Your Health Information is worth Millions and what the industry is not telling you….

“Most of us believe that our medical and other health information is private and should be protected, and we want to know who has this information. The Privacy Rule, a Federal law, gives you rights over your health information and sets rules and limits on who can look at and receive your health information. The Privacy Rule applies to all forms of individuals’ protected health information, whether electronic, written, or oral. The Security Rule is a Federal law that requires security for health information in electronic form.” HHS.GOV

When you read statements like these on government websites you want to believe the statements to be true. They are true however the ability of many companies and entities to “do work arounds” of these laws is shocking.

After working in healthcare for over 30 plus years with my focus on the nursing home patients I am no longer shocked by the schemes, lack of transparency and overall lack of integrity of many in the industry.

The Covid pandemic has highlighted the many issues and problems that our most vulnerable and seniors deal with on a daily basis by exposing the problems on a grand scale. Unfortunately these problems have been around since the late 50's.

I have a very hard time accepting that many who decide to work in healthcare really don’t care about the patients they serve. Rather these patients are just a means to generate revenue.Unfortunately the systems that are set up to protect us, are the same ones that the bad operators have figured out how to manipulate and game the system.

When talking to family members who have loved ones in nursing homes or assisted living homes, most do not know who actually owns them.The consolidation of the industry has left the consumer with little or no options and not a clear understanding of who is really taking care of their loved ones and their information.They usually do not know who the pharmacy that provides their medications and whether or not they are owned by the same company. Another shocking piece of information is that the nursing homes receive a specific amount of money for a patient under a medicare stay. That rate is dependent on a number of factors and it is to include the cost of the medications. A standard of practice that most consumers do not know is that the nursing home tries to pay the least amount of money to the pharmacy for these patient’s medications and often have “formularies” that prohibit the prescribing of high cost medications. There is alot of pressure put on the doctors to switch medications to a less expensive medication to save the nursing home money. Sometimes the choices are not really the best or clinically appropriate. When the nursing home receives money from the federal government for the drugs and all services provided they must pay the various vendors, pharmacy, therapy etc. You would be amazed at how many pharmacy’s also act as banks for the operators of these homes. No other industry functions like this and most consumers have no idea of the back office shenanigans.

The most recent conversations about “patient care” is “population health” and how it is revolutionizing the way we look at healthcare for patients leaving the hospitals and going home. Does anybody even understand what “population Health”?Some nursing homes claim to be saving thousand of lives by their program. Does anyone ask these nursing homes to show them the results, the data?It is a usual process that during the intake ,they require that you sign a document stating you will participate in their program to help you achieve better health. Or one of the newest processes is you are automatically enrolled unless you OPT OUT. (This is usually in the fine print that your Readers are needed to read.)There is usually a clause, again in very fine print, allowing them to use your health information and share it so they can improve YOUR overall health all at no cost to you, a “Free Service”.What seems to be missing is who are they sharing your information with and what is it being used for?

“Free Service” is never free- you pay for it in your taxes or increased premiums, but it is never really free. There is NOTHING in HEALTHCARE that is FREE.

For years companies have found ways to “data mine” your information. There is big money to be made and it seems every day there is another company or industry that has identified a way to capture your data.

Every time you give your email to a website company you are adding to their data base and helping to contribute revenue to someone’s bank account.

It is time to take control of our information and health and that means advocating, researching, ASKING questions, holding people accountable and not assuming that the agencies that are tasked with protecting you ARE.