effectively, and tailor preventive measures. Such data-driven strategies can help MA plans stay financially viable even when CMS policies become less favorable. However, with the recent earnings, we are seeing many companies failing on their cost modeling.
The twist behind all of this is the whole process might not be all rainbow and butterflies. In a somewhat new findings in the JAMA health forum, vertical consolidation might actually drive higher utilization and spending. In the words of Moocao, "Integration of health systems allows PCP to refer to higher-level specialists if they can't solve something. Before integration, they have to think really hard before referral"
https://www.fiercehealthcare.com/providers/newly-integrated-pcps-steer-patients-toward-systems-higher-utilization-spending-study
Despite previous studies, vertical integration isn't beneficial for healthcare access or coordination. This is why the Biden administration and other lawmakers are scrutinizing mergers that lead to greater vertical integration and provider consolidation. This scrutiny includes proposed updates by the Federal Trade Commission and the Department of Justice to antitrust guidelines, specifically considering the impacts of vertical integration. There is ongoing debate, with some stakeholders arguing that consolidation can help providers survive economically challenging times, while others believe these mergers cause significant market harm without benefiting patients.
Anyway, I hope this helps explain to you why you are seeing so much consolidation, but the cost saving isn't showing up, and why these giant healthcare companies are being sued.
2024.05.11 10:53 Xello_99 Full List of German Physical Releases on PS Vita
Hey everybody,
I'm trying to compile a List of all the German physical releases for the vita. I mostly used PSO Archives Region 2 List and just checked each one on german eBay and Amazon. If any of you have any additions, please let me know. I am trying to get a full list, including Limited Editions!
Titles I've found German Releases for (if there's no title in the "German title" column, it's the same as in english):
Region 2 Titles Without German releases:
Question about Zero Escape: Volume 1 & 2: The Nonary Games, according to the PSO Archive list this game has a physical region 2 release. But I haven't found any info or pictures of it. Can anyone confirm if this game even has a Region 2 release (easily identified by the PEGI rating on the cover).
submitted by Xello_99 to vita [link] [comments]
I'm trying to compile a List of all the German physical releases for the vita. I mostly used PSO Archives Region 2 List and just checked each one on german eBay and Amazon. If any of you have any additions, please let me know. I am trying to get a full list, including Limited Editions!
Titles I've found German Releases for (if there's no title in the "German title" column, it's the same as in english):
| Game | German Title or [Notes] |
|---|---|
| 99 Vidas | [Limited Run] |
| 99 Vidas [Collector's Edition] | [Limited Run] |
| Aegis of Earth: Protonovus Assault | |
| Akiba's Beat | |
| Akiba's Trip: Undead & Undressed | |
| Angry Birds: Star Wars | |
| Arcana Heart 3: LOVE MAX!!!!! | |
| Army Corps of Hell | |
| Asphalt Injection | |
| Assassin's Creed Chronicles | |
| Assassin's Creed III: Liberation | |
| Atelier Shallie Plus: ~Alchemists of the Dusk Sea~ | |
| Batman: Arkham Origins: Blackgate | |
| Best of Arcade Games | |
| BlazBlue: Chrono Phantasma Extend | |
| BlazBlue: Continuum Shift Extend | |
| Borderlands 2 | |
| Bunny Must Die! | [Limited Run] |
| Bunny Must Die! [Soundtrack Bundle] | [Limited Run] |
| Call of Duty: Black Ops: Declassified | |
| Chaos;Child | |
| Child of Light: Complete Edition | |
| Criminal Girls: Invite Only | |
| Danganronpa 2: Goodbye Despair | |
| Danganronpa Another Episode: Ultra Despair Girls | |
| Danganronpa V3: Killing Harmony | |
| Danganronpa: Trigger Happy Havoc | |
| Dead or Alive 5+ | |
| Deception IV: Blood Ties | |
| Demon Gaze | |
| Demon Gaze II | |
| Disgaea 3: Absence of Detention | |
| Disgaea 4: A Promise Revisited | |
| Disney Epic Mickey 2: The Power of Two | Disney Micky Epic 2: Die Macht der Zwei |
| Disney Infinity 2.0: Marvel Super Heroes | |
| Dragon Ball Z: Battle of Z | |
| Dragon's Crown | |
| Dungeon Hunter Alliance | |
| Dungeon Travelers 2 | |
| Dynasty Warriors 8: Xtreme Legends | |
| Dynasty Warriors: Next | |
| Earth Defense Force 2: Invaders From Planet Space | |
| Everybody's Golf | |
| Farming Simulator 14 | Landwirtschafts-Simulator 14 |
| Farming Simulator 16 | Landwirtschafts-Simulator 16 |
| Farming Simulator 18 | Landwirtschafts-Simulator 18 |
| Fate/EXTELLA: The Umbral Star | |
| FIFA 13 | |
| FIFA 14: Legacy Edition | |
| FIFA 15: Legacy Edition | |
| FIFA Football | |
| Final Fantasy X/X-2 HD Remaster† | [X-2 HD Remaster Digital only] |
| Formula 1: 2011 | |
| Freedom Wars | |
| Gal*Gun: Double Peace | |
| God Eater 2: Rage Burst/God Eater: Resurrection† | [God Eater: Resurrection Digital only] |
| God of War Collection | |
| God Wars: Future Past | |
| Grand Kingdom | |
| Gravity Rush | |
| Gundemoniums | [Limited Run] |
| Gundemoniums [Soundtrack Bundle] | [Limited Run] |
| Hakuoki: Edo Blossoms | |
| Hakuoki: Kyoto Winds | |
| Handball 16 | |
| Hatsune Miku: Project Diva F 2nd | |
| Helldivers Super-Earth Ultimate Edition | |
| History: Legends of War | |
| Hyperdevotion Noire: Goddess Black Heart | |
| Hyperdimension Neptunia Re;Birth2 | |
| Hyperdimension Neptunia Re;Birth3 | |
| Hyperdimension Neptunia U: Action Unleashed | |
| Hyperdimension Neptunia: Producing Perfection | |
| Injustice: Gods Among Us: Ultimate Edition | |
| inviZimals: The Alliance | InviZimals - Das Bündnis |
| inviZimals: The Resistance | Invizimals - Der Widerstand |
| J-Stars Victory VS + | |
| Killzone: Mercenary | |
| LEGO Batman 2 - DC Super Heroes | |
| LEGO Batman 3 - Beyond Gotham | LEGO Batman 3 - Jenseits von Gotham |
| LEGO Harry Potter - Years 5 - 7 | LEGO Harry Potter - Die Jahre 5 - 7 |
| LEGO Jurassic World | |
| LEGO Legends of Chima - Laval's Journey | |
| LEGO Marvel Avengers | |
| LEGO Marvel Super Heroes: Universe in Peril | LEGO Marvel Super Heroes - Universum in Gefahr |
| LEGO Ninjago - Nindroids | |
| LEGO Ninjago - Shadow of Ronin | LEGO Ninjago - Schatten des Ronin |
| LEGO Star Wars - The Force Awakens | LEGO Star Wars - Das Erwachen der Macht |
| LEGO The Hobbit | LEGO Der Hobbit |
| LEGO The Lego Movie Videogame | |
| LEGO The Lord of the Rings | LEGO Der Herr der Ringe |
| Little Big Planet: Marvel Super Hero Edition | |
| Little Big Planet: PS Vita | |
| Little Deviants | |
| Looney Tunes: Galactic Sports | Looney Tunes - Die galaktischen Spiele |
| Lost Dimension | |
| Lumines: Electronic Symphony | |
| Lumo | |
| Mary Skelter: Nightmares | |
| MegaTagmension Blanc + Neptune VS Zombies | |
| MeiQ: Labyrinth of Death | |
| Metal Gear Solid: HD Collection | |
| Michael Jackson: The Experience HD | |
| Minecraft: PlayStation Vita Edition | |
| ModNation Racers: Road Trip | |
| Moto GP 13 | |
| Moto GP 14 | |
| MUD: FIM Motorcross World Championship | |
| MXGP The Official Motocross Videogame | MX GP - Die offizielle Motocross-Simulation |
| NAtURAL DOCtRINE | |
| Necrosphere Deluxe | [Limited Run] |
| Necrosphere Deluxe [Soundtrack Bundle] | [Limited Run] |
| Need for Speed: Most Wanted | |
| New Little King's Story | |
| Ninja Gaiden: Sigma Plus | |
| Odin Sphere: Leifthrasir | |
| One Piece: Burning Blood | |
| One Piece: Pirate Warriors 3 | |
| One Piece: Unlimited World Red | |
| Operation Abyss: New Tokyo Legacy | |
| Operation Babel: New Tokyo Legacy | |
| Persona 4: Dancing All Night | |
| Persona 4: Golden | |
| Phineas & Ferb: Day of Doofensmirtz | Phineas & Ferb - Doofenshmirtz' große Stunde |
| PlayStation All-Stars Battle Royale | |
| PlayStation Vita Pets | |
| Psycho-Pass: Mandatory Happiness | |
| Putty Squad | |
| Rayman Legends | |
| Rayman Legends/Rayman Origins | |
| Rayman Origins | |
| Reality Fighters | |
| Resistance: Burning Skies | |
| Ridge Racer | |
| Root Letter | |
| Sayonara UmiharaKawase++ | [Limited Run] |
| Sayonara UmiharaKawase++ [Collector's Edition] | [Limited Run] |
| Senran Kagura: Estival Versus | |
| Shinobido 2: Revenge of Zen | |
| Silent Hill: Book of Memories | |
| Sly Cooper: Thieves in Time | Sly Cooper: Jagd durch die Zeit |
| Smart as... | |
| Sonic & All Star Racing Transformed | |
| Sonic & All Star Racing Transformed Limited Edition | |
| Sorcery Saga: Curse of the Great Curry God | |
| Soul Sacrifice | |
| Space Hulk | |
| Spy Hunter | |
| Steins;Gate | |
| Steins;Gate 0 | |
| Stranger of Sword City | |
| Street Fighter X Tekken | |
| Super Monkey Ball: Banana Splitz | |
| SuperDimension Neptune vs Sega Hard Girls | |
| Sword Art Online: Hollow Realization | |
| Sword Art Online: Lost Song | |
| Tales of Hearts R | |
| Tearaway | |
| Teslagrad | |
| Tetris Ultimate | |
| The Amazing Spider-Man | |
| The Jak and Daxter Trilogy | |
| The Legend of Heroes: Trails of Cold Steel | |
| The Legend of Heroes: Trails of Cold Steel II | |
| The Muppets Movie Adventures | Die Muppets Filmabenteuer |
| The Ratchet and Clank Trilogy | |
| The Sly Trilogy† | [Sly 3 Digital only] |
| Tokyo Twilight Ghost Hunters | |
| Touch My Katamari | |
| Toukiden 2 | |
| Toukiden: Kiwami | |
| Toukiden: The Age of Demons | |
| Trillion: God of Destruction | |
| Ultimate Marvel vs. Capcom 3 | |
| Uncharted: Golden Abyss | |
| Unit 13 | |
| Vasara Collection | [Limited Run] |
| Vasara Collection [Collector's Edition] | [Limited Run] |
| Velocity 2X: Critical Mass Edition | |
| Virtua Tennis 4: World Tour Edition | |
| Wipeout 2048 | |
| World of Final Fantasy | |
| WRC 5 | |
| WRC: FIA World Rally Championships 3 | |
| WRC: FIA World Rally Championships 4 | |
| Yomawari: Night Alone | |
| Ys VIII: Lacrimosa of DANA | |
| Ys: Memories of Celceta | |
| Zero Escape: Volume 2: Virtue's Last Reward |
| Game | Notes |
|---|---|
| 7’s Carlet | |
| A Rose in the Twilight | |
| Axiom Verge | |
| Bad Apple Wars | |
| Ben 10: Galactic Racing | |
| Bit Dungeon + | Limited Run |
| Code: Realize ~Future Blessings~ | |
| Code: Realize ~Wintertide Miracles~ | |
| Collar x Malice | |
| Corpse Party: Blood Drive | |
| Criminal Girls 2: Party Favors | Banned in Germany |
| Darkest Dungeon | |
| Death Mark | |
| Demetrios: The Big Cynical Adventure | |
| Drive Girls | |
| Football Manager Classic 2014 | |
| Ice Cream Surfer | Limited Run |
| Jonah Lomu Rugby Challenge | |
| Mortal Kombat | Banned in Germany, only UK Version found |
| Muv-Luv | |
| Muv-Luv Alternative | |
| Ninja Gaiden: Sigma 2+ | |
| Period: Cube ~Shackles of Amadeus~ | |
| Psychedelica of the Ashen Hawk | |
| Psychedelica of the Black Butterfly | |
| Punch Line | |
| Riddled Corpses EX | Limited Run |
| Rugby 15 | |
| Rugby World Cup 2015 | |
| Slain: Back from Hell | |
| Slain: Back from Hell - Signature Edition | |
| Spongebob Hero Pants | |
| Superbeat: XONiC | |
| Tadeo Jones | |
| Tadeo Jones: Y El Manuscrito Perdido | |
| Terraria | |
| The Bard's Tale: Remastered and Resnarkled | Limited Run |
| The Count Lucanor | |
| The Deer God | Limited Run |
| The Long Reach | |
| The Longest 5 Minutes | |
| Tokyo Tattoo Girls | |
| Tokyo Xanadu | |
| Top Trumps Turbo | |
| Valkyrie Drive: Bhikkhuni | Banned in Germany |
| Vegas Party | |
| XBlaze Code: Embryo | |
| Yomawari: Midnight Shadows |
2024.05.11 09:41 isaac_kelvin ClickFunnels vs. Builderall: Choosing the Right Marketing Platform for Your Business
In the digital age, having a robust online presence is essential for businesses of all sizes. Whether you're a small startup or a large corporation, effective marketing tools can make or break your success. ClickFunnels and Builderall are two prominent platforms that offer comprehensive marketing solutions, each with its own set of features and benefits. In this comprehensive comparison, we'll delve into the strengths and weaknesses of ClickFunnels and Builderall to help you make an informed decision for your business needs.
Join Builderall Now
Conclusion:
In conclusion, ClickFunnels and Builderall are both powerful marketing platforms that cater to different needs and preferences. ClickFunnels excels in creating high-converting sales funnels and offers a user-friendly interface, making it ideal for beginners and small businesses. On the other hand, Builderall provides a comprehensive suite of tools for building and growing an online business, including website building, email marketing, and e-learning capabilities.
Ultimately, the choice between ClickFunnels and Builderall depends on your specific requirements, budget, and long-term business goals. If you're primarily focused on sales funnel optimization and simplicity, ClickFunnels may be the better option. However, if you need a more extensive set of tools and are willing to invest the time to learn them, Builderall could be the right choice for you. Whichever platform you choose, both ClickFunnels and Builderall have the potential to help you succeed in your online marketing efforts.
Join Builderall Now
submitted by isaac_kelvin to Webhostinger [link] [comments]
Join Builderall Now
Section 1: Understanding ClickFunnels
ClickFunnels is a popular marketing platform founded by Russell Brunson in 2014. It is renowned for its user-friendly interface and its focus on creating high-converting sales funnels. Here are some key features of ClickFunnels:- Intuitive Funnel Builder: ClickFunnels provides a drag-and-drop funnel builder that allows users to create sales funnels without any coding knowledge. With its wide range of templates, you can easily customize your funnels to suit your specific marketing goals.
- Seamless Integration: ClickFunnels integrates with a variety of third-party tools, including email marketing platforms, payment gateways, and webinar services. This ensures smooth workflow automation and enhanced functionality.
- A/B Testing: ClickFunnels offers built-in A/B testing functionality, allowing users to compare different versions of their funnels to determine which one performs better. This helps in optimizing conversion rates and maximizing ROI.
- Membership Sites: ClickFunnels enables you to create membership sites where you can deliver exclusive content to your subscribers. This is ideal for businesses looking to monetize their expertise and build a loyal customer base.
Section 2: Exploring Builderall
Builderall is an all-in-one digital marketing platform that offers a wide range of tools and features for online entrepreneurs. Founded in 2011 by Erick Salgado, Builderall aims to provide a comprehensive solution for building and growing an online business. Here are some key features of Builderall:- Versatile Website Builder: Builderall provides a powerful drag-and-drop website builder that allows users to create responsive websites, blogs, and e-commerce stores with ease. It offers a variety of templates and customization options to suit different business needs.
- Email Marketing Automation: Builderall includes an email marketing automation platform that enables users to create and send personalized email campaigns to their subscribers. It also provides advanced segmentation and analytics features to track campaign performance.
- App Builder: Builderall's app builder allows users to create and customize mobile applications for iOS and Android devices. This is particularly useful for businesses looking to expand their reach and engage with their audience on mobile platforms.
- E-Learning Platform: Builderall offers an e-learning platform that allows users to create and sell online courses, webinars, and digital products. It provides tools for course creation, student management, and payment processing, making it easy to monetize your knowledge.
Section 3: ClickFunnels vs. Builderall: A Comparative Analysis
Now that we've explored the key features of ClickFunnels and Builderall, let's compare the two platforms based on various factors:- Ease of Use: ClickFunnels is known for its user-friendly interface and intuitive funnel builder, making it ideal for beginners. Builderall, on the other hand, offers a more comprehensive set of tools, which can be overwhelming for some users.
- Pricing: ClickFunnels offers tiered pricing plans starting from $97 per month, while Builderall's plans start from $19.90 per month. However, Builderall's lower-priced plans come with limitations on features and functionality, whereas ClickFunnels offers more advanced features even in its basic plan.
- Funnel Building Capabilities: ClickFunnels specializes in creating high-converting sales funnels and offers a wide range of templates and customization options. Builderall also provides funnel building tools but lacks the depth and sophistication of ClickFunnels in this aspect.
- Integration Options: Both ClickFunnels and Builderall offer integration with third-party tools and services. However, ClickFunnels has a larger ecosystem of integrations, including popular platforms like Shopify, WordPress, and Salesforce, making it more versatile for businesses with diverse needs.
Conclusion:
In conclusion, ClickFunnels and Builderall are both powerful marketing platforms that cater to different needs and preferences. ClickFunnels excels in creating high-converting sales funnels and offers a user-friendly interface, making it ideal for beginners and small businesses. On the other hand, Builderall provides a comprehensive suite of tools for building and growing an online business, including website building, email marketing, and e-learning capabilities.
Ultimately, the choice between ClickFunnels and Builderall depends on your specific requirements, budget, and long-term business goals. If you're primarily focused on sales funnel optimization and simplicity, ClickFunnels may be the better option. However, if you need a more extensive set of tools and are willing to invest the time to learn them, Builderall could be the right choice for you. Whichever platform you choose, both ClickFunnels and Builderall have the potential to help you succeed in your online marketing efforts.
Join Builderall Now
2024.05.11 01:59 Apocryhpal SECO Compliance Question (Texas)
I was wondering if anyone had experience dealing with SECO compliance or there expectations? Currently our firm is working on a state-funded commercial building under the 2018 IECC code in Texas; however, on there website it says that it also requires submission of ASHRAE 90.1-2016 form. The non-residential form says to do IECC or ASHRAE 90.1-2016, but the statement in the other image sounds like we're required to also these ASHRAE 90.1-2016 forms.
https://preview.redd.it/6zl3wdt1tozc1.png?width=993&format=png&auto=webp&s=90ccacbf692c6de937369ada521a6cbf434a94de
Doing both IECC and ASHRAE 90.1-2016 theoretically is going to cause some discrepancies based on the differences between the two. Has anyone delt with this recently and can clarify if SECO need these ASHRAE forms filled out in addition to the IECC documentation we provided? I know in the IECC you have an option to use ASHRAE 90.1-2016 to show compliance wit IECC, but I've been told to do only the IECC prescriptive compliance path. I tried calling and emailing the contact they have on their website, but since they're government regulated I don't think I will get a response any time soon lol. Honestly I would like to hear anyone's opinion if they have one.
https://preview.redd.it/vwmus1muqozc1.png?width=878&format=png&auto=webp&s=1a4a016aacc1adec835052674f4140eab99e0b03
submitted by Apocryhpal to MEPEngineering [link] [comments]
https://preview.redd.it/6zl3wdt1tozc1.png?width=993&format=png&auto=webp&s=90ccacbf692c6de937369ada521a6cbf434a94de
Doing both IECC and ASHRAE 90.1-2016 theoretically is going to cause some discrepancies based on the differences between the two. Has anyone delt with this recently and can clarify if SECO need these ASHRAE forms filled out in addition to the IECC documentation we provided? I know in the IECC you have an option to use ASHRAE 90.1-2016 to show compliance wit IECC, but I've been told to do only the IECC prescriptive compliance path. I tried calling and emailing the contact they have on their website, but since they're government regulated I don't think I will get a response any time soon lol. Honestly I would like to hear anyone's opinion if they have one.
https://preview.redd.it/vwmus1muqozc1.png?width=878&format=png&auto=webp&s=1a4a016aacc1adec835052674f4140eab99e0b03
2024.05.10 18:40 Ill_Boysenberry5264 Insurance Reimbursement for Couples Sessions
Can anyone help me understand why couples sessions (90847) are reimbursed at a lower rate and given less time than individual sessions (90837)? It makes absolutely no sense to me that an individual session is at least 53 minutes, whereas a couples session is 45. Why would the rule be less time and lower payment for seeing 2 people instead of one? It's more work! Of course I always end up spending the entire hour with a couple, but then if I don't want to be committing insurance fraud I have to use a code that only gives me credit/payment for 45 minutes.
This probably doesn't deserve its own post, but it's been boggling my mind for years. I chose the "rant" flair, because that's definitely what this is, but I'm also receptive to advice.
submitted by Ill_Boysenberry5264 to therapists [link] [comments]
This probably doesn't deserve its own post, but it's been boggling my mind for years. I chose the "rant" flair, because that's definitely what this is, but I'm also receptive to advice.
2024.05.09 23:16 checkmaterr Crowns and insurance
I asked for an estimate from my dental clinic prior to my crown appointment. Here's what they sent:
Back story, I was reimbursed by this dental clinic in the past as they charged me out of pocket and billed my insurance for the same, so they double dipped and thought I just wouldn't check my EOB.
Let me know if I am just being suspicious now, or if this is sketchy.
submitted by checkmaterr to askdentists [link] [comments]
- 27200: 1167$
- 99111: 308$
Back story, I was reimbursed by this dental clinic in the past as they charged me out of pocket and billed my insurance for the same, so they double dipped and thought I just wouldn't check my EOB.
Let me know if I am just being suspicious now, or if this is sketchy.
2024.05.09 21:50 RedditVaccineInjury "What The News Isn't Saying About Vaccine-Autism Studies"
Full article here:
https://sharylattkisson.com/2016/11/what-the-news-isnt-saying-about-vaccine-autism-studies/
A Small Sampling
Many of the studies have common themes regarding a subset of susceptible children with immunity issues who, when faced with various vaccine challenges, end up with brain damage described as autism.
“Permanent brain damage” is an acknowledged, rare side effect of vaccines; there’s no dispute in that arena. The question is whether the specific form of autism brain injury after vaccination is in any way related to vaccination.
So what are a few of these published studies supporting a possible link between vaccines and autism?
As far back as 1998, a serology study by the College of Pharmacy at University of Michigan supported the hypothesis that an autoimmune response from the live measles virus in MMR vaccine “may play a causal role in autism.” (Nothing to see here, say the critics, that study is old.)
In 2002, a Utah State University study found that “an inappropriate antibody response to MMR [vaccine], specifically the measles component thereof, might be related to pathogenesis of autism.” (“Flawed and non-replicable,” insist the propagandists.)
Also in 2002, the Autism Research Institute in San Diego looked at a combination of vaccine factors. Scientists found the mercury preservative thimerosal used in some vaccines (such as flu shots) could depress a baby’s immunity. That could make him susceptible to chronic measles infection of the gut when he gets MMR vaccine, which contains live measles virus. (The bloggers say it’s an old study, and that other studies contradict it.)
In 2006, a team of microbiologists in Cairo, Egypt concluded, “deficient immune response to measles, mumps and rubella vaccine antigens might be associated with autism, as a leading cause or a resulting event.”
A 2007 study found statistically significant evidence suggesting that boys who got the triple series Hepatitis B vaccine when it contained thimerosal were “more susceptible to developmental disability” than unvaccinated boys.
Similarly, a 5-year study of 79,000 children by the same institution found boys given Hepatitis B vaccine at birth had a three times increased risk for autism than boys vaccinated later or not at all. Nonwhite boys were at greatest risk. (“Weak study,” say the critics.)
A 2009 study in The Journal of Child Neurology found a major flaw in a widely-cited study that claimed no link between thimerosal in vaccines and autism. Their analysis found that “the original p value was in error and that a significant relation does exist between the blood levels of mercury and diagnosis of an autism spectrum disorder.”
[quote]The researchers noted, “Like the link between aspirin and heart attack, even a small effect can have major health implications. If there is any link between autism and mercury, it is absolutely crucial that the first reports of the question are not falsely stating that no link occurs.”[/quote] (Critics: the study is not to be believed.)
A 2010 rat study by the Polish Academy of Sciences suggested “likely involvement” of thimerosal in vaccines (such as flu shots) “in neurodevelopmental disorders such as autism.” (The critics dismiss rat studies.)
In 2010, a pilot study in Acta Neurobiologiae Experimentalis found that infant monkeys given the 1990’s recommended pediatric vaccine regimen showed important brain changes warranting “additional research into the potential impact of an interaction between the MMR and thimerosal-containing vaccines on brain structure and function.”
A study from Japan’s Kinki University in 2010 supported “the possible biological plausibility for how low-dose exposure to mercury from thimerosal-containing vaccines may be associated with autism.”
A 2011 study from Australia’s Swinburne University supported the hypothesis that sensitivity to mercury, such as thimerosal in flu shots, may be a genetic risk factor for autism. (Critics call the study “strange” with “logical hurdles.”)
A Journal of Immunotoxicology review in 2011 by a former pharmaceutical company senior scientist concluded autism could result from more than one cause including encephalitis (brain damage) following vaccination. (Critics say she reviewed “debunked and fringe” science.)
In 2011, City University of New York correlated autism prevalence with increased childhood vaccine uptake. “Although mercury has been removed from many vaccines, other culprits may link vaccines to autism,” said the study’s lead author. (To critics, it’s “junk science.”)
A University of British Columbia study in 2011 that found “the correlation between Aluminum [an adjuvant] in vaccines and [autism] may be causal.” (More “junk science,” say the propagandists.)
A 2011 rat study out of Warsaw, Poland found thimerosal in vaccines given at a young age could contribute to neurodevelopmental disorders. (Proves nothing, say critics.)
A Chinese study in 2012 suggested that febrile seizures (an acknowledged side effect of some vaccines) and family history of neuropsychiatric disorders correlate with autistic regression.
A 2012 study from the Neurochemistry Research Marie Curie Chairs Program in Poland found that newborn exposure to vaccines with thimerosal (such as flu shots) might cause glutamate-related brain injuries.
In 2013, neurosurgeons at the Methodist Neurological Institute found that children with mild mitochondrial defect may be highly susceptible to toxins like the vaccine preservative thimerosal found in vaccines such as flu shots. (“Too small” of a study, say the critics.)
In 2016, Frontiers published a survey of vaccinated vs. unvaccinated children. The vaccinated had a higher rate of allergies and NDD (neurodevelopmental disorders, including autism) than the unvaccinated. Vaccination, but not preterm birth, remained significantly associated with NDD after controlling for other factors. However, preterm birth combined with vaccination was associated with an apparent synergistic increase in the odds of NDD.
Then, there’s a 2004 Columbia University study presented at the Institute of Medicine. It found that mice predisposed for genetic autoimmune disorder developed autistic-like behavior after receiving mercury-containing vaccines. (Critics say that’s not proof, and the work was not replicable.)
There’s Dr. William Thompson, the current CDC senior scientist who has come forward with an extraordinary statement to say that he and his agency have engaged in long term efforts to obscure a study’s significant link between vaccines and autism, heightened in African Americans boys. (The CDC says the data changes made were for legitimate reasons.)
There’s the current CDC immunization safety director who acknowledged to me that it’s possible vaccines may rarely trigger autism in children who are biologically or genetically susceptible to vaccine injury.
There’s the case of Hannah Poling, in which the government secretly admitted multiple vaccines given in one day triggered her brain injuries, including autism, then paid a multi-million dollar settlement, and had the case sealed from the prying public eyes under a confidentiality order.
There was the former head of the National Institutes of Health, Dr. Bernadine Healy, who stoked her peers’ ire by publicly stating that the vaccine-autism link was not a “myth” as so many tried to claim. She disclosed that her colleagues at the Institute of Medicine did not wish to investigate the possible link because they feared the impact it would have on the vaccination program.
There’s former CDC researcher Poul Thorsen, whose studies dispelled a vaccine autism link. He’s now a “most wanted fugitive” after being charged with 13 counts of wire fraud and nine counts of money laundering for allegedly using CDC grants of tax dollars to buy a house and cars for himself.
And there are the former scientists from Merck, maker of the MMR vaccine in question, who have turned into whistleblowers and accuse their company of committing vaccine fraud.
submitted by RedditVaccineInjury to conspiracy_commons [link] [comments]
https://sharylattkisson.com/2016/11/what-the-news-isnt-saying-about-vaccine-autism-studies/
A Small Sampling
Many of the studies have common themes regarding a subset of susceptible children with immunity issues who, when faced with various vaccine challenges, end up with brain damage described as autism.
“Permanent brain damage” is an acknowledged, rare side effect of vaccines; there’s no dispute in that arena. The question is whether the specific form of autism brain injury after vaccination is in any way related to vaccination.
So what are a few of these published studies supporting a possible link between vaccines and autism?
As far back as 1998, a serology study by the College of Pharmacy at University of Michigan supported the hypothesis that an autoimmune response from the live measles virus in MMR vaccine “may play a causal role in autism.” (Nothing to see here, say the critics, that study is old.)
In 2002, a Utah State University study found that “an inappropriate antibody response to MMR [vaccine], specifically the measles component thereof, might be related to pathogenesis of autism.” (“Flawed and non-replicable,” insist the propagandists.)
Also in 2002, the Autism Research Institute in San Diego looked at a combination of vaccine factors. Scientists found the mercury preservative thimerosal used in some vaccines (such as flu shots) could depress a baby’s immunity. That could make him susceptible to chronic measles infection of the gut when he gets MMR vaccine, which contains live measles virus. (The bloggers say it’s an old study, and that other studies contradict it.)
In 2006, a team of microbiologists in Cairo, Egypt concluded, “deficient immune response to measles, mumps and rubella vaccine antigens might be associated with autism, as a leading cause or a resulting event.”
A 2007 study found statistically significant evidence suggesting that boys who got the triple series Hepatitis B vaccine when it contained thimerosal were “more susceptible to developmental disability” than unvaccinated boys.
Similarly, a 5-year study of 79,000 children by the same institution found boys given Hepatitis B vaccine at birth had a three times increased risk for autism than boys vaccinated later or not at all. Nonwhite boys were at greatest risk. (“Weak study,” say the critics.)
A 2009 study in The Journal of Child Neurology found a major flaw in a widely-cited study that claimed no link between thimerosal in vaccines and autism. Their analysis found that “the original p value was in error and that a significant relation does exist between the blood levels of mercury and diagnosis of an autism spectrum disorder.”
[quote]The researchers noted, “Like the link between aspirin and heart attack, even a small effect can have major health implications. If there is any link between autism and mercury, it is absolutely crucial that the first reports of the question are not falsely stating that no link occurs.”[/quote] (Critics: the study is not to be believed.)
A 2010 rat study by the Polish Academy of Sciences suggested “likely involvement” of thimerosal in vaccines (such as flu shots) “in neurodevelopmental disorders such as autism.” (The critics dismiss rat studies.)
In 2010, a pilot study in Acta Neurobiologiae Experimentalis found that infant monkeys given the 1990’s recommended pediatric vaccine regimen showed important brain changes warranting “additional research into the potential impact of an interaction between the MMR and thimerosal-containing vaccines on brain structure and function.”
A study from Japan’s Kinki University in 2010 supported “the possible biological plausibility for how low-dose exposure to mercury from thimerosal-containing vaccines may be associated with autism.”
A 2011 study from Australia’s Swinburne University supported the hypothesis that sensitivity to mercury, such as thimerosal in flu shots, may be a genetic risk factor for autism. (Critics call the study “strange” with “logical hurdles.”)
A Journal of Immunotoxicology review in 2011 by a former pharmaceutical company senior scientist concluded autism could result from more than one cause including encephalitis (brain damage) following vaccination. (Critics say she reviewed “debunked and fringe” science.)
In 2011, City University of New York correlated autism prevalence with increased childhood vaccine uptake. “Although mercury has been removed from many vaccines, other culprits may link vaccines to autism,” said the study’s lead author. (To critics, it’s “junk science.”)
A University of British Columbia study in 2011 that found “the correlation between Aluminum [an adjuvant] in vaccines and [autism] may be causal.” (More “junk science,” say the propagandists.)
A 2011 rat study out of Warsaw, Poland found thimerosal in vaccines given at a young age could contribute to neurodevelopmental disorders. (Proves nothing, say critics.)
A Chinese study in 2012 suggested that febrile seizures (an acknowledged side effect of some vaccines) and family history of neuropsychiatric disorders correlate with autistic regression.
A 2012 study from the Neurochemistry Research Marie Curie Chairs Program in Poland found that newborn exposure to vaccines with thimerosal (such as flu shots) might cause glutamate-related brain injuries.
In 2013, neurosurgeons at the Methodist Neurological Institute found that children with mild mitochondrial defect may be highly susceptible to toxins like the vaccine preservative thimerosal found in vaccines such as flu shots. (“Too small” of a study, say the critics.)
In 2016, Frontiers published a survey of vaccinated vs. unvaccinated children. The vaccinated had a higher rate of allergies and NDD (neurodevelopmental disorders, including autism) than the unvaccinated. Vaccination, but not preterm birth, remained significantly associated with NDD after controlling for other factors. However, preterm birth combined with vaccination was associated with an apparent synergistic increase in the odds of NDD.
Then, there’s a 2004 Columbia University study presented at the Institute of Medicine. It found that mice predisposed for genetic autoimmune disorder developed autistic-like behavior after receiving mercury-containing vaccines. (Critics say that’s not proof, and the work was not replicable.)
There’s Dr. William Thompson, the current CDC senior scientist who has come forward with an extraordinary statement to say that he and his agency have engaged in long term efforts to obscure a study’s significant link between vaccines and autism, heightened in African Americans boys. (The CDC says the data changes made were for legitimate reasons.)
There’s the current CDC immunization safety director who acknowledged to me that it’s possible vaccines may rarely trigger autism in children who are biologically or genetically susceptible to vaccine injury.
There’s the case of Hannah Poling, in which the government secretly admitted multiple vaccines given in one day triggered her brain injuries, including autism, then paid a multi-million dollar settlement, and had the case sealed from the prying public eyes under a confidentiality order.
There was the former head of the National Institutes of Health, Dr. Bernadine Healy, who stoked her peers’ ire by publicly stating that the vaccine-autism link was not a “myth” as so many tried to claim. She disclosed that her colleagues at the Institute of Medicine did not wish to investigate the possible link because they feared the impact it would have on the vaccination program.
There’s former CDC researcher Poul Thorsen, whose studies dispelled a vaccine autism link. He’s now a “most wanted fugitive” after being charged with 13 counts of wire fraud and nine counts of money laundering for allegedly using CDC grants of tax dollars to buy a house and cars for himself.
And there are the former scientists from Merck, maker of the MMR vaccine in question, who have turned into whistleblowers and accuse their company of committing vaccine fraud.
2024.05.09 21:50 RedditVaccineInjury "What The News Isn't Saying About Vaccine-Autism Studies"
Full article here:
https://sharylattkisson.com/2016/11/what-the-news-isnt-saying-about-vaccine-autism-studies/
A Small Sampling
Many of the studies have common themes regarding a subset of susceptible children with immunity issues who, when faced with various vaccine challenges, end up with brain damage described as autism.
“Permanent brain damage” is an acknowledged, rare side effect of vaccines; there’s no dispute in that arena. The question is whether the specific form of autism brain injury after vaccination is in any way related to vaccination.
So what are a few of these published studies supporting a possible link between vaccines and autism?
As far back as 1998, a serology study by the College of Pharmacy at University of Michigan supported the hypothesis that an autoimmune response from the live measles virus in MMR vaccine “may play a causal role in autism.” (Nothing to see here, say the critics, that study is old.)
In 2002, a Utah State University study found that “an inappropriate antibody response to MMR [vaccine], specifically the measles component thereof, might be related to pathogenesis of autism.” (“Flawed and non-replicable,” insist the propagandists.)
Also in 2002, the Autism Research Institute in San Diego looked at a combination of vaccine factors. Scientists found the mercury preservative thimerosal used in some vaccines (such as flu shots) could depress a baby’s immunity. That could make him susceptible to chronic measles infection of the gut when he gets MMR vaccine, which contains live measles virus. (The bloggers say it’s an old study, and that other studies contradict it.)
In 2006, a team of microbiologists in Cairo, Egypt concluded, “deficient immune response to measles, mumps and rubella vaccine antigens might be associated with autism, as a leading cause or a resulting event.”
A 2007 study found statistically significant evidence suggesting that boys who got the triple series Hepatitis B vaccine when it contained thimerosal were “more susceptible to developmental disability” than unvaccinated boys.
Similarly, a 5-year study of 79,000 children by the same institution found boys given Hepatitis B vaccine at birth had a three times increased risk for autism than boys vaccinated later or not at all. Nonwhite boys were at greatest risk. (“Weak study,” say the critics.)
A 2009 study in The Journal of Child Neurology found a major flaw in a widely-cited study that claimed no link between thimerosal in vaccines and autism. Their analysis found that “the original p value was in error and that a significant relation does exist between the blood levels of mercury and diagnosis of an autism spectrum disorder.”
[quote]The researchers noted, “Like the link between aspirin and heart attack, even a small effect can have major health implications. If there is any link between autism and mercury, it is absolutely crucial that the first reports of the question are not falsely stating that no link occurs.”[/quote] (Critics: the study is not to be believed.)
A 2010 rat study by the Polish Academy of Sciences suggested “likely involvement” of thimerosal in vaccines (such as flu shots) “in neurodevelopmental disorders such as autism.” (The critics dismiss rat studies.)
In 2010, a pilot study in Acta Neurobiologiae Experimentalis found that infant monkeys given the 1990’s recommended pediatric vaccine regimen showed important brain changes warranting “additional research into the potential impact of an interaction between the MMR and thimerosal-containing vaccines on brain structure and function.”
A study from Japan’s Kinki University in 2010 supported “the possible biological plausibility for how low-dose exposure to mercury from thimerosal-containing vaccines may be associated with autism.”
A 2011 study from Australia’s Swinburne University supported the hypothesis that sensitivity to mercury, such as thimerosal in flu shots, may be a genetic risk factor for autism. (Critics call the study “strange” with “logical hurdles.”)
A Journal of Immunotoxicology review in 2011 by a former pharmaceutical company senior scientist concluded autism could result from more than one cause including encephalitis (brain damage) following vaccination. (Critics say she reviewed “debunked and fringe” science.)
In 2011, City University of New York correlated autism prevalence with increased childhood vaccine uptake. “Although mercury has been removed from many vaccines, other culprits may link vaccines to autism,” said the study’s lead author. (To critics, it’s “junk science.”)
A University of British Columbia study in 2011 that found “the correlation between Aluminum [an adjuvant] in vaccines and [autism] may be causal.” (More “junk science,” say the propagandists.)
A 2011 rat study out of Warsaw, Poland found thimerosal in vaccines given at a young age could contribute to neurodevelopmental disorders. (Proves nothing, say critics.)
A Chinese study in 2012 suggested that febrile seizures (an acknowledged side effect of some vaccines) and family history of neuropsychiatric disorders correlate with autistic regression.
A 2012 study from the Neurochemistry Research Marie Curie Chairs Program in Poland found that newborn exposure to vaccines with thimerosal (such as flu shots) might cause glutamate-related brain injuries.
In 2013, neurosurgeons at the Methodist Neurological Institute found that children with mild mitochondrial defect may be highly susceptible to toxins like the vaccine preservative thimerosal found in vaccines such as flu shots. (“Too small” of a study, say the critics.)
In 2016, Frontiers published a survey of vaccinated vs. unvaccinated children. The vaccinated had a higher rate of allergies and NDD (neurodevelopmental disorders, including autism) than the unvaccinated. Vaccination, but not preterm birth, remained significantly associated with NDD after controlling for other factors. However, preterm birth combined with vaccination was associated with an apparent synergistic increase in the odds of NDD.
Then, there’s a 2004 Columbia University study presented at the Institute of Medicine. It found that mice predisposed for genetic autoimmune disorder developed autistic-like behavior after receiving mercury-containing vaccines. (Critics say that’s not proof, and the work was not replicable.)
There’s Dr. William Thompson, the current CDC senior scientist who has come forward with an extraordinary statement to say that he and his agency have engaged in long term efforts to obscure a study’s significant link between vaccines and autism, heightened in African Americans boys. (The CDC says the data changes made were for legitimate reasons.)
There’s the current CDC immunization safety director who acknowledged to me that it’s possible vaccines may rarely trigger autism in children who are biologically or genetically susceptible to vaccine injury.
There’s the case of Hannah Poling, in which the government secretly admitted multiple vaccines given in one day triggered her brain injuries, including autism, then paid a multi-million dollar settlement, and had the case sealed from the prying public eyes under a confidentiality order.
There was the former head of the National Institutes of Health, Dr. Bernadine Healy, who stoked her peers’ ire by publicly stating that the vaccine-autism link was not a “myth” as so many tried to claim. She disclosed that her colleagues at the Institute of Medicine did not wish to investigate the possible link because they feared the impact it would have on the vaccination program.
There’s former CDC researcher Poul Thorsen, whose studies dispelled a vaccine autism link. He’s now a “most wanted fugitive” after being charged with 13 counts of wire fraud and nine counts of money laundering for allegedly using CDC grants of tax dollars to buy a house and cars for himself.
And there are the former scientists from Merck, maker of the MMR vaccine in question, who have turned into whistleblowers and accuse their company of committing vaccine fraud.
submitted by RedditVaccineInjury to conspiracy [link] [comments]
https://sharylattkisson.com/2016/11/what-the-news-isnt-saying-about-vaccine-autism-studies/
A Small Sampling
Many of the studies have common themes regarding a subset of susceptible children with immunity issues who, when faced with various vaccine challenges, end up with brain damage described as autism.
“Permanent brain damage” is an acknowledged, rare side effect of vaccines; there’s no dispute in that arena. The question is whether the specific form of autism brain injury after vaccination is in any way related to vaccination.
So what are a few of these published studies supporting a possible link between vaccines and autism?
As far back as 1998, a serology study by the College of Pharmacy at University of Michigan supported the hypothesis that an autoimmune response from the live measles virus in MMR vaccine “may play a causal role in autism.” (Nothing to see here, say the critics, that study is old.)
In 2002, a Utah State University study found that “an inappropriate antibody response to MMR [vaccine], specifically the measles component thereof, might be related to pathogenesis of autism.” (“Flawed and non-replicable,” insist the propagandists.)
Also in 2002, the Autism Research Institute in San Diego looked at a combination of vaccine factors. Scientists found the mercury preservative thimerosal used in some vaccines (such as flu shots) could depress a baby’s immunity. That could make him susceptible to chronic measles infection of the gut when he gets MMR vaccine, which contains live measles virus. (The bloggers say it’s an old study, and that other studies contradict it.)
In 2006, a team of microbiologists in Cairo, Egypt concluded, “deficient immune response to measles, mumps and rubella vaccine antigens might be associated with autism, as a leading cause or a resulting event.”
A 2007 study found statistically significant evidence suggesting that boys who got the triple series Hepatitis B vaccine when it contained thimerosal were “more susceptible to developmental disability” than unvaccinated boys.
Similarly, a 5-year study of 79,000 children by the same institution found boys given Hepatitis B vaccine at birth had a three times increased risk for autism than boys vaccinated later or not at all. Nonwhite boys were at greatest risk. (“Weak study,” say the critics.)
A 2009 study in The Journal of Child Neurology found a major flaw in a widely-cited study that claimed no link between thimerosal in vaccines and autism. Their analysis found that “the original p value was in error and that a significant relation does exist between the blood levels of mercury and diagnosis of an autism spectrum disorder.”
[quote]The researchers noted, “Like the link between aspirin and heart attack, even a small effect can have major health implications. If there is any link between autism and mercury, it is absolutely crucial that the first reports of the question are not falsely stating that no link occurs.”[/quote] (Critics: the study is not to be believed.)
A 2010 rat study by the Polish Academy of Sciences suggested “likely involvement” of thimerosal in vaccines (such as flu shots) “in neurodevelopmental disorders such as autism.” (The critics dismiss rat studies.)
In 2010, a pilot study in Acta Neurobiologiae Experimentalis found that infant monkeys given the 1990’s recommended pediatric vaccine regimen showed important brain changes warranting “additional research into the potential impact of an interaction between the MMR and thimerosal-containing vaccines on brain structure and function.”
A study from Japan’s Kinki University in 2010 supported “the possible biological plausibility for how low-dose exposure to mercury from thimerosal-containing vaccines may be associated with autism.”
A 2011 study from Australia’s Swinburne University supported the hypothesis that sensitivity to mercury, such as thimerosal in flu shots, may be a genetic risk factor for autism. (Critics call the study “strange” with “logical hurdles.”)
A Journal of Immunotoxicology review in 2011 by a former pharmaceutical company senior scientist concluded autism could result from more than one cause including encephalitis (brain damage) following vaccination. (Critics say she reviewed “debunked and fringe” science.)
In 2011, City University of New York correlated autism prevalence with increased childhood vaccine uptake. “Although mercury has been removed from many vaccines, other culprits may link vaccines to autism,” said the study’s lead author. (To critics, it’s “junk science.”)
A University of British Columbia study in 2011 that found “the correlation between Aluminum [an adjuvant] in vaccines and [autism] may be causal.” (More “junk science,” say the propagandists.)
A 2011 rat study out of Warsaw, Poland found thimerosal in vaccines given at a young age could contribute to neurodevelopmental disorders. (Proves nothing, say critics.)
A Chinese study in 2012 suggested that febrile seizures (an acknowledged side effect of some vaccines) and family history of neuropsychiatric disorders correlate with autistic regression.
A 2012 study from the Neurochemistry Research Marie Curie Chairs Program in Poland found that newborn exposure to vaccines with thimerosal (such as flu shots) might cause glutamate-related brain injuries.
In 2013, neurosurgeons at the Methodist Neurological Institute found that children with mild mitochondrial defect may be highly susceptible to toxins like the vaccine preservative thimerosal found in vaccines such as flu shots. (“Too small” of a study, say the critics.)
In 2016, Frontiers published a survey of vaccinated vs. unvaccinated children. The vaccinated had a higher rate of allergies and NDD (neurodevelopmental disorders, including autism) than the unvaccinated. Vaccination, but not preterm birth, remained significantly associated with NDD after controlling for other factors. However, preterm birth combined with vaccination was associated with an apparent synergistic increase in the odds of NDD.
Then, there’s a 2004 Columbia University study presented at the Institute of Medicine. It found that mice predisposed for genetic autoimmune disorder developed autistic-like behavior after receiving mercury-containing vaccines. (Critics say that’s not proof, and the work was not replicable.)
There’s Dr. William Thompson, the current CDC senior scientist who has come forward with an extraordinary statement to say that he and his agency have engaged in long term efforts to obscure a study’s significant link between vaccines and autism, heightened in African Americans boys. (The CDC says the data changes made were for legitimate reasons.)
There’s the current CDC immunization safety director who acknowledged to me that it’s possible vaccines may rarely trigger autism in children who are biologically or genetically susceptible to vaccine injury.
There’s the case of Hannah Poling, in which the government secretly admitted multiple vaccines given in one day triggered her brain injuries, including autism, then paid a multi-million dollar settlement, and had the case sealed from the prying public eyes under a confidentiality order.
There was the former head of the National Institutes of Health, Dr. Bernadine Healy, who stoked her peers’ ire by publicly stating that the vaccine-autism link was not a “myth” as so many tried to claim. She disclosed that her colleagues at the Institute of Medicine did not wish to investigate the possible link because they feared the impact it would have on the vaccination program.
There’s former CDC researcher Poul Thorsen, whose studies dispelled a vaccine autism link. He’s now a “most wanted fugitive” after being charged with 13 counts of wire fraud and nine counts of money laundering for allegedly using CDC grants of tax dollars to buy a house and cars for himself.
And there are the former scientists from Merck, maker of the MMR vaccine in question, who have turned into whistleblowers and accuse their company of committing vaccine fraud.
2024.05.09 20:55 RedditVaccineInjury "What The News Isn't Saying About Vaccine-Autism Link"
Full article here:
https://sharylattkisson.com/2016/11/what-the-news-isnt-saying-about-vaccine-autism-studies/
A Small Sampling
Many of the studies have common themes regarding a subset of susceptible children with immunity issues who, when faced with various vaccine challenges, end up with brain damage described as autism.
“Permanent brain damage” is an acknowledged, rare side effect of vaccines; there’s no dispute in that arena. The question is whether the specific form of autism brain injury after vaccination is in any way related to vaccination.
So what are a few of these published studies supporting a possible link between vaccines and autism?
As far back as 1998, a serology study by the College of Pharmacy at University of Michigan supported the hypothesis that an autoimmune response from the live measles virus in MMR vaccine “may play a causal role in autism.” (Nothing to see here, say the critics, that study is old.)
In 2002, a Utah State University study found that “an inappropriate antibody response to MMR [vaccine], specifically the measles component thereof, might be related to pathogenesis of autism.” (“Flawed and non-replicable,” insist the propagandists.)
Also in 2002, the Autism Research Institute in San Diego looked at a combination of vaccine factors. Scientists found the mercury preservative thimerosal used in some vaccines (such as flu shots) could depress a baby’s immunity. That could make him susceptible to chronic measles infection of the gut when he gets MMR vaccine, which contains live measles virus. (The bloggers say it’s an old study, and that other studies contradict it.)
In 2006, a team of microbiologists in Cairo, Egypt concluded, “deficient immune response to measles, mumps and rubella vaccine antigens might be associated with autism, as a leading cause or a resulting event.”
A 2007 study found statistically significant evidence suggesting that boys who got the triple series Hepatitis B vaccine when it contained thimerosal were “more susceptible to developmental disability” than unvaccinated boys.
Similarly, a 5-year study of 79,000 children by the same institution found boys given Hepatitis B vaccine at birth had a three times increased risk for autism than boys vaccinated later or not at all. Nonwhite boys were at greatest risk. (“Weak study,” say the critics.)
A 2009 study in The Journal of Child Neurology found a major flaw in a widely-cited study that claimed no link between thimerosal in vaccines and autism. Their analysis found that “the original p value was in error and that a significant relation does exist between the blood levels of mercury and diagnosis of an autism spectrum disorder.”
[quote]The researchers noted, “Like the link between aspirin and heart attack, even a small effect can have major health implications. If there is any link between autism and mercury, it is absolutely crucial that the first reports of the question are not falsely stating that no link occurs.”[/quote] (Critics: the study is not to be believed.)
A 2010 rat study by the Polish Academy of Sciences suggested “likely involvement” of thimerosal in vaccines (such as flu shots) “in neurodevelopmental disorders such as autism.” (The critics dismiss rat studies.)
In 2010, a pilot study in Acta Neurobiologiae Experimentalis found that infant monkeys given the 1990’s recommended pediatric vaccine regimen showed important brain changes warranting “additional research into the potential impact of an interaction between the MMR and thimerosal-containing vaccines on brain structure and function.”
A study from Japan’s Kinki University in 2010 supported “the possible biological plausibility for how low-dose exposure to mercury from thimerosal-containing vaccines may be associated with autism.”
A 2011 study from Australia’s Swinburne University supported the hypothesis that sensitivity to mercury, such as thimerosal in flu shots, may be a genetic risk factor for autism. (Critics call the study “strange” with “logical hurdles.”)
A Journal of Immunotoxicology review in 2011 by a former pharmaceutical company senior scientist concluded autism could result from more than one cause including encephalitis (brain damage) following vaccination. (Critics say she reviewed “debunked and fringe” science.)
In 2011, City University of New York correlated autism prevalence with increased childhood vaccine uptake. “Although mercury has been removed from many vaccines, other culprits may link vaccines to autism,” said the study’s lead author. (To critics, it’s “junk science.”)
A University of British Columbia study in 2011 that found “the correlation between Aluminum [an adjuvant] in vaccines and [autism] may be causal.” (More “junk science,” say the propagandists.)
A 2011 rat study out of Warsaw, Poland found thimerosal in vaccines given at a young age could contribute to neurodevelopmental disorders. (Proves nothing, say critics.)
A Chinese study in 2012 suggested that febrile seizures (an acknowledged side effect of some vaccines) and family history of neuropsychiatric disorders correlate with autistic regression.
A 2012 study from the Neurochemistry Research Marie Curie Chairs Program in Poland found that newborn exposure to vaccines with thimerosal (such as flu shots) might cause glutamate-related brain injuries.
In 2013, neurosurgeons at the Methodist Neurological Institute found that children with mild mitochondrial defect may be highly susceptible to toxins like the vaccine preservative thimerosal found in vaccines such as flu shots. (“Too small” of a study, say the critics.)
In 2016, Frontiers published a survey of vaccinated vs. unvaccinated children. The vaccinated had a higher rate of allergies and NDD (neurodevelopmental disorders, including autism) than the unvaccinated. Vaccination, but not preterm birth, remained significantly associated with NDD after controlling for other factors. However, preterm birth combined with vaccination was associated with an apparent synergistic increase in the odds of NDD.
Then, there’s a 2004 Columbia University study presented at the Institute of Medicine. It found that mice predisposed for genetic autoimmune disorder developed autistic-like behavior after receiving mercury-containing vaccines. (Critics say that’s not proof, and the work was not replicable.)
There’s Dr. William Thompson, the current CDC senior scientist who has come forward with an extraordinary statement to say that he and his agency have engaged in long term efforts to obscure a study’s significant link between vaccines and autism, heightened in African Americans boys. (The CDC says the data changes made were for legitimate reasons.)
There’s the current CDC immunization safety director who acknowledged to me that it’s possible vaccines may rarely trigger autism in children who are biologically or genetically susceptible to vaccine injury.
There’s the case of Hannah Poling, in which the government secretly admitted multiple vaccines given in one day triggered her brain injuries, including autism, then paid a multi-million dollar settlement, and had the case sealed from the prying public eyes under a confidentiality order.
There was the former head of the National Institutes of Health, Dr. Bernadine Healy, who stoked her peers’ ire by publicly stating that the vaccine-autism link was not a “myth” as so many tried to claim. She disclosed that her colleagues at the Institute of Medicine did not wish to investigate the possible link because they feared the impact it would have on the vaccination program.
There’s former CDC researcher Poul Thorsen, whose studies dispelled a vaccine autism link. He’s now a “most wanted fugitive” after being charged with 13 counts of wire fraud and nine counts of money laundering for allegedly using CDC grants of tax dollars to buy a house and cars for himself.
And there are the former scientists from Merck, maker of the MMR vaccine in question, who have turned into whistleblowers and accuse their company of committing vaccine fraud.
submitted by RedditVaccineInjury to DebateVaccines [link] [comments]
https://sharylattkisson.com/2016/11/what-the-news-isnt-saying-about-vaccine-autism-studies/
A Small Sampling
Many of the studies have common themes regarding a subset of susceptible children with immunity issues who, when faced with various vaccine challenges, end up with brain damage described as autism.
“Permanent brain damage” is an acknowledged, rare side effect of vaccines; there’s no dispute in that arena. The question is whether the specific form of autism brain injury after vaccination is in any way related to vaccination.
So what are a few of these published studies supporting a possible link between vaccines and autism?
As far back as 1998, a serology study by the College of Pharmacy at University of Michigan supported the hypothesis that an autoimmune response from the live measles virus in MMR vaccine “may play a causal role in autism.” (Nothing to see here, say the critics, that study is old.)
In 2002, a Utah State University study found that “an inappropriate antibody response to MMR [vaccine], specifically the measles component thereof, might be related to pathogenesis of autism.” (“Flawed and non-replicable,” insist the propagandists.)
Also in 2002, the Autism Research Institute in San Diego looked at a combination of vaccine factors. Scientists found the mercury preservative thimerosal used in some vaccines (such as flu shots) could depress a baby’s immunity. That could make him susceptible to chronic measles infection of the gut when he gets MMR vaccine, which contains live measles virus. (The bloggers say it’s an old study, and that other studies contradict it.)
In 2006, a team of microbiologists in Cairo, Egypt concluded, “deficient immune response to measles, mumps and rubella vaccine antigens might be associated with autism, as a leading cause or a resulting event.”
A 2007 study found statistically significant evidence suggesting that boys who got the triple series Hepatitis B vaccine when it contained thimerosal were “more susceptible to developmental disability” than unvaccinated boys.
Similarly, a 5-year study of 79,000 children by the same institution found boys given Hepatitis B vaccine at birth had a three times increased risk for autism than boys vaccinated later or not at all. Nonwhite boys were at greatest risk. (“Weak study,” say the critics.)
A 2009 study in The Journal of Child Neurology found a major flaw in a widely-cited study that claimed no link between thimerosal in vaccines and autism. Their analysis found that “the original p value was in error and that a significant relation does exist between the blood levels of mercury and diagnosis of an autism spectrum disorder.”
[quote]The researchers noted, “Like the link between aspirin and heart attack, even a small effect can have major health implications. If there is any link between autism and mercury, it is absolutely crucial that the first reports of the question are not falsely stating that no link occurs.”[/quote] (Critics: the study is not to be believed.)
A 2010 rat study by the Polish Academy of Sciences suggested “likely involvement” of thimerosal in vaccines (such as flu shots) “in neurodevelopmental disorders such as autism.” (The critics dismiss rat studies.)
In 2010, a pilot study in Acta Neurobiologiae Experimentalis found that infant monkeys given the 1990’s recommended pediatric vaccine regimen showed important brain changes warranting “additional research into the potential impact of an interaction between the MMR and thimerosal-containing vaccines on brain structure and function.”
A study from Japan’s Kinki University in 2010 supported “the possible biological plausibility for how low-dose exposure to mercury from thimerosal-containing vaccines may be associated with autism.”
A 2011 study from Australia’s Swinburne University supported the hypothesis that sensitivity to mercury, such as thimerosal in flu shots, may be a genetic risk factor for autism. (Critics call the study “strange” with “logical hurdles.”)
A Journal of Immunotoxicology review in 2011 by a former pharmaceutical company senior scientist concluded autism could result from more than one cause including encephalitis (brain damage) following vaccination. (Critics say she reviewed “debunked and fringe” science.)
In 2011, City University of New York correlated autism prevalence with increased childhood vaccine uptake. “Although mercury has been removed from many vaccines, other culprits may link vaccines to autism,” said the study’s lead author. (To critics, it’s “junk science.”)
A University of British Columbia study in 2011 that found “the correlation between Aluminum [an adjuvant] in vaccines and [autism] may be causal.” (More “junk science,” say the propagandists.)
A 2011 rat study out of Warsaw, Poland found thimerosal in vaccines given at a young age could contribute to neurodevelopmental disorders. (Proves nothing, say critics.)
A Chinese study in 2012 suggested that febrile seizures (an acknowledged side effect of some vaccines) and family history of neuropsychiatric disorders correlate with autistic regression.
A 2012 study from the Neurochemistry Research Marie Curie Chairs Program in Poland found that newborn exposure to vaccines with thimerosal (such as flu shots) might cause glutamate-related brain injuries.
In 2013, neurosurgeons at the Methodist Neurological Institute found that children with mild mitochondrial defect may be highly susceptible to toxins like the vaccine preservative thimerosal found in vaccines such as flu shots. (“Too small” of a study, say the critics.)
In 2016, Frontiers published a survey of vaccinated vs. unvaccinated children. The vaccinated had a higher rate of allergies and NDD (neurodevelopmental disorders, including autism) than the unvaccinated. Vaccination, but not preterm birth, remained significantly associated with NDD after controlling for other factors. However, preterm birth combined with vaccination was associated with an apparent synergistic increase in the odds of NDD.
Then, there’s a 2004 Columbia University study presented at the Institute of Medicine. It found that mice predisposed for genetic autoimmune disorder developed autistic-like behavior after receiving mercury-containing vaccines. (Critics say that’s not proof, and the work was not replicable.)
There’s Dr. William Thompson, the current CDC senior scientist who has come forward with an extraordinary statement to say that he and his agency have engaged in long term efforts to obscure a study’s significant link between vaccines and autism, heightened in African Americans boys. (The CDC says the data changes made were for legitimate reasons.)
There’s the current CDC immunization safety director who acknowledged to me that it’s possible vaccines may rarely trigger autism in children who are biologically or genetically susceptible to vaccine injury.
There’s the case of Hannah Poling, in which the government secretly admitted multiple vaccines given in one day triggered her brain injuries, including autism, then paid a multi-million dollar settlement, and had the case sealed from the prying public eyes under a confidentiality order.
There was the former head of the National Institutes of Health, Dr. Bernadine Healy, who stoked her peers’ ire by publicly stating that the vaccine-autism link was not a “myth” as so many tried to claim. She disclosed that her colleagues at the Institute of Medicine did not wish to investigate the possible link because they feared the impact it would have on the vaccination program.
There’s former CDC researcher Poul Thorsen, whose studies dispelled a vaccine autism link. He’s now a “most wanted fugitive” after being charged with 13 counts of wire fraud and nine counts of money laundering for allegedly using CDC grants of tax dollars to buy a house and cars for himself.
And there are the former scientists from Merck, maker of the MMR vaccine in question, who have turned into whistleblowers and accuse their company of committing vaccine fraud.
2024.05.09 15:34 healthmedicinet Health Daily News May 8 2024
DAY: MAY 8 2024
submitted by healthmedicinet to u/healthmedicinet [link] [comments]
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2024.05.09 13:56 Tikkanen Report shows Indiana hospitals lost more than $700 million in income in 2023 - Hospitals hope to see increase in Medicaid and Medicare reimbursement rates
 | submitted by Tikkanen to Indiana [link] [comments] |
2024.05.09 12:35 ahead-market AVAH Q1 2024 Earnings: Modest Growth Amid Challenges
AVAH reported a revenue increase to $490.7 million in Q1 2024, up 5.2% year-over-year, with a net loss of $11.2 million, slightly worse than analyst expectations.
Segment Performance
Expectations: AVAH's reported revenue of $490.7 million slightly exceeded the average analyst estimate of $483.98 million for Q1 2024. However, the EPS of -$0.06 was below the average estimate of -$0.05. The company's revenue growth and raised full-year guidance are positive, but the net loss poses concerns.
submitted by ahead-market to ahead_market [link] [comments]
Key Metrics
| Revenue | $490.7M | 5.2% |
| Gross Profit | $145.9M | |
| Net Income | $-11.2M | |
| Earnings Per Share | $-0.06 | |
| Cash and Cash Equivalents | $42.6M |
- Private Duty Services (PDS) (revenue - $395.009M, growth - 5.9%) - Revenue increased by $22.1 million, driven by higher demand for home health services.
- Home Health & Hospice (HHH) (revenue - $54.613M, growth - -2.7%) - Revenue decreased by $1.5 million, primarily due to lower Medicare reimbursement rates.
- Medical Solutions (MS) (revenue - $41.031M, growth - 9.9%) - Revenue increased by $3.7 million, driven by growth in the company's respiratory therapy business.
- Increased Adjusted EBITDA by 22.5% to $34.9 million, driven by cost reductions and improved operating efficiency.
- Raised full-year 2024 revenue guidance to greater than $1,970 million and Adjusted EBITDA guidance to greater than $150 million.
- Revenue (full year): $greater than $1,970 millionM
Expectations: AVAH's reported revenue of $490.7 million slightly exceeded the average analyst estimate of $483.98 million for Q1 2024. However, the EPS of -$0.06 was below the average estimate of -$0.05. The company's revenue growth and raised full-year guidance are positive, but the net loss poses concerns.
2024.05.09 09:42 Beneficial-Leg4239 The role of the registered nurse BSN in expanding under value based care. The roles of the nurse and pharmacist (clinical nurse specialist and clinical pharmacist) look more alike everyday. References provided.
Clinical Nurse Specialist References: This looks like the acute care pharmacist role in ICU and ER.
You Tube Nursing Uncharted. The Role of a Clinical Nurse Specialist (CNS) Ep. 06 Highlight Nursing Uncharted
https://www.youtube.com/watch?v=L1_QwTuS3Hc
You Tube Nurse.org. How to Become a Clinical Nurse Specialist (CNS)How to Become a Clinical Nurse Specialist (CNS)
Nurse.org
https://www.youtube.com/watch?v=n8RXYQC0uIo
Nurse.org
How to Become a Clinical Nurse Specialist
https://nurse.org/resources/clinical-nurse-specialist/
“My day-to-day can transition from being in my office planning for a project. So I'm doing a lot of reading, researching, writing, things like that. Other days, I'm out on the unit helping the nurses, running to codes, running simulations, teaching classes, running meetings, etc. No one day is ever the same.”
In fact, according to the 2020 NACNS survey, CNSs said they spent 26.6 percent of their day providing direct patient care, 22.1 percent consulting with nurses and other staff, 26.5 percent teaching nurses and staff, and 19.7 percent leading evidence-based practice projects. The majority of their time is spent precepting students (32.5%).
Clinical nurse specialists will also perform the following activities according to the survey:
What Does a Clinical Nurse Specialist Do? A clinical nurse specialist's job varies depending on the type of facility they work at and their chosen specialty. However, their primary goal is always to improve outcomes. Therefore, they constantly ask questions like: How can I help the nurses at the bedside? How can I help these patients on the unit? What changes would improve processes throughout the hospital system?
Clinical Nurse Specialist Duties and Responsibilities According to CNS Andrea Paddock, CNS responsibilities may change daily: “My day-to-day can transition from being in my office planning for a project. So I'm doing a lot of reading, researching, writing, things like that. Other days, I'm out on the unit helping the nurses, running to codes, running simulations, teaching classes, running meetings, etc. No one day is ever the same.”
In fact, according to the 2020 NACNS survey, CNSs said they spent 26.6 percent of their day providing direct patient care, 22.1 percent consulting with nurses and other staff, 26.5 percent teaching nurses and staff, and 19.7 percent leading evidence-based practice projects. The majority of their time is spent precepting students (32.5%).
Clinical nurse specialists will also perform the following activities according to the survey: Assist with evidence-based practice projects Assist other nurses/staff with direct patient care (aka act as a resource) Assist with research Teach patients and families Conduct research as the primary investigator Teach in the community Provide transitional care In other words, CNSs wear several hats and are valued members of healthcare teams.
NP, CNS, and CNM Services:7 Medicare makes payment for NP, CNS, and CNM services based on the MPFS.
The MPFS is a fee schedule with an individual payment amount for as many as 8,000 different procedure
codes. Section 1833(a)(1)(O) of the Act requires NPs and CNSs to be paid 85% of what Medicare would pay a
physician for the same service or 85% of the MPFS payment amount. Until January 1, 2011, CNMs were paid
65% of the MPFS payment amount. Beginning January 1, 2011, Medicare allows CNMs to be paid 100% of
the MPFS amount. The final section of this paper will posit arguments for changing the statute so that all
APRNs are paid at 100% of the MPFS.
Reference ANA: Medicare Payment for Registered Nurse Services and Care Coordination
https://www.nursingworld.org/~498582/globalassets/practiceandpolicy/health-policy/final_carecoordination.pdf
All Nursing Schools:
https://preview.redd.it/jlk3in7crczc1.png?width=798&format=png&auto=webp&s=f6d55786d31c2eb16c766654faf8c9e0f0a83466
International Council of Nurses. Guidelines for Advance Practice Nursing 2020:
https://www.icn.ch/resources/publications-and-reports/guidelines-advanced-practice-nursing-2020
https://www.icn.ch/sites/default/files/2023-04/ICN_APN%20Report_EN.pdf
https://preview.redd.it/wh0da0a2sczc1.png?width=749&format=png&auto=webp&s=3244c41cae29378b5b16cea0c81450ed7b4014d7
https://preview.redd.it/hljay7v6sczc1.png?width=781&format=png&auto=webp&s=a31841593469f6cbb913a6ab27b064f020a555c1
https://preview.redd.it/4abhhsn9sczc1.png?width=768&format=png&auto=webp&s=cf2d63e1b9b50de0142b2997e1bb42dbf829b598
The role of the nurse is also expanding in Ambulatory care. This looks like the AMCare RPH References:
https://improvingprimarycare.org/sites/default/files/topics/RN-Intro1-RN%20Role%20Reimagined-CHCF-Aug2015.pdf
With growing demands on primary care and a shortage of primary care clinicians, safety-net clinics are asking, What is the role of the registered nurse (RN) in primary care?
This report describes how 11 community health centers and county health systems in California, as well as two health centers outside California, are using the following strategies to expand the RN role in primary care:
American Nurse:
https://macyfoundation.org/assets/reports/publications/macy_monograph_nurses_2016_webpdf.pdf
Registered nurses, the largest health profession in the nation with over 3.5 million
members, are ideally suited to provide the bulk of care for people with chronic
illnesses. In primary care, RNs may assume at least four responsibilities: 1) Engaging
patients with chronic conditions in behavior change and adjusting medications
according to practitioner-written protocols; 2) Leading teams to improve the care
and reduce the costs of high-need, high-cost patients; 3) Coordinating the care
of chronically ill patients between the primary care home and the surrounding
healthcare neighborhood; and 4) Promoting population health, including working
with communities to create healthier spaces for people to live, work, learn, and play.
Depending on their level of education and experience, the BMC Health Service Research Article observes, nurses can independently "provide a broad range of patient services, including preventative screening, health education and promotion, chronic disease management, acute episodic care, and a wide variety of therapeutic interventions."
The activation of nurses—under the guidance of MDs, physician assistants, and nurse practitioners—was a hallmark of 30 "high-performing, innovative primary care practices" highlighted in a 2017 study published by the Journal of Ambulatory Care Management. These organizations had "practice-wide standing orders" that directed nurses to "independently conduct preventative visits, manage minor acute illnesses, and provide significant chronic illness care and management" to the patient panels.
For example, a patient may need to see only the nurse and nurse assistant for one scheduled visit but on another visit needs to be examined by the physician and provided training by the nurse.
Additionally, the patient pathway from appointment preparation to next appointment rescheduling was streamlined to shorten wait time by starting intake procedures from the moment the patient enters the office. Further, the critical handoff between the physician and the nurse is expedited by the needs-based stratification of patients, each associated with evidenced-based care protocol. This expands the role of nurse, allowing them to assume greater responsibility for patient care.
To be successful in such value-based initiatives, healthcare organizations must ensure nurses are working at the top of their license. Progressive providers have increased patient access by conducting new nurse-only patient visits during which registered nurses document patient histories, order lab and other diagnostic tests, and determine patient acuity.
By implementing newly defined standardized procedures, clinics are increasing the registered nurse’s scope of clinical decision making including medication refills and anticoagulant and chronic care management. Nurses also are conducting physical examinations, providing triage, and subsequently presenting patient cases to practitioners—activities that significantly improve overall workflow and efficiency. Moreover, evidence shows nurse-led chronic, complex, and transitional care management results in decreased hospital days and emergency department (ED) admissions.
The Ohio State School of Nursing
https://preview.redd.it/uidu1bhktczc1.png?width=514&format=png&auto=webp&s=0c4b7aaf011e99de7c902915d66da15f7c2e7112
Implementing Nurse-Run Hypertension Clinics
https://www.careinnovations.org/resources/nurse-run-hypertension-care/
https://preview.redd.it/xpcdyccttczc1.png?width=798&format=png&auto=webp&s=67261d97068fd650e07c6e09f27a8ef876243782
https://preview.redd.it/zqwqlyywtczc1.png?width=855&format=png&auto=webp&s=5ea5fd3225bf154d658c8b3424fbc337d1d6e3d4
These tread seems to be international as all countries seem to move toward Value Based Care.
submitted by Beneficial-Leg4239 to pharmacy [link] [comments]
You Tube Nursing Uncharted. The Role of a Clinical Nurse Specialist (CNS) Ep. 06 Highlight Nursing Uncharted
https://www.youtube.com/watch?v=L1_QwTuS3Hc
You Tube Nurse.org. How to Become a Clinical Nurse Specialist (CNS)How to Become a Clinical Nurse Specialist (CNS)
Nurse.org
https://www.youtube.com/watch?v=n8RXYQC0uIo
Nurse.org
How to Become a Clinical Nurse Specialist
https://nurse.org/resources/clinical-nurse-specialist/
What Does a Clinical Nurse Specialist Do?
A clinical nurse specialist's job varies depending on the type of facility they work at and their chosen specialty. However, their primary goal is always to improve outcomes. Therefore, they constantly ask questions like:- How can I help the nurses at the bedside?
- How can I help these patients on the unit?
- What changes would improve processes throughout the hospital system?
Clinical Nurse Specialist Duties and Responsibilities
According to CNS Andrea Paddock, CNS responsibilities may change daily:“My day-to-day can transition from being in my office planning for a project. So I'm doing a lot of reading, researching, writing, things like that. Other days, I'm out on the unit helping the nurses, running to codes, running simulations, teaching classes, running meetings, etc. No one day is ever the same.”
In fact, according to the 2020 NACNS survey, CNSs said they spent 26.6 percent of their day providing direct patient care, 22.1 percent consulting with nurses and other staff, 26.5 percent teaching nurses and staff, and 19.7 percent leading evidence-based practice projects. The majority of their time is spent precepting students (32.5%).
Clinical nurse specialists will also perform the following activities according to the survey:
- Assist with evidence-based practice projects
- Assist other nurses/staff with direct patient care (aka act as a resource)
- Assist with research
- Teach patients and families
- Conduct research as the primary investigator
- Teach in the community
- Provide transitional care
What Does a Clinical Nurse Specialist Do? A clinical nurse specialist's job varies depending on the type of facility they work at and their chosen specialty. However, their primary goal is always to improve outcomes. Therefore, they constantly ask questions like: How can I help the nurses at the bedside? How can I help these patients on the unit? What changes would improve processes throughout the hospital system?
Clinical Nurse Specialist Duties and Responsibilities According to CNS Andrea Paddock, CNS responsibilities may change daily: “My day-to-day can transition from being in my office planning for a project. So I'm doing a lot of reading, researching, writing, things like that. Other days, I'm out on the unit helping the nurses, running to codes, running simulations, teaching classes, running meetings, etc. No one day is ever the same.”
In fact, according to the 2020 NACNS survey, CNSs said they spent 26.6 percent of their day providing direct patient care, 22.1 percent consulting with nurses and other staff, 26.5 percent teaching nurses and staff, and 19.7 percent leading evidence-based practice projects. The majority of their time is spent precepting students (32.5%).
Clinical nurse specialists will also perform the following activities according to the survey: Assist with evidence-based practice projects Assist other nurses/staff with direct patient care (aka act as a resource) Assist with research Teach patients and families Conduct research as the primary investigator Teach in the community Provide transitional care In other words, CNSs wear several hats and are valued members of healthcare teams.
CNS Certifications & Specialties
CNS certifications don't cover all specialty areas of nursing like other degrees. Currently, clinical nurse specialists can earn certifications in the following specialties:- Adult
- Pediatric
- Neonatal
- Geriatric
- Oncology
- Critical Care (Adult, Pediatric & Neonatal)
- Orthopedic
- Perioperative
- Psychiatric-Mental Health (Adult, Adolescent/Child) CNS Certifications & Specialties CNS certifications don't cover all specialty areas of nursing like other degrees. Currently, clinical nurse specialists can earn certifications in the following specialties: Adult Pediatric Neonatal Geriatric Oncology Critical Care (Adult, Pediatric & Neonatal) Orthopedic Perioperative Psychiatric-Mental Health (Adult, Adolescent/Child)
NP, CNS, and CNM Services:7 Medicare makes payment for NP, CNS, and CNM services based on the MPFS.
The MPFS is a fee schedule with an individual payment amount for as many as 8,000 different procedure
codes. Section 1833(a)(1)(O) of the Act requires NPs and CNSs to be paid 85% of what Medicare would pay a
physician for the same service or 85% of the MPFS payment amount. Until January 1, 2011, CNMs were paid
65% of the MPFS payment amount. Beginning January 1, 2011, Medicare allows CNMs to be paid 100% of
the MPFS amount. The final section of this paper will posit arguments for changing the statute so that all
APRNs are paid at 100% of the MPFS.
Reference ANA: Medicare Payment for Registered Nurse Services and Care Coordination
https://www.nursingworld.org/~498582/globalassets/practiceandpolicy/health-policy/final_carecoordination.pdf
CNS Independent Practice MapCNS Independent Practice Map
https://www.ncsbn.org/nursing-regulation/practice/aprn/aprn-consensus-implementation-status/cns-independent-practice-map.pageAll Nursing Schools:
What You’ll Do as a Clinical Nurse Specialist (CNS Job Description)
https://www.allnursingschools.com/clinical-nurse-specialist/job-description/https://preview.redd.it/jlk3in7crczc1.png?width=798&format=png&auto=webp&s=f6d55786d31c2eb16c766654faf8c9e0f0a83466
International Council of Nurses. Guidelines for Advance Practice Nursing 2020:
https://www.icn.ch/resources/publications-and-reports/guidelines-advanced-practice-nursing-2020
https://www.icn.ch/sites/default/files/2023-04/ICN_APN%20Report_EN.pdf
https://preview.redd.it/wh0da0a2sczc1.png?width=749&format=png&auto=webp&s=3244c41cae29378b5b16cea0c81450ed7b4014d7
https://preview.redd.it/hljay7v6sczc1.png?width=781&format=png&auto=webp&s=a31841593469f6cbb913a6ab27b064f020a555c1
https://preview.redd.it/4abhhsn9sczc1.png?width=768&format=png&auto=webp&s=cf2d63e1b9b50de0142b2997e1bb42dbf829b598
The role of the nurse is also expanding in Ambulatory care. This looks like the AMCare RPH References:
RN Role Reimagined: How Empowering Registered Nurses Can Improve Primary Care
https://www.chcf.org/publication/rn-role-reimagined-how-empowering-registered-nurses-can-improve-primary-care/https://improvingprimarycare.org/sites/default/files/topics/RN-Intro1-RN%20Role%20Reimagined-CHCF-Aug2015.pdf
With growing demands on primary care and a shortage of primary care clinicians, safety-net clinics are asking, What is the role of the registered nurse (RN) in primary care?
This report describes how 11 community health centers and county health systems in California, as well as two health centers outside California, are using the following strategies to expand the RN role in primary care:
- Provide RNs with additional training in primary care skills, so they can make more clinical decisions
- Empower RNs to make more clinical decisions, using standardized procedures
- Reduce the triage burden on RNs to free up time for other responsibilities
- Include RNs on care teams, allowing them to focus on their team’s patients
- Implement RN-led new-patient visits to increase patient access to care
- Offer patients co-visits in which RNs conduct most of the visit, with providers joining in at the end
- Deploy RNs as “tactical nurses”
- Provide patients with RN-led chronic care management visits
- Employ RNs’ skills to care-manage patients with complex health care needs
- Train some RNs to take responsibility for specialized functions
- Schedule RNs to perform different roles on different days
- Preserve the traditional RN role and focus on training medical assistants (MAs) and licensed vocational nurses (LVNs) to take on new responsibilities
American Nurse:
Preparing RNs for emerging roles in primary care
https://www.myamericannurse.com/preparing-rns-for-emerging-roles-in-primary-care/Registered Nurses: Partners in Transforming Primary Care
https://macyfoundation.org/publications/registered-nurses-partners-in-transforming-primary-carehttps://macyfoundation.org/assets/reports/publications/macy_monograph_nurses_2016_webpdf.pdf
Registered nurses, the largest health profession in the nation with over 3.5 million
members, are ideally suited to provide the bulk of care for people with chronic
illnesses. In primary care, RNs may assume at least four responsibilities: 1) Engaging
patients with chronic conditions in behavior change and adjusting medications
according to practitioner-written protocols; 2) Leading teams to improve the care
and reduce the costs of high-need, high-cost patients; 3) Coordinating the care
of chronically ill patients between the primary care home and the surrounding
healthcare neighborhood; and 4) Promoting population health, including working
with communities to create healthier spaces for people to live, work, learn, and play.
The Vital Role of Nurses in Delivering Transformative Primary Care
https://www.chenmed.com/blog/vital-role-nurses-delivering-transformative-primary-careDepending on their level of education and experience, the BMC Health Service Research Article observes, nurses can independently "provide a broad range of patient services, including preventative screening, health education and promotion, chronic disease management, acute episodic care, and a wide variety of therapeutic interventions."
The activation of nurses—under the guidance of MDs, physician assistants, and nurse practitioners—was a hallmark of 30 "high-performing, innovative primary care practices" highlighted in a 2017 study published by the Journal of Ambulatory Care Management. These organizations had "practice-wide standing orders" that directed nurses to "independently conduct preventative visits, manage minor acute illnesses, and provide significant chronic illness care and management" to the patient panels.
Value-Based Care Elevates the Role of the Registered Nurse in Primary Care
https://www.hfma.org/payment-reimbursement-and-managed-care/value-based-payment/54348/For example, a patient may need to see only the nurse and nurse assistant for one scheduled visit but on another visit needs to be examined by the physician and provided training by the nurse.
Additionally, the patient pathway from appointment preparation to next appointment rescheduling was streamlined to shorten wait time by starting intake procedures from the moment the patient enters the office. Further, the critical handoff between the physician and the nurse is expedited by the needs-based stratification of patients, each associated with evidenced-based care protocol. This expands the role of nurse, allowing them to assume greater responsibility for patient care.
To be successful in such value-based initiatives, healthcare organizations must ensure nurses are working at the top of their license. Progressive providers have increased patient access by conducting new nurse-only patient visits during which registered nurses document patient histories, order lab and other diagnostic tests, and determine patient acuity.
By implementing newly defined standardized procedures, clinics are increasing the registered nurse’s scope of clinical decision making including medication refills and anticoagulant and chronic care management. Nurses also are conducting physical examinations, providing triage, and subsequently presenting patient cases to practitioners—activities that significantly improve overall workflow and efficiency. Moreover, evidence shows nurse-led chronic, complex, and transitional care management results in decreased hospital days and emergency department (ED) admissions.
The Ohio State School of Nursing
Redesigning nursing education to support patients in primary care
https://nursing.osu.edu/news/2020/12/16/redesigning-nursing-education-support-patients-primary-carehttps://preview.redd.it/uidu1bhktczc1.png?width=514&format=png&auto=webp&s=0c4b7aaf011e99de7c902915d66da15f7c2e7112
Implementing Nurse-Run Hypertension Clinics
https://www.careinnovations.org/resources/nurse-run-hypertension-care/
https://preview.redd.it/xpcdyccttczc1.png?width=798&format=png&auto=webp&s=67261d97068fd650e07c6e09f27a8ef876243782
https://preview.redd.it/zqwqlyywtczc1.png?width=855&format=png&auto=webp&s=5ea5fd3225bf154d658c8b3424fbc337d1d6e3d4
These tread seems to be international as all countries seem to move toward Value Based Care.
Tension as practice pharmacists ‘encroach’ on nurse duties
https://www.nursingtimes.net/news/primary-care/tension-as-practice-pharmacists-encroach-on-nurse-duties-12-03-2019/Hospital hires newly qualified pharmacists for wards amid nurse shortage
https://pharmaceutical-journal.com/article/news/hospital-hires-newly-qualified-pharmacists-for-wards-amid-nurse-shortage2024.05.09 06:06 ReportsStack Revenue Cycle Management Market Size, Growth & Statistics Report from 2024 to 2030
The global revenue cycle management (RCM) market is projected to witness a notable Compound Annual Growth Rate (CAGR) exceeding 11%, reaching approximately USD 600 billion by 2027. Key drivers for this growth include the escalating adoption of RCM tools by healthcare providers worldwide and the rapid advancements in technology within the sector. Additionally, the increasing emphasis on optimizing organizational workflows, coupled with ongoing innovations in integrated management software and systems aimed at error reduction, is expected to further propel market expansion throughout the forecast period.
To know more about this study, request a free sample report @ https://www.researchcorridor.com/request-sample/?id=35606
Market Trends:
· Transition to Value-Based Care: There is a shift towards value-based care models, where healthcare providers are reimbursed based on patient outcomes rather than the volume of services provided. This transition is driving the adoption of RCM solutions that can accurately capture and track patient data, facilitate quality reporting, and ensure compliance with value-based payment requirements.
· Integration of Artificial Intelligence (AI) and Automation: Healthcare organizations are increasingly leveraging AI and automation technologies within their RCM systems to streamline administrative processes, improve billing accuracy, reduce claim denials, and enhance revenue cycle efficiency. AI-powered analytics also enable predictive modeling and revenue forecasting, helping organizations make data-driven decisions to optimize financial performance.
· Focus on Patient Engagement and Experience: There is a growing emphasis on patient engagement and satisfaction throughout the revenue cycle. RCM solutions that incorporate patient-friendly billing and payment options, transparent cost estimates, and personalized communication strategies are becoming increasingly important for enhancing patient experience and fostering patient loyalty.
· Interoperability and Data Exchange: Interoperability and seamless data exchange between different healthcare systems and stakeholders are critical for efficient revenue cycle management. As healthcare organizations adopt electronic health records (EHRs) and other digital health technologies, interoperable RCM solutions that can integrate with various systems and facilitate data sharing are in high demand.
· Regulatory Compliance and Coding Changes: Healthcare regulations and coding requirements are constantly evolving, necessitating ongoing updates to RCM systems to ensure compliance and accurate reimbursement. RCM vendors are focused on providing solutions that can adapt to regulatory changes, automate coding processes, and minimize compliance risks for healthcare organizations.
Market Opportunities:
The revenue cycle management (RCM) market presents numerous opportunities for growth and innovation. One significant opportunity lies in addressing the evolving needs of healthcare providers as they navigate the transition to value-based care models and the increasing complexity of healthcare regulations. RCM vendors can capitalize on this by developing solutions that facilitate accurate and timely reimbursement, support quality reporting, and enable organizations to demonstrate value-based care outcomes. Additionally, the integration of artificial intelligence (AI) and automation technologies presents opportunities to streamline administrative processes, reduce costs, and enhance revenue cycle efficiency.
According to the recent report published by RC Market Analytics, the Global Revenue Cycle Management Market is expected to provide sustainable growth opportunities during the forecast period from 2024 to 2030. This latest industry research study analyzes the revenue cycle management market by various product segments, applications, regions and countries while assessing regional performances of numerous leading market participants. The report offers a holistic view of the revenue cycle management industry encompassing numerous stakeholders including raw material suppliers, providers, distributors, consumers and government agencies, among others. Furthermore, the report includes detailed quantitative and qualitative analysis of the global market considering market history, product development, regional dynamics, competitive landscape, and key success factors (KSFs) in the industry.
Browse the Full Report Discretion @ https://www.researchcorridor.com/revenue-cycle-management-market/
Geographically, the revenue cycle management market report comprises dedicated sections centering on the regional market revenue and trends. The revenue cycle management market has been segmented on the basis of geographic regions into North America, Europe, Asia Pacific, Latin America, and the Middle East & Africa. Revenue cycle management market estimates have also been provided for the historical years 2020 to 2023 along with forecast for the period from 2024 - 2030.The report includes a deep-dive analysis of key countries including the U.S., Canada, the U.K., Germany, France, Italy, China, Japan, India, Australia, Mexico, Brazil and South Africa, among others. Thereby, the report identifies unique growth opportunities across the world based on trends occurring in various developed and developing economies.
The Revenue Cycle Management Market Segmentation:
By Product:
To know more about this study, request a free sample report @ https://www.researchcorridor.com/request-sample/?id=35606
Key Questions Answered by Revenue Cycle Management Market Report:
Media Contact:
Company Name: RC Market Analytics Pvt. Ltd. Contact Person: Vijendra Singh Email: sales@researchcorridor.com Visit us: https://www.researchcorridor.com/
submitted by ReportsStack to u/ReportsStack [link] [comments]
To know more about this study, request a free sample report @ https://www.researchcorridor.com/request-sample/?id=35606
Market Trends:
· Transition to Value-Based Care: There is a shift towards value-based care models, where healthcare providers are reimbursed based on patient outcomes rather than the volume of services provided. This transition is driving the adoption of RCM solutions that can accurately capture and track patient data, facilitate quality reporting, and ensure compliance with value-based payment requirements.
· Integration of Artificial Intelligence (AI) and Automation: Healthcare organizations are increasingly leveraging AI and automation technologies within their RCM systems to streamline administrative processes, improve billing accuracy, reduce claim denials, and enhance revenue cycle efficiency. AI-powered analytics also enable predictive modeling and revenue forecasting, helping organizations make data-driven decisions to optimize financial performance.
· Focus on Patient Engagement and Experience: There is a growing emphasis on patient engagement and satisfaction throughout the revenue cycle. RCM solutions that incorporate patient-friendly billing and payment options, transparent cost estimates, and personalized communication strategies are becoming increasingly important for enhancing patient experience and fostering patient loyalty.
· Interoperability and Data Exchange: Interoperability and seamless data exchange between different healthcare systems and stakeholders are critical for efficient revenue cycle management. As healthcare organizations adopt electronic health records (EHRs) and other digital health technologies, interoperable RCM solutions that can integrate with various systems and facilitate data sharing are in high demand.
· Regulatory Compliance and Coding Changes: Healthcare regulations and coding requirements are constantly evolving, necessitating ongoing updates to RCM systems to ensure compliance and accurate reimbursement. RCM vendors are focused on providing solutions that can adapt to regulatory changes, automate coding processes, and minimize compliance risks for healthcare organizations.
Market Opportunities:
The revenue cycle management (RCM) market presents numerous opportunities for growth and innovation. One significant opportunity lies in addressing the evolving needs of healthcare providers as they navigate the transition to value-based care models and the increasing complexity of healthcare regulations. RCM vendors can capitalize on this by developing solutions that facilitate accurate and timely reimbursement, support quality reporting, and enable organizations to demonstrate value-based care outcomes. Additionally, the integration of artificial intelligence (AI) and automation technologies presents opportunities to streamline administrative processes, reduce costs, and enhance revenue cycle efficiency.
According to the recent report published by RC Market Analytics, the Global Revenue Cycle Management Market is expected to provide sustainable growth opportunities during the forecast period from 2024 to 2030. This latest industry research study analyzes the revenue cycle management market by various product segments, applications, regions and countries while assessing regional performances of numerous leading market participants. The report offers a holistic view of the revenue cycle management industry encompassing numerous stakeholders including raw material suppliers, providers, distributors, consumers and government agencies, among others. Furthermore, the report includes detailed quantitative and qualitative analysis of the global market considering market history, product development, regional dynamics, competitive landscape, and key success factors (KSFs) in the industry.
Browse the Full Report Discretion @ https://www.researchcorridor.com/revenue-cycle-management-market/
Geographically, the revenue cycle management market report comprises dedicated sections centering on the regional market revenue and trends. The revenue cycle management market has been segmented on the basis of geographic regions into North America, Europe, Asia Pacific, Latin America, and the Middle East & Africa. Revenue cycle management market estimates have also been provided for the historical years 2020 to 2023 along with forecast for the period from 2024 - 2030.The report includes a deep-dive analysis of key countries including the U.S., Canada, the U.K., Germany, France, Italy, China, Japan, India, Australia, Mexico, Brazil and South Africa, among others. Thereby, the report identifies unique growth opportunities across the world based on trends occurring in various developed and developing economies.
The Revenue Cycle Management Market Segmentation:
By Product:
- Software
- Services
- Integrated
- Standalone
- On-premise
- Web-based
- Cloud-based
- Physician Offices
- Hospitals
- Diagnostic Laboratories
- Others
- North America
- Europe
- Asia Pacific
- Latin America
- Middle East & Africa
To know more about this study, request a free sample report @ https://www.researchcorridor.com/request-sample/?id=35606
Key Questions Answered by Revenue Cycle Management Market Report:
- Product popularity and adoption based on various country-level dynamics
- Regional presence and product development for leading market participants
- Market forecasts and trend analysis based on ongoing investments and economic growth in key countries
- Competitive landscape based on revenue, product offerings, years of presence, number of employees and market concentration, among others
- Various industry models such as SWOT analysis, Pestle Analysis, Porter’s Five Force model, Value Chain Analysis pertaining to Revenue Cycle Management market
- Analysis of the key factors driving and restraining the growth of the global, regional and country-level markets from 2020-2030
Media Contact:
Company Name: RC Market Analytics Pvt. Ltd. Contact Person: Vijendra Singh Email: sales@researchcorridor.com Visit us: https://www.researchcorridor.com/
2024.05.08 22:59 Mountaingal84 Utah Insurance Reimbursement Rates Help!
LPC moving to Utah later this summer from Colorado and wondering if anyone can share the reimbursement rates for the 90837 CPT code. I am already credentialed with the United, Cigna, Aetna in CO. Any help is appreciated!!
submitted by Mountaingal84 to therapists [link] [comments]
2024.05.08 14:59 Herban_Myth Florida Gov. Ron DeSantis receives 20 more bills. They could soon be law. Deadline is 5/22/24 (Credit: Anthony Talcott)
 | Published by Anthony Talcott submitted by Herban_Myth to florida [link] [comments] TALLAHASSEE, Fla. – Florida Gov. Ron DeSantis on Tuesday received 20 bills from the state Legislature covering a variety of issues, including building regulations, critical infrastructure crimes and rental security deposits. DeSantis has until Wednesday, May 22 to decide whether to sign the bills into law. The news bills include the following: HB 191 — Town of OrchidHouse Bill 191 refers to the town of Orchid in Indian River County.Under state law, local governments are required to hold public meetings within their jurisdictions — unless they have a population of 500 people or fewer. Orchid — with a population of 531 as of last year — doesn’t have any meeting facilities in its boundaries, so it’s been holding public meetings at a local privately owned golf club instead. As such, this bill would provide an exception under state statutes to allow Orchid to hold such meetings within five miles of its boundaries. If signed into law, the bill would take effect immediately. HB 267 — Building RegulationsHouse Bill 267 aims to amend the state’s building code.More specifically, the bill would implement set time limits for local governments to either approve or deny permit applications. In addition, the bill would make the following changes: Local governments must create auditing standards before auditing a private provider. Completing an internship program for residential building inspectors is a pathway for licensure as a residential building inspector. Sealed drawings will not be required for replacements of windows, doors, or garage doors in certain homes so long as they meet state standards. If signed into law, the bill would take effect on Jan. 1, 2025. HB 275 — “Critical Infrastructure” CrimesHouse Bill 275 aims to create new offenses under state law involving critical infrastructure.“Critical infrastructure” in the bill refers to linear assets that are designed to exclude unauthorized people, such as fences, no-trespassing signs, generators, energy plants, or TV stations. Under this bill, damaging, accessing or tampering with critical infrastructure could result in both criminal and civil penalties. If signed into law, the bill would take effect on July 1. HB 415 — Pregnancy and Parenting ResourcesHouse Bill 415 seeks to create a “comprehensive state website” with information about pregnancy and parenting resources.Under this bill, the Department of Health would be responsible for contracting a third party to create the website with details on both public and private resources. That website would have to include information on resources related to: Education materials on pregnancy and parenting Maternal health services Prenatal and postnatal services Educational and mentorship programs for fathers Social services Financial assistance Adoption services If signed into law, this bill would take effect on July 1. HB 509 — Collier Mosquito Control DistrictHouse Bill 509 aims to revise the boundaries of the Collier Mosquito Control District.The special district is responsible for cutting down on local mosquito populations, though this bill would expand its boundaries and allow it to service a broader area. If signed into law, the bill would take effect on Oct. 1. HB 691 — Town of Horseshoe BeachHouse Bill 691 aims to provide exceptions for the quota limitation of “quota licenses” for certain restaurants in the town of Horseshoe Beach.The bill is expected to increase revenues for local businesses in Horseshoe Beach, according to Legislative analysts. If signed into law, the bill would take effect immediately. HB 793 — Coral Springs Improvement DistrictHouse Bill 793 aims to address the Coral Springs Improvement District, which develops and operates water and sewer systems in Broward County.This bill would revise certain purchasing and contract requirements for the special district, such as requiring the district to public bid notices, increasing the threshold for competitive bidding, and clarifying that the district must accept the bid of the lowest responsible bidder (unless it’s in the district’s best interest to reject all bids). If signed into law, the bill would take effect immediately. HB 819 — Lehigh Acres Municipal Services Improvement DistrictHouse Bill 819 aims to address the Lehigh Acres Municipal Services Improvement District, which is responsible for public infrastructure in parts of Lee and Hendry counties.This bill would expand the boundaries of the special district, which is expected to increase revenues for the district. If signed into law, the bill would take effect on Oct. 1 HB 867 — North River Ranch Improvement Stewardship DistrictHouse Bill 867 aims to address the North River Ranch Improvement Stewardship District in Manatee County, which is responsible for overseeing community development.This bill would revise the boundaries of the special district, ultimately adding over 100 acres to it. The changes are estimated to raise an extra $500,000 for the district. If signed into law, the bill would take effect immediately. HB 1023 — St. Lucie CountyHouse Bill 1023 aims to amend health care policies for inmates at the St. Lucie County detention center.Under this bill, health care providers who provide medical services to these inmates may only be compensated for up to 110% of the Medicare reimbursement rate if the provider doesn’t have a contract with the county. In addition, such compensation would be limited to 125% of the Medicare reimbursement rate if the hospital reported a negative operating margin in the prior year. If signed into law, the bill would take effect immediately. HB 1025 — Municipal Service District of Ponte Vedra BeachHouse Bill 1025 aims to address the Municipal Service District of Ponte Vedra Beach in St. Johns County, which is responsible for providing certain community services.Under this bill, term limits for Trustees would receive a lifetime limit of 12 years. In addition, the bill would increase the threshold for capital projects that require voter approval. If signed into law, the bill would take effect on Oct. 1. HB 1133 — Vulnerable Road UsersHouse Bill 1133 aims to amend state statutes regarding traffic infractions involving “vulnerable road users.”Under state law, “vulnerable road users” are defined as one of the following: Pedestrian, including a person actually engaged in work upon a highway, or in work upon utility facilities along a highway, or engaged in the provision of emergency services within the right-of-way Person operating a bicycle, an electric bicycle, a motorcycle, a scooter, or a moped lawfully on the roadway; Person riding an animal; or Person lawfully operating on a public right-of-way, crosswalk, or shoulder of the roadway any: farm tractor or similar vehicle designed primarily for farm use; skateboard, roller skates, or in-line skates; horse-drawn carriage; electric personal assistive mobility device; or wheelchair. S. 316.027 (1)normal HB 1133 would set up specific penalties for anyone who commits a non-criminal traffic infraction that seriously injures or kills a vulnerable road user. Those penalties include fines, suspension of driver’s licenses, and the requirement to complete a driver improvement course. These are in addition to any other criminal charges that could arise from such incidents. If signed into law, the bill would take effect on July 1. HB 1305 — Security DepositsHouse Bill 1305 aims to amend the state’s Residential Landlord and Tenant Act following a recent case out of Palm Beach County.According to Seeking Rents, the case involved two tenants who sued their former apartment complex after it failed to return a $500 security deposit. Under state law, security deposits have to be held in a “Florida banking institution,” and the complex had kept the tenants’ deposits in an account with JP Morgan Chase — a national bank headquartered in New York. Legislative analysts said that the definition of “Florida banking institution” used by plaintiffs in that case have since been repealed, but because the Act doesn’t define that term, it opens up the possibility of similar lawsuits in the future, which could deter developers from investing in more rental housing that would drop prices. As a result, HB 1305 adds the following definition for “Florida banking institution” to the Act: A bank, credit union, trust company, savings bank, or savings or thrift association doing business under the authority of a charter issued by the United States, this state, or any other state which is authorized to transact business in this state and whose deposits or share accounts are insured by the Federal Deposit Insurance Corporation or the National Credit Union Share Insurance Fund House Bill 1305normal If signed into law, the bill would go into effect immediately. HB 1567 — Emergency Management DirectorsHouse Bill 1567 aims to create requirements to qualify for Emergency Management Directors in the state.Under the State Emergency Management Act, each county is required to have a director for its respective emergency management agency. These directors are appointed by local leaders, though there are no specific minimum qualifications to serve as one. As such, this bill seeks to establish minimum education, experience and training requirements to qualify for a director position. These standards include holding a bachelor’s degree, having at least four years of similar experience in another role, and completing 150 hours of emergency management training. If HB 1567 is approved, existing county emergency management directors will have until June 30, 2026 to meet the new criteria. If signed into law, the bill would go into effect on July 1. HB 5401 — New JudgeshipsHouse Bill 5401 aims to establish a few new judge positions in Florida.According to Legislative analysts, the state’s Supreme Court issued an order in November detailing the need for the new positions. As a result, this bill would set up the following: A circuit court judgeship in the First Judicial Circuit (Escambia, Okaloosa, Santa Rosa and Walton counties) A circuit court judgeship in the Twentieth Judicial Circuit (Charlotte, Collier, Glades, Hendry and Lee counties) A county court judgeship in Columbia County A county court judgeship in Santa Rosa County Two county court judgeships in Hillsborough County Three new county court judgeships in Orange County If signed into law, the bill would go into effect on July 1. SB 92 — Yacht and Ship Brokers’ ActSenate Bill 92 aims to revise state regulations of yacht and ship brokers/salespeople.Under this bill, such brokers wouldn’t be required to hold a license in Florida if they primarily operate as a broker in another state and buy a yacht from someone in Florida who is licensed. If signed into law, the bill would go into effect on Oct. 1. SB 328 — Affordable HousingSenate Bill 328 aims to amend parts of the Live Local Act.Some of those changes are as follows: Preempting local governments’ “floor area ratio” for certain developments Prohibiting qualifying developments within 1/4-mile of a military installation from using the Act’s administrative approval process Exempting certain airport-impacted areas from the Act’s provisions Modifying parking reduction requirements for qualifying developments located near certain transportation facilities Requiring local governments to publish policies on their websites about the procedures and expectations for approval of qualifying developments Clarifying that only the affordable units in a qualifying development must be rental units For ad valorem tax exemptions on newly constructed multifamily developments, the bill would require 10 units — rather than 70 — be set aside for income-limited households in the Florida Keys to qualify for the exemption. If signed into law, the bill would take effect immediately. SB 382 — Continuing Education RequirementsSenate Bill 382 aims to revise requirements for licensure by the Florida Department of Business and Professional Regulation.Under this bill, someone trying to renew their license with the DBPR and who has held their license for at least 10 years is exempted from being required to complete continuing education — so long as there is no disciplinary action imposed on the license. However, this rule would not apply to engineers, CPAs, brokers, broker associates, sales associates, real estate appraisers, architects or interior designers. If signed into law, the bill would take effect on July 1. SB 892 — Dental Insurance ClaimsSenate Bill 892 aims to revise parts of the Florida Insurance Code related to covered dental services.Under this bill, insurers would be prohibited from denying claim payments if a dental procedure was authorized by an insurer before taking place, with few exceptions. In addition, the bill seeks to make other changes, like requiring insurers to receive written consent from dentists prior to employing claim payments via credit cards, and prohibiting insurers from charging dentists a fee when paying a claim through an automatic clearinghouse. If signed into law, the bill would take effect on Jan. 1, 2025. SB 994 — Student Transportation SafetySenate Bill 994 aims to revise state statutes related to camera enforcement of traffic infractions where a driver passes a stopped school bus.More specifically, the bill would make the following changes: Manufacturers of school bus infraction detectors may receive a fixed amount of collected proceeds for services rendered regarding those detectors. Required signage on school buses with these detectors must be revised. Funds collected from related civil penalties are allocated to the respective school district to pay for the detector program and other student transportation safety enhancements. The collection of evidence from such a detector doesn’t constitute remote surveillance. The use of video and images on these detection systems are limited to their specific purpose. Certain traffic fines are remitted to the respective school district. If signed into law, the bill would take effect immediately. |
2024.05.08 09:12 NefariousnessAny7346 Indiana Rule 21
Please delete if this has been previously discussed.
Does anyone else interpret the below as possible outcomes should further actions be taken?
(A) Selection under Local Rule Adopted by Counties. Upon granting a change of judge or the disqualification or recusal of a judge in a criminal case, post-conviction proceeding, infraction, or ordinance violation, a successor judge shall be assigned in the same manner as the initial judge. Where this process does not result in the selection of a successor judge, selection shall be made by local rule. The local rule required must include an alternative assignment list of full-time judicial officers from contiguous counties and counties within the administrative district of the court as set forth in Administrative Rule 3(A) and senior judges. The local rule must take into account the effective use of all judicial resources within an administrative district. Except for those serving pursuant to Criminal Rule 2.4(E)(6), judges previously assigned to the case are ineligible for reassignment. A person appointed to serve as special judge must accept jurisdiction in the case unless the appointed special judge is disqualified pursuant to the Code of Judicial Conduct, ineligible for service under this Rule, or excused from service by the Indiana Supreme Court.
(B) Appointment by Indiana Supreme Court. A trial court may request the Indiana Supreme Court to appoint a special judge in the following circumstances: (1) no judge under the local rule is available for appointment; or (2) the circumstance warrants selection of a special judge by the Indiana Supreme Court.
(D) Discontinuance of Service. In the event the case has been reassigned or a special judge assumes jurisdiction and thereafter ceases to act for any reason, further reassignment or the selection of a successor special judge must be in the same manner as set forth in section (A).
(E) Compensation. A full-time judge, magistrate, or other employee of the judiciary must not be paid a special judge fee for serving as a special judge or serving in a case reassigned pursuant to this rule. All other persons serving as special judge shall be paid a special judge fee of twenty-five dollars per day for each jurisdiction served for the entry of judgments and orders and hearings incidental to such entries. All judges, magistrates, and other persons who serve in courts outside of their county of residence shall be entitled to mileage at a rate equal to other public officials as established by state law, hotel accommodations, and reimbursement for meals and other expenses. Senior Judges who serve as special judges shall be paid in accordance with a schedule published by the Chief Administrative Officer of the Office of Judicial Administration. At the discretion of the special judge and following consultation with the parties, a special judge or a judge reassigned a case in another court may schedule conferences, entertain motions, and perform all administrative tasks without travel to the court where the case is pending. All hearings involving testimony by witnesses, unless the parties agree to the contrary on record, shall be held in the court where the case is assigned. Special judges are encouraged to employ procedures that reduce the necessity for travel, such as telephone conferences, facsimile exchange of information, and other time-saving measures of communication. Compensation as permitted under this provision shall be paid by the State upon presentation of a claim for such services signed by the special judge.
submitted by NefariousnessAny7346 to DelphiDocs [link] [comments]
Does anyone else interpret the below as possible outcomes should further actions be taken?
- Original Action (III) could cite Gull’s failure to act (“for any reason”); and
- Factoring in Carroll County’s Local Rules, Rule 21(A), Gull’s denied Motion to Change Venue, the Administrative District (or Diener’s replacement) could take the case back;
- Any hearing that occurred in Allen county may be considered reversible error because it didn’t occur within Carroll County according to 21(E) (Hennessy is genius for creating a record).
- Based on the above, the speedy trial rule may be in play (this one is a leap).
(A) Selection under Local Rule Adopted by Counties. Upon granting a change of judge or the disqualification or recusal of a judge in a criminal case, post-conviction proceeding, infraction, or ordinance violation, a successor judge shall be assigned in the same manner as the initial judge. Where this process does not result in the selection of a successor judge, selection shall be made by local rule. The local rule required must include an alternative assignment list of full-time judicial officers from contiguous counties and counties within the administrative district of the court as set forth in Administrative Rule 3(A) and senior judges. The local rule must take into account the effective use of all judicial resources within an administrative district. Except for those serving pursuant to Criminal Rule 2.4(E)(6), judges previously assigned to the case are ineligible for reassignment. A person appointed to serve as special judge must accept jurisdiction in the case unless the appointed special judge is disqualified pursuant to the Code of Judicial Conduct, ineligible for service under this Rule, or excused from service by the Indiana Supreme Court.
(B) Appointment by Indiana Supreme Court. A trial court may request the Indiana Supreme Court to appoint a special judge in the following circumstances: (1) no judge under the local rule is available for appointment; or (2) the circumstance warrants selection of a special judge by the Indiana Supreme Court.
(D) Discontinuance of Service. In the event the case has been reassigned or a special judge assumes jurisdiction and thereafter ceases to act for any reason, further reassignment or the selection of a successor special judge must be in the same manner as set forth in section (A).
(E) Compensation. A full-time judge, magistrate, or other employee of the judiciary must not be paid a special judge fee for serving as a special judge or serving in a case reassigned pursuant to this rule. All other persons serving as special judge shall be paid a special judge fee of twenty-five dollars per day for each jurisdiction served for the entry of judgments and orders and hearings incidental to such entries. All judges, magistrates, and other persons who serve in courts outside of their county of residence shall be entitled to mileage at a rate equal to other public officials as established by state law, hotel accommodations, and reimbursement for meals and other expenses. Senior Judges who serve as special judges shall be paid in accordance with a schedule published by the Chief Administrative Officer of the Office of Judicial Administration. At the discretion of the special judge and following consultation with the parties, a special judge or a judge reassigned a case in another court may schedule conferences, entertain motions, and perform all administrative tasks without travel to the court where the case is pending. All hearings involving testimony by witnesses, unless the parties agree to the contrary on record, shall be held in the court where the case is assigned. Special judges are encouraged to employ procedures that reduce the necessity for travel, such as telephone conferences, facsimile exchange of information, and other time-saving measures of communication. Compensation as permitted under this provision shall be paid by the State upon presentation of a claim for such services signed by the special judge.
2024.05.08 06:47 Rainyfriedtofu Clover Health Q1 earning brief: Andrew Troy is an absolute chad
 | Hello Fellow Apes, submitted by Rainyfriedtofu to Healthcare_Anon [link] [comments] since some of you are hype about the Q1 earning of Clov, I will be writing my DD of the Clov's Q1 earning call a little earlier than our usual weekend update. Nevertheless, Moocao's detailed posts with the numbers will still be on the weekend. With that said, we're going to start by looking at this post from investor place. https://investorplace.com/2024/05/3-healthcare-stocks-to-sell-in-may-before-they-crash-burn/ I want to start with that post because it aged like milk. "3 Healthcare stock to sell in May before they crash and burn." The article aged like rancid cheese. It was published today, and Clov absolutely killed on its earnings, which is why it went up 20% after hours. Now, I know what you are thinking, "Rainy, what makes the earning so hyped that the shorts on clov's reddit are panicking?" Many things. First and most noticeable is the company is profitable. You can look at the information in the link below https://www.tradingview.com/symbols/NASDAQ-CLOV/ https://investors.cloverhealth.com/static-files/7ffeafc6-2947-4982-aeb1-7fb522b06f55 https://investors.cloverhealth.com/static-files/d932a8b9-c877-40b7-a28f-d5618bae2573 For a publicly traded company to be considered profitable, it means that its total revenues exceed its total expenses during a specific period, usually reported quarterly or annually. This leads to net income or net profit, which are crucial indicators of the company's financial health and efficiency. These details are typically outlined in the 10-Q and 10-K reports, which will be covered in more detail by Moocao later. However, it's important to note that these financial figures alone don't usually cause a company's stock price to surge. Instead, the stock often reacts to the company's future earnings potential and the strategic insights shared during earnings calls. Before we proceed, I want to give a huge shout-out to our team for their exceptional work on the healthcare industry changes. We were on point in predicting the result of the earnings including the unexpected yet strategic decision to buy back shares, approved by Clov's board—a bold move that demonstrated great foresight and courage. Moving forward, I will outline some key points that stood out during our analysis. Please note, these points are not listed in order of importance.
https://www.reddit.com/Healthcare_Anon/comments/1btpdyy/412024_cms_is_not_joking_around/ Also Andrew Toy was hinting about this in April https://www.fiercehealthcare.com/ai-and-machine-learning/medicare-advantage-rate-cut-remains-feds-keep-pressure Clover Health is now profitable, even with their conservative financial projections. A key factor to note is the impressive performance of the Clover Assistant, which has provided the company with the necessary insights to make forward-thinking decisions. Clover Health is optimistic about regaining its 3.5-star rating and potentially achieving 4 stars--this year--thanks in large part to its AI platforms. These technologies have enabled superior risk adjustment and forecasting, contributing to expanding margins. Moreover, Clover Health remains profitable and continues to improve its margins despite reductions in Medicare Advantage rates. This is a significant achievement, especially in contrast to traditional healthcare companies, which have frequently voiced complaints to CMS about rate changes. Moocao wrote like 3 posts about this going over the complaints. https://www.reddit.com/Healthcare_Anon/comments/1c14x5g/cms_finalizes_payment_updates_for_2025_medicare/ https://www.reddit.com/Healthcare_Anon/comments/1c1n3tf/cms_finalizes_payment_updates_for_2025_medicare/ https://www.reddit.com/Healthcare_Anon/comments/1c1yg8q/cms_finalizes_payment_updates_for_2025_medicare/ Another key point from the earnings call was the effectiveness of the Clover Assistant in managing and reducing chronic diseases. Clover is also working in compliance with CMS to streamline billing codes, essentially meaning that the Clover Assistant is compliant with CMS-HCC v28, helping providers deliver care more quickly and accurately. This is significant as it enables primary care providers (PCPs) to offer more consistent and higher quality care. Importantly, Clover Health plans to offer the Clover Assistant as a Software as a Service (SaaS), but it will not be sold directly by Clover Health. Instead, Clover is establishing a separate company to market and sell Clover Assistant as a SaaS solution—similar to how Optum operates under UnitedHealthcare. Initially, this venture will start in New Jersey and potentially expand to include other third parties. The decision to set up a separate company for this service is mainly due to liability concerns and differing regulatory requirements. Regarding the regulatory aspect of reporting significant contracts through an 8-K form, the requirement depends on several factors, including the size and significance of the contract relative to the company's overall operations and financial health. There isn't a universally defined threshold for what constitutes a "large" or "substantial" contract. Typically, a contract must be material to the company’s business, finances, or operations to necessitate an 8-K filing. Materiality is assessed based on factors such as the dollar amount, the percentage of revenue or assets involved, strategic importance, and the nature of the transactions or obligations involved. For Clover, it's $2 billion company (rough estimate) a substantial contract might be about 10% of their operations by dollar value. However, since Clover plans to conduct this business through a separate entity and distribute it in smaller contracts to PCPs, it likely won't require direct reporting on their 8-K, assuming these smaller contracts individually fall below the materiality threshold. Nevertheless, physician would want to use CA moving forward because of the big CMS-HCC v28 problem which was mentioned during the earning. If they don't lose it, they will make less money, and nobody wants to make less money. Below are the problems with CMS-HCC V28. https://www.reddit.com/Healthcare_Anon/comments/1bvf551/cmshcc_v28/ Clover Health is particularly well-positioned in relation to the changes being implemented by CMS compared to its competitors. A surprising revelation from the earnings call was that Clover Assistant (CA) had accurately predicted trends that diverged from the widespread industry expectations of increased utilization. Instead, Clover observed the same trends that CMS had identified in its modeling. This alignment is significant. What this means is that Clover Assistant is enhancing Clover's capabilities in several critical areas: it's improving the accuracy of their projections, streamlining their claims processing, and enabling faster and more precise service delivery. This demonstrates Clover Assistant's effectiveness in adapting to and predicting regulatory and market changes, which is a considerable advantage for Clover Health. But wait... there is more, "Clover health is still not optimized" and they are planning to role out more features this year! Aside from that note, Clover Health was impacted by the cyberattack like many others. However, thanks to the resilience provided by Clover Assistant (CA) and Clover Health's allowance for providers to submit claims through an alternative pathway, the situation was managed well. The volume of claims was low and there were no significant delays in processing. Overall, Clover Health handled the incident competently, leading to a normalization of claim inventory and a return to normal operations. Looking ahead to the next quarter, Clover Health plans to enhance its reporting transparency by introducing an additional metric: the Benefit Care Ratio (BCR). This inclusion aims to make Clover's performance comparable to that of other established healthcare providers. In short, Clover Health is striving to position itself alongside major healthcare organizations. The Benefit Care Ratio is often referred to as the Medical Cost Ratio (MCR) or Medical Loss Ratio (MLR) in different contexts, is a financial metric used by insurance companies, particularly in health insurance, to indicate the percentage of premium revenues spent on medical claims and healthcare services for policyholders. The Benefit Care Ratio is calculated by dividing the total healthcare benefits paid out by the insurer by the total premium income received from policyholders. This ratio is expressed as a percentage. The main purpose of this ratio is to assess how much of the insurance premiums collected are actually used for paying for the medical care of insured individuals. It is a measure of the value policyholders receive from their insurance plan. In the U.S. and under the Affordable Care Act (ACA), there are specific minimum requirements for this ratio to ensure that insurers spend a substantial portion of premium dollars on patient care rather than on overhead, administrative costs, or profit. For example, the ACA requires health insurers in the individual and small group markets to have an MLR of at least 80%, and in the large group market, at least 85%. Clover health has completely exited ACO-REACH (non-insurance) and they will be paying CMS $39 million to say "fuck it, i'm out." The most interesting thing about the whole earnings was the announcement of the approved $20 million share buyback program. https://www.fiercehealthcare.com/payers/clover-health-authorizes-20-million-share-buyback-program Why is this significant? It's means Clover's board and Investor Relation are listening. There have been reports filed with them regarding brigade groups shorting clover below the 1:1 ratio. https://preview.redd.it/1a72e0bur4zc1.jpg?width=536&format=pjpg&auto=webp&s=9ff330b67faec0e1ff5f154501e59a43ce9a4528 Andrew Toy is basically throwing down the gauntlet and challenging the shorts to short the stock of a profitable company with expanding margins and new revenue streams. When we filed the reports with SEC and Clover IR, this was last solution we came up with. Andrew has some really big balls to do this. Companies typically initiate stock buybacks under certain circumstances that align with their financial strategies and market conditions. Some of the common reasons and timing for initiating a stock buyback include:
I was planning to delve deeper into the hiring of the new CFO, Peter, because he is exceptionally qualified. During his tenure starting in 2018, Peter played a crucial role in growing Omnicell’s value from $50 to $177 per share. Clover Health has managed to bring him on board, and judging by the financial performance they are achieving, it looks like Clover will benefit greatly from his expertise in the future. However, I'm quite tired, so I’ll keep this brief. You'll have to take this summary for now. https://www.bizjournals.com/sanfrancisco/news/2018/06/08/winner-public-company-small-to-medium-peter.html Stay tune for Moocao's post on the weekend. I am only thing this post because you guys are so hyped about the earning and bugging me. Edit 5/7/2024 I forgo to add the Q&A note. BCR for 2024 will be around low to mid 80s. With the higher utilization of healthcare, more providers are interested in clover assistant because of the CMS-HCC v28 compliance and they can make billing easier. Edit 5/7/2024 As a side note, I might be hearing this wrong, but if Andrew didn't use the words benefit-care ratio (BCR), then he might be using the words "Benefit-Cost Ratio." It is a financial ratio used to assess the relative cost-effectiveness of a health intervention compared to its benefits. The BCR is calculated by dividing the total benefits of a healthcare intervention (usually measured in monetary terms) by its total costs. This ratio helps healthcare providers, policymakers, and researchers determine whether the benefits of a healthcare intervention justify its costs, facilitating more informed decisions about resource allocation. In a broader context, BCR is used in various industries and projects to evaluate the economic value of investments and to prioritize projects based on their potential return compared to their costs. If this is this context, then it means clov is aiming to assess the value of CA (AI) and how its impacting care and service delivery. If they are talking about BER (Benefit expense ratio) like those of you who are mentioning it in the comment. This ratio is used to assess the portion of premium dollars that an insurance company spends on claims and benefits provided to policyholders. It is an important measure used by insurance companies to evaluate their financial health and operational efficiency.The Benefit Expense Ratio is calculated by dividing the total benefits paid out by the total premiums earned. A higher Benefit Expense Ratio can suggest that the insurance company is efficiently using its resources to provide benefits to its policyholders, whereas a lower ratio might indicate administrative costs or other expenses are consuming a significant portion of premiums. This metric is also closely monitored by regulatory agencies to ensure that insurance companies meet minimum standards for spending on policyholder benefits. The analyst did asked about the new entity, but andrew didn't reveal much except they are operating in New Jersey first because the infrastructure is there. I talked about the infrastructure in the post below. https://www.reddit.com/Healthcare_Anon/comments/1bpnf5p/clover_healths_diamond_mine_irb_hipaa_p4_and_ai/ |
2024.05.08 01:34 Sell-Glad Independent Pharmacy: Is Contracting with Humana Worth It
Hi, Opening an Independent...leaning toward LTC but not yet. I'm PIC and the owner is filling out the applications for certain insurances. Apparently, Humana has very intrusive questions. Much more than the other applications he has filled out. I'm wondering, how much business/reimbursement/profit would we be missing out on if we don't contract with Humana. Is it mostly Medicare Part D? Please explain as I am not familiar with the details of Humana.
We will focus a lot on Medi-Cal (Medicaid in CA) which has good reimbursement rates. Possible compounding.
I would appreciate any thoughts.
submitted by Sell-Glad to pharmacy [link] [comments]
We will focus a lot on Medi-Cal (Medicaid in CA) which has good reimbursement rates. Possible compounding.
I would appreciate any thoughts.
2024.05.07 23:07 Toddsteez Looking for a Web Developer
We are a local, small business seeking a skilled and motivated Web Developer to join our team on a contract basis. This role is ideal for an experienced individual who thrives in a mostly remote environment and is keen to contribute to a niche market.
Job Description
In this role, you will be responsible for designing, coding, and modifying a website, from layout to function, according to specifications. You will strive to create a visually appealing site that feature user-friendly design and clear navigation while working with a designated designer.
Responsibilities
Please submit your resume and a portfolio of your work to tw@nickel5.com. We look forward to exploring how your skills and experiences align with our needs.
[Edit for formatting]
submitted by Toddsteez to denverjobs [link] [comments]
Job Description
In this role, you will be responsible for designing, coding, and modifying a website, from layout to function, according to specifications. You will strive to create a visually appealing site that feature user-friendly design and clear navigation while working with a designated designer.
Responsibilities
- Develop new user-facing features and build reusable code and libraries for future use.
- Ensure the technical feasibility of UI/UX designs.
- Use ASP.NET (Blazor) and Microsoft frameworks extensively to implement web, business logic and database layers.
- Optimize applications for maximum speed and scalability.
- Collaborate with other team members and stakeholders.
- Work within platforms like GitHub for version control and Discord for team communication.
- Follow best practices and standards for accessibility and cross-browser compatibility.
- Proven experience as a Web Developer with examples of recent work.
- Strong understanding of ASP.NET (Blazor) and Microsoft frameworks.
- Familiarity with web markup, including HTML5 and CSS3.
- Proficient understanding of client-side scripting and JavaScript frameworks.
- Experience with GitHub and effective version control practices.
- Comfortable using Discord for daily communications.
- Excellent problem-solving skills and attention to detail.
- Collaborative mindset.
- Must live within driving distance of Boulder, Colorado.
- Competitive hourly rate, $100-$150 per hour based on experience.
- Front-loaded payment with ongoing support component.
- 80 - 120 remote, project-based hours to start.
- More hours may be available after website launch.
- This position is a 1099 contract role. Persons paid on a 1099 basis are independent contractors and are self-employed. Independent contractors are required to pay all self-employment taxes (Social Security & Medicare) as well as income tax.
- Candidates must be authorized to work in the U.S. as no visa sponsorship is available for this position.
Please submit your resume and a portfolio of your work to tw@nickel5.com. We look forward to exploring how your skills and experiences align with our needs.
[Edit for formatting]
2024.05.07 06:45 Rainyfriedtofu CVS Q1 2024 Earnings analysis: Rainyfriedtofu's version.
Hello Fellow Apes,
I want to take a quick minute to write a post about Moocao's post regarding CVS Q1 2024 earning.
https://www.reddit.com/Healthcare_Anon/comments/1cjpur9/cvs_q1_2024_earnings_analysis_earnings_call10q/
It is a great post with many implications taken from the perspective of an investor and someone who is on the front line. We're literally seeing CVS' earning unfold in real time. Additionally, I want to juxtapose it with the things that are being written on WSB because comparisons often serve as a good frame of reference.
https://www.reddit.com/wallstreetbets/comments/1ckq8i2/cvs_got_crushed_so_pntg_may_soa?share_id=vWu2IAVOKrdbdYRsz0UOF&utm_content=1&utm_medium=android_app&utm_name=androidcss&utm_source=share&utm_term=1
We often don't know what we're looking at until we have something to compare it to. We're going to start off with Moocao's DD before going to the WSB DD (Sorta)
Starting with Moocao's DD.
CVS reported that their first quarter earnings were negatively impacted by an increase in the use of Medicare Advantage services, which affected their profitability. However, this issue does not stem from the Centers for Medicare and Medicaid Services (CMS). Instead, as a provider of managed care, companies like CVS are responsible for delivering this care to their consumers. The goals of the managed care model include improving cost efficiency, coordinating care, enhancing benefits, promoting preventive care, and managing risk. This model is designed to be cost-effective, focused on preventative care, and capable of delivering high-quality health outcomes. If there is a significant increase in service utilization that is not related to extraordinary circumstances like delayed elective surgeries post-COVID or other exceptional reasons often cited by healthcare companies, it likely indicates a failure in effectively managing the health of the population. In essence, they have reached a point where they must provide necessary care without the ability to further profit by denying services. This situation implies that their management of member health was inadequate, forcing them to address these health issues more intensively now.
CVS reported a revenue growth of 3.7% and an adjusted earnings per share (EPS) of $1.31 for the first quarter of 2024. However, they have revised their EPS forecast for the year downwards to at least $7.00. This adjustment is primarily attributed to higher than expected Medicare utilization. Although these figures appear positive, they don't fully reveal the underlying dynamics affecting the company.
Previously, CVS had forecasted a normalization of service use, building upon an already high baseline from the fourth quarter of 2023. However, they have now observed that the current utilization trends are exceeding those of Q4 2023. This might be the first earnings report this season where a company has reported higher utilization compared to the previous quarter, setting CVS apart from others. Most companies noted an increase in inpatient services in January and February, with a decline in March, but none have reported a higher utilization than in Q4 2023 until now. As mentioned, I believe this is just a consequence of their action, and it is one of the reason why they are desperate for CMS to increase the fee for service rate to be higher than the 3.7% increase they will be getting.
Additionally, CVS has increased its reserves to cover any unprocessed claims resulting from the Change Healthcare cyberattack. Both outpatient services and Medicare supplement utilization have remained high in the first quarter of 2024, surpassing previous projections.
Furthermore, Aetna evaluated the CMS final rate notice for Calendar Year (CY) 2025, along with changes to the Medicare Part D plan as mandated by the Inflation Reduction Act. The company concluded that the reimbursement rates are insufficient (CMS doesn't care and the rules are final). Aetna points out that the lower rate increases specified by CMS will significantly disrupt the level of benefits and the range of options available to seniors nationwide which is another way of saying it will punish the consumers by cutting back on benefits and probably denying the shit out of any claim. Consequently, Aetna plans to reduce benefits and will strategically withdraw from certain markets during the bidding process for CY 2025, a move that is in line with trends seen among other players in the market. My bet is they will start withdrawing from poorer areas where the self-managed care of the population is bad. They will probably still still in more affluent areas where people are managing their own care and has more money. Aetna is focusing on improving its profit margins and has decided not to pursue growth in this market segment in CY 2025.
In response to increased utilization, Aetna has established multidisciplinary teams to analyze claims data for specific conditions, geographic regions, or unusual patterns in service use. It's important to clarify that Aetna is well-equipped to identify the reasons behind this increase. By categorizing and reviewing billing codes, they can easily pinpoint which areas are contributing to higher utilization. CVS has attributed the rise in costs to increased outpatient services and higher drug prices. Prominent factors that typically escalate healthcare expenses include dialysis, diabetes, and drugs for multiple coexisting conditions, which are notoriously expensive and difficult to cut back on. Moreover, this situation is compounded by a deteriorating general health among the population, driven by years of inadequate investment in population health management, leading to a critical point where reversing the trend becomes exceedingly challenging.
Additionally, CVS will be using biosimilar drugs to save money while providing "equivalent clinical care." Biosimilar drugs are a type of medication designed to be highly similar to an already approved biological drug, known as a reference or originator biologic. Unlike generic drugs, which are exact copies of chemically synthesized drugs, biosimilars are derived from living organisms and are not identical replicas but are closely matched in terms of safety, effectiveness, and quality to their reference biologics. Biosimilars are developed to compete with existing biological drugs, offering potentially lower-cost options once the original products' patents expire. This might result in higher claim denials, but slower delivery of care. If this is the case, the issues of population health will just get worse.
In the first quarter of 2024, CVS reported a Medical Benefit Ratio (MBR) of 90.4%, marking an increase of 580 basis points compared to the first quarter of 2023. This rise is attributed to increased utilization of services and a decrease in STARS ratings for the year 2024. Specifically, CVS has observed heightened utilization in outpatient and supplemental benefits, alongside rising pressures on inpatient services. The latter is characterized by seasonal patterns in inpatient admissions that CVS has not encountered since before the pandemic.
In response to these financial pressures, CVS is considering the retirement of certain health plans and the introduction of new plans less impacted by Total Benefit Cost (TBC) thresholds. Additionally, CVS plans to recalibrate the pricing on their existing plans to compensate for the eroded margins.
Moreover, CVS/Aetna is prioritizing pricing strategies aimed at maintaining profit margins rather than expanding membership. Despite these pricing adjustments, CVS does not anticipate a significant loss in membership. This expectation is based on the assumption that similar industry-wide pressures will lead to widespread plan price increases, encouraging members to stay with CVS/Aetna. Concurrently, CVS is exploring reductions in benefits as part of its strategy to improve profit margins. Now... what would happen if there are companies that do not experience similar industry-wide pressure? CVS and similar companies with have real competitions!
The other points Moocao made in the post are self-explanatory and I highly suggest you give it a read. I'm only highlighting keypoints and their implications. I don't see how CVS MCR is going to improve when their population health is so bad that they can't even explain it on an earning calls. We know they know. You can't be a company like CVS and fail at projecting population health. Their profit making caught up to them, and now they have to git gud real fast.
Now for the CVS DD from WSB.
I find the post particularly amusing, and I give the author credit for suggesting that home healthcare would solve CVS' problems. However, he is very wrong in his understanding of healthcare companies and home health. Home health care is a solution and will be the replacement for nursing homes. In is a most cost-effective solution. As for healthcare companies, they will first start cutting cost before they explore introducing another product such as home health care. There are companies such as CLOV that does have a home health care, but CVS doesn't have one and will not be exploring one anytime soon. As for PNTG, the crowd went mild after the recent earning a large part of this is because home health margin isn't that great and the new 80/20 rules for HCBS waivers aren't that great, but we're not going to dive into that here.
I just want to highlight the contrast between Moocao DD and the kind of stuff others such as WSB would post. I know that it may look simple, but there are real nuances to the stuff that we write. For those of you who know how to use census track, you can figure out which geographic areas is causing the most pain for CVS. older, poorer, and less educated seniors are the ones causing the high uptick in utilization. If they really want to reduce the utilization, they need to invest more money into improving access to care and education to improve public health.
submitted by Rainyfriedtofu to Healthcare_Anon [link] [comments]
I want to take a quick minute to write a post about Moocao's post regarding CVS Q1 2024 earning.
https://www.reddit.com/Healthcare_Anon/comments/1cjpur9/cvs_q1_2024_earnings_analysis_earnings_call10q/
It is a great post with many implications taken from the perspective of an investor and someone who is on the front line. We're literally seeing CVS' earning unfold in real time. Additionally, I want to juxtapose it with the things that are being written on WSB because comparisons often serve as a good frame of reference.
https://www.reddit.com/wallstreetbets/comments/1ckq8i2/cvs_got_crushed_so_pntg_may_soa?share_id=vWu2IAVOKrdbdYRsz0UOF&utm_content=1&utm_medium=android_app&utm_name=androidcss&utm_source=share&utm_term=1
We often don't know what we're looking at until we have something to compare it to. We're going to start off with Moocao's DD before going to the WSB DD (Sorta)
Starting with Moocao's DD.
CVS reported that their first quarter earnings were negatively impacted by an increase in the use of Medicare Advantage services, which affected their profitability. However, this issue does not stem from the Centers for Medicare and Medicaid Services (CMS). Instead, as a provider of managed care, companies like CVS are responsible for delivering this care to their consumers. The goals of the managed care model include improving cost efficiency, coordinating care, enhancing benefits, promoting preventive care, and managing risk. This model is designed to be cost-effective, focused on preventative care, and capable of delivering high-quality health outcomes. If there is a significant increase in service utilization that is not related to extraordinary circumstances like delayed elective surgeries post-COVID or other exceptional reasons often cited by healthcare companies, it likely indicates a failure in effectively managing the health of the population. In essence, they have reached a point where they must provide necessary care without the ability to further profit by denying services. This situation implies that their management of member health was inadequate, forcing them to address these health issues more intensively now.
CVS reported a revenue growth of 3.7% and an adjusted earnings per share (EPS) of $1.31 for the first quarter of 2024. However, they have revised their EPS forecast for the year downwards to at least $7.00. This adjustment is primarily attributed to higher than expected Medicare utilization. Although these figures appear positive, they don't fully reveal the underlying dynamics affecting the company.
Previously, CVS had forecasted a normalization of service use, building upon an already high baseline from the fourth quarter of 2023. However, they have now observed that the current utilization trends are exceeding those of Q4 2023. This might be the first earnings report this season where a company has reported higher utilization compared to the previous quarter, setting CVS apart from others. Most companies noted an increase in inpatient services in January and February, with a decline in March, but none have reported a higher utilization than in Q4 2023 until now. As mentioned, I believe this is just a consequence of their action, and it is one of the reason why they are desperate for CMS to increase the fee for service rate to be higher than the 3.7% increase they will be getting.
Additionally, CVS has increased its reserves to cover any unprocessed claims resulting from the Change Healthcare cyberattack. Both outpatient services and Medicare supplement utilization have remained high in the first quarter of 2024, surpassing previous projections.
Furthermore, Aetna evaluated the CMS final rate notice for Calendar Year (CY) 2025, along with changes to the Medicare Part D plan as mandated by the Inflation Reduction Act. The company concluded that the reimbursement rates are insufficient (CMS doesn't care and the rules are final). Aetna points out that the lower rate increases specified by CMS will significantly disrupt the level of benefits and the range of options available to seniors nationwide which is another way of saying it will punish the consumers by cutting back on benefits and probably denying the shit out of any claim. Consequently, Aetna plans to reduce benefits and will strategically withdraw from certain markets during the bidding process for CY 2025, a move that is in line with trends seen among other players in the market. My bet is they will start withdrawing from poorer areas where the self-managed care of the population is bad. They will probably still still in more affluent areas where people are managing their own care and has more money. Aetna is focusing on improving its profit margins and has decided not to pursue growth in this market segment in CY 2025.
In response to increased utilization, Aetna has established multidisciplinary teams to analyze claims data for specific conditions, geographic regions, or unusual patterns in service use. It's important to clarify that Aetna is well-equipped to identify the reasons behind this increase. By categorizing and reviewing billing codes, they can easily pinpoint which areas are contributing to higher utilization. CVS has attributed the rise in costs to increased outpatient services and higher drug prices. Prominent factors that typically escalate healthcare expenses include dialysis, diabetes, and drugs for multiple coexisting conditions, which are notoriously expensive and difficult to cut back on. Moreover, this situation is compounded by a deteriorating general health among the population, driven by years of inadequate investment in population health management, leading to a critical point where reversing the trend becomes exceedingly challenging.
Additionally, CVS will be using biosimilar drugs to save money while providing "equivalent clinical care." Biosimilar drugs are a type of medication designed to be highly similar to an already approved biological drug, known as a reference or originator biologic. Unlike generic drugs, which are exact copies of chemically synthesized drugs, biosimilars are derived from living organisms and are not identical replicas but are closely matched in terms of safety, effectiveness, and quality to their reference biologics. Biosimilars are developed to compete with existing biological drugs, offering potentially lower-cost options once the original products' patents expire. This might result in higher claim denials, but slower delivery of care. If this is the case, the issues of population health will just get worse.
In the first quarter of 2024, CVS reported a Medical Benefit Ratio (MBR) of 90.4%, marking an increase of 580 basis points compared to the first quarter of 2023. This rise is attributed to increased utilization of services and a decrease in STARS ratings for the year 2024. Specifically, CVS has observed heightened utilization in outpatient and supplemental benefits, alongside rising pressures on inpatient services. The latter is characterized by seasonal patterns in inpatient admissions that CVS has not encountered since before the pandemic.
In response to these financial pressures, CVS is considering the retirement of certain health plans and the introduction of new plans less impacted by Total Benefit Cost (TBC) thresholds. Additionally, CVS plans to recalibrate the pricing on their existing plans to compensate for the eroded margins.
Moreover, CVS/Aetna is prioritizing pricing strategies aimed at maintaining profit margins rather than expanding membership. Despite these pricing adjustments, CVS does not anticipate a significant loss in membership. This expectation is based on the assumption that similar industry-wide pressures will lead to widespread plan price increases, encouraging members to stay with CVS/Aetna. Concurrently, CVS is exploring reductions in benefits as part of its strategy to improve profit margins. Now... what would happen if there are companies that do not experience similar industry-wide pressure? CVS and similar companies with have real competitions!
The other points Moocao made in the post are self-explanatory and I highly suggest you give it a read. I'm only highlighting keypoints and their implications. I don't see how CVS MCR is going to improve when their population health is so bad that they can't even explain it on an earning calls. We know they know. You can't be a company like CVS and fail at projecting population health. Their profit making caught up to them, and now they have to git gud real fast.
Now for the CVS DD from WSB.
I find the post particularly amusing, and I give the author credit for suggesting that home healthcare would solve CVS' problems. However, he is very wrong in his understanding of healthcare companies and home health. Home health care is a solution and will be the replacement for nursing homes. In is a most cost-effective solution. As for healthcare companies, they will first start cutting cost before they explore introducing another product such as home health care. There are companies such as CLOV that does have a home health care, but CVS doesn't have one and will not be exploring one anytime soon. As for PNTG, the crowd went mild after the recent earning a large part of this is because home health margin isn't that great and the new 80/20 rules for HCBS waivers aren't that great, but we're not going to dive into that here.
I just want to highlight the contrast between Moocao DD and the kind of stuff others such as WSB would post. I know that it may look simple, but there are real nuances to the stuff that we write. For those of you who know how to use census track, you can figure out which geographic areas is causing the most pain for CVS. older, poorer, and less educated seniors are the ones causing the high uptick in utilization. If they really want to reduce the utilization, they need to invest more money into improving access to care and education to improve public health.