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jthatoi · 3 months

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Transforming Real Estate: The Power of Custom Software

Tailored real estate software solutions are crafted to meet specific organizational or individual requirements, distinguishing them from off-the-shelf alternatives designed for general use. In contrast to readily available software, custom solutions in the real estate sector are meticulously designed to address unique challenges and workflows. They offer enhanced flexibility, scalability, and customization compared to pre-packaged alternatives.

In the residential real estate sector, custom software plays a pivotal role in streamlining intricate workflows. Businesses that leverage bespoke software solutions report a notable 29% boost in sales revenue. These solutions empower real estate agencies with tools precisely aligned with their current needs while adapting to industry changes, ensuring consistent growth and success. As the real estate landscape undergoes continual transformation, personalized property technology is set to be a driving force in shaping its future.

Can Custom Software Transform Real Estate Growth?

Custom software can significantly transform real estate growth by addressing the unique operations of agencies, enhancing efficiency and productivity, providing scalability for business growth, and fostering a client-centric approach. By adapting to the agency's specific operations, real estate agent software offers tailored functionalities to manage property, client relations, and transaction processes. It streamlines workflows, automates routine tasks, and reduces manual efforts, allowing professionals to focus on high-value activities.

Custom software solutions are designed to scale alongside the agency's growth, handling increasing data loads and user numbers without compromising performance. Custom CRM modules within the software enable personalized client interactions, efficient communication, and tailored service offerings, thereby enhancing client satisfaction and loyalty.

Data security and compliance are prioritized in custom real estate agent software, incorporating robust encryption and access controls to ensure compliance with industry regulations. Custom real estate agent software includes reporting and analytics tools, providing real-time insights into key performance indicators and market trends, empowering decision-makers to make informed strategic choices.

Custom real estate agent software gains a competitive edge by allowing agencies to quickly adapt to market changes, adopt emerging technologies, and offer unique services. It can also integrate emerging technologies like AI, blockchain, and virtual reality, ensuring the agency stays at the forefront of innovation and competitiveness in the ever-evolving landscape.

Benefits of Custom Real Estate Software:

In the dynamic and competitive landscape of residential real estate, having a robust and efficient system is crucial for success. Off-the-shelf real estate software might not be equipped to handle the complexities of a real estate agency’s operations. This is where custom real estate software solutions come in, offering several key advantages:

1. Streamlined Operations:

• Automates repetitive tasks and workflows, freeing up time and resources for agents and staff.

• Includes lead management, property listings, communication, marketing, and financial management.

2. Enhanced Efficiency:

• Eliminates manual processes and integrates various systems, improving efficiency.

• Resulting in faster turnaround times, improved data accuracy, and better customer service.

3. Customized Features:

• Includes only essential features for the agency’s workflow and business goals.

• Provides a user-friendly experience and eliminates unnecessary clutter.

4. Scalability and Growth:

• Can be easily scaled to accommodate future growth and changing requirements.

5. Competitive Advantage:

• Addresses the agency’s unique selling points, offering a competitive advantage.

6. Security and Data Protection:

• Built with enhanced security features, ensuring protection of sensitive client and business data.

7. Integration with Existing Systems:

• Eliminates data silos and ensures smooth data flow.

8. Improved Customer Experience:

• Provides a personalized and interactive experience, leading to higher client satisfaction and loyalty.

9. Increased Transparency:

• Provides real-time insights into key performance indicators and business metrics.

10. Reduced Costs:

• Initial investment in custom real estate software solutions can lead to significant cost savings in the long run.

5 Key Features of Custom Real Estate Software:

5 essential features for custom real estate software:

1. Centralized Data Management:

Consolidate all client, property, and transaction data in a single, secure platform.

Eliminate data silos and ensure seamless information flow across departments and teams.

Simplify data access and reporting for improved decision-making and efficiency.

2. Streamlined Workflows and Automation:

Automate repetitive tasks like rent collection, lease renewals, and maintenance request tracking.

Custom real estate software creates customized workflows for different processes, such as lead management, property marketing, and tenant onboarding.

Free up valuable time and resources for agents and staff to focus on strategic activities.

3. Integrated Communication and Collaboration:

Facilitate seamless communication between agents, tenants, owners, and vendors through various channels like email, SMS, and online messaging.

Share documents, updates, and announcements within the platform for improved transparency and collaboration.

Boost internal communication and coordination for a more cohesive and efficient organization.

4. Real-Time Data Insights and Reporting:

Generate customized dashboards and reports to visualize key performance indicators (KPIs) and track progress.

Gain insights into property performance, tenant satisfaction, and market trends.

Make data-driven decisions for optimizing pricing strategies, marketing campaigns, and resource allocation.

5. Scalability and Flexibility:

Adapt and grow as the organization expands and evolves.

Integrate with existing systems and tools to avoid data silos and ensure smooth operation.

Customize features and functionalities to fit the unique needs and workflows of the organization.

In the dynamic realm of real estate, the transformative power of custom software emerges as a beacon of innovation, reshaping the way agencies operate and thrive. From streamlined workflows to enhanced efficiency, the benefits of tailored solutions are undeniable. As we've explored the pivotal role of custom real estate software, it's evident that these solutions not only address the unique challenges of agencies but also propel them toward sustained growth and success.

Unlock the full spectrum of insights by delving into our comprehensive blog. Discover how custom software can revolutionize your real estate operations, offering scalability, personalized features, and a competitive edge in the ever-evolving landscape. Don't miss the chance to empower your agency with the tools needed to adapt to market changes, integrate emerging technologies, and provide unparalleled services.

#outsourcing partner #call center outsourcing for mental healthcare #software development #outsourcing #automation #call center outsourcing #realestate #custom application development #custom software development

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mostlysignssomeportents · 3 years

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Telehealth chickenizes docs

The "shitty technology adoption curve" describes the arc of oppressive technology: when you have a manifestly terrible idea, you can't ram it down the throats of rich, powerful people who get to say no. You have to find people whose complaints no one will listen to.

So our worst tech ideas start out with prisoners, asylum seekers and mental patients, spread to children and blue collar workers, and ascend the privilege gradient to the wealthy and powerful as they are normalized and have their roughest corners sanded down.

For example: If you ate your dinner under the unblinking gaze of a networked, remote-monitored video-camera 20 years ago, it was because you were in a supermax prison. Today, it's because you've been unwise enough to buy home cameras from Amazon, Google, or Apple.

I'm skeptical of prediction (fortune tellers are charlatans), but I do believe in leading indicators. If you want a look at your likely techno-oppressive future, just look at how we treat kids, blue-collar workers, and prisoners:

https://slate.com/technology/2019/10/affordances-cory-doctorow-sf-story-algorithmic-bias-facial-recognition.html

Another important concept: the quantitative fallacy. If you want to do computer work on a complex issue, the qualitative elements are daunting. Say you want to do exposure notification - it's easy to use Bluetooth beacons to tell whether two people are close to each other.

But it's hard to know what's actually going on with the people those beacons represent: are they in adjacent, sealed cars stuck in traffic, or are they college kids attending an eyeball-licking party?

https://pluralistic.net/2020/08/20/dubious-quantitative-residue/#thick-description

Rather than address chewy, irreducible, hard-to-compute qualitative stuff, quants are prone to just incinerating it, leaving behind a quantitative residue of dubious value, which is nevertheless easy to do computation on.

It's not just contact tracing: think of the urge to reduce fair use (a complex, qualitative doctrine hinging on an artist's intent and the resulting aesthetic effect) into a set of hard and fast rules: if you quote two lines of poetry, you're cool. Three lines? Piracy.

This powers Goodhart's Law: "a measurement becomes a target, then ceases to be a good measurement." Discarding the qualitative leads us to extend the lives of suffering, terminally ill people even when they beg for release: they're living longer!

https://en.wikipedia.org/wiki/Goodhart%27s_law

Connected to this: Chickenization, a term from the poultry industry, describing the misclassification of workers as contractors, allowing employers to shift all the risk onto workers and all the benefits to themselves.

https://pluralistic.net/2020/10/02/chickenized-by-arise/#arise

Think of Uber drivers, paying their own insurance, gas, depreciation, etc, but not being able to set their prices, not being able to decline a fare, not being able to form a union, having no guaranteed minimum wage, no disability benefits and no workplace safety guarantees.

Put it all together: the shitty technology curve, the quantitative fallacy, and chickenization, and what do you get?

Telemedicine.

https://techcrunch.com/2020/11/17/why-are-telehealth-companies-treating-healthcare-like-the-gig-economy/

As Oliver Kharraz writes in Techcrunch, telemedicine is here to stay, and while there are many ways telemedicine could benefit doctors and patients, that's not the system we're getting.

Instead, we're getting doctors-as-commodities, paid for piecework (chickenization), with outcomes measured in patients-per-hour not long-term health (quantitative fallacy).

Doctors are powerful, wealthy white-collar workers, but the pandemic has replaced their working conditions with those of a Pacific Rim outsource call-center worker (shitty technology adoption curve).

An exploited call-center worker who can only fill in online forms - not change policies, make exceptions, or even relay your dissatisfaction - rarely solves your problem. That's not what the system's for - it's there to neutralize your ability to negatively impact profits.

If they end up helping you, it's incidental to containing the risk you present.

Likewise, shareholder-first telehealth isn't designed to make you well, it's designed to respond to your immediate complaint and get you off the line.

This medical worst-practice: replacing a personal relationship with a medical professional that develops over time and treats you as a whole person with hastily jotted EHR notes. The literature and the practice of medicine are unequivocal: this doesn't make people well.

Kharraz provides two fixes that are critical to a qualitative, non-shitty, de-chickenized telehealth system:

The ability to choose a doc

The ability to specify a nearby doc

The fact that these modest goals are out of reach of contemporary telehealth really tells you all you need to know about who it serves.

Cryteria (modified) https://commons.wikimedia.org/wiki/File:HAL9000.svg

CC BY: https://creativecommons.org/licenses/by/3.0/deed.en

#pluralistic

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kramlabs · 5 years

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six norms that may be making your family less healthy

via Shane Trotter

What is normal is not normal. The human biology expects sunlight, constant movement, physical novelty, whole, natural foods, close relationships built upon shared purposeful efforts for survival, and a generally slow life pace.

Today it is normal to eat exclusively processed, convenience foods, to remain indoors all day except for trips in our temperature controlled cars, to feel pulled and prodded by constant message alerts, and to sit all day, predominantly with our face in a screen while being passively entertained. Normal is a relative term.

Very few forces are as powerful as the human need to belong. Consequently, we naturally tend towards herd mentality, behaving as the masses do, regardless of personal benefit. In fact, we’ll adopt odd “normal” behaviors without even realizing they directly contradict our desires, or that we could choose not to.

The standard model of life that we’ve been handed has created a devastating global health picture and all signs point to this trend worsening in our youngest generation. Now, more than ever, we must be willing to question what is normal and carve a different path.

Freedom is not just having the ability to behave as we wish, but knowing why we choose those behaviors. Through reflection and education, we truly become free and are then able to craft an environment that pulls our family to health and vitality.

If wondering where to start, I recommend exploring these six norms that may be making your family less healthy.

1. Having “Kid Food” Around

There is a widespread belief that there should be a distinction between kid’s foods and adult foods. I’ll never forget a client telling me how she ate well for most meals, but often found herself snacking on her kid's chips or popping a soda. When I suggested she stop keeping these foods in the house, she responded angrily, “I’m not going to not have chips and sodas for my kids.”

I’ve even seen this in healthy parents who make separate meals for their children so the young ones aren’t subjected to nutritious eating, as if this was a torturous experience. They’ll have roasted chicken, brown rice, and mixed vegetables while making chicken nuggets, mac and cheese, or frozen pizza for the young ones.

We’ve been sold the belief that kids can only eat chicken in nugget form, fish in fried stick form, and that the rest of their diet should come from packaged junk. While it is true that palates have to develop, children have always eaten natural, whole foods.

Fruits, vegetables, meat, seeds, and nuts have been the only available foods for almost all of human history. Roasted vegetables, sweet potatoes, and fish are actually childhood favorites when children aren’t engulfed in a world of Pop Tarts and pudding that only further serves to warp their palate. Without a diet predominantly consisting of whole foods, children are virtually ensured of future struggles with health and eating.

Make it simple. Make meals from foods that could have existed 10,000 years ago and have your children eat what you do. Ice cream and other desserts are wonderful occasional treats, but they should require a special trip, not be an always available temptation.

2. Driving As Your Only Mode of Transportation

For most of human history, human muscle moved us wherever we went. Today locomotion outside of our sanitized home or office environment is typically outsourced to the automobile. We even drive across the work campus or endlessly circle in search of a closer parking spot.

Most people struggle to find time for fitness while neglecting to incorporate normal activity into their everyday life. Why is there a need to drive your kids to school if it is less than a mile away? Why must you drive to work if it is just across town? My daily trip to work only went from 10 to 20 beautiful minutes when I switched to a bike commuting lifestyle.

According to the CDC, 71.6% of Americans over age 20 are overweight. Healthcare costs are unsustainable, and yet we drive when it would be almost as easy to use human muscle.

Help your kids break free of this pattern. What a model it would be to make it standard practice to bike when round trips are 10-miles or less, or to walk to pick your kids up from school until they are old enough to walk home themselves.

Despite modern helicopter norms, this is the goal of parenting: to create self-sufficient people capable of creating a purpose and contributing to something bigger than themselves. As much as it scares us we should want them to have this desire for independence and exploration. It sure beats smartphone addiction.

3. Letting Kids Have a TV in the Bedroom

Our environment is powerful. If cookies are always on a plate in the kitchen, we’ll probably make it a norm to grab one while walking by. Replace that norm with a bowl of fruit or ants on a log (peanut butter and raisins on celery), and our snacking norms change.

Screens are an especially pervasive temptation in the modern world. They bring an infinite number of messages. Nowadays, televisions are the focal point of our homes, constantly beckoning us to sit down and stop conversations. But at least we share the programs. They can provide talking points, mutual laughter, and a communal experience not too much different from the primal experience of fireside stories.

Yet, in a kid’s bedroom, the TV brings no positives and many negatives. It is a constant source of distraction from study, reading, getting out to play, or trying any creative endeavor. It is a pull towards more time in isolation and more ability to avoid dealing with potential family conflicts. Most destructively, it is a recipe for poor sleep.

Adolescents and teens need 8 1/2 to 10 hours of sleep per night but tend to average 7 or less. Absent of this they will be foggy, moody, lacking concentration, and at increased risk for the poor decisions that characterize this age.

Their natural body rhythms pull them towards later hours, but school start times rarely honor that reality. Add extra-curriculars and socializing and it can be very difficult for teens to adopt a healthy sleep schedule. These struggles magnify tenfold when they have a TV in their bedroom, which they’ll inevitably watch from bed.

Dr. Craig Canapari, director of the Yale Pediatric Sleep Center, says that the number one thing you can do to help your kids avoid sleep problems now and into adulthood is, never put a television in their bedroom.

The only rationale I can see for putting a TV in bed is to appease your children, despite their own well-being. You are the parent. Be the parent.

4. Giving Kids Smartphones Without Boundaries

Nothing poses a greater risk to your children than that screen they can walk around with every hour of the day. The phone allows millions of messages to shape unhealthy beliefs and values, it prompts poor posture and sitting, it precludes face-to-face communication and overcoming social fears, and it wraps the mind in a vortex of anxiety and a compulsive need for distraction.

At least with the TV you sit and share a single program with other people. The smartphone isolates and constantly prompts you to search for the next best thing after only a brief superficial scan. Take everything wrong with having a television in the bedroom and multiply that by a trillion with the smartphone.

There is no culprit more responsible for the terrifying state of American physical, mental, and emotional health, particularly in childhood than smartphone ubiquity.

But, what are you gonna do, right? It is the world we live in, right?

Please, parents, piss your children off. Tell them no, not until 8th grade and not without tons of boundaries. Why open Pandora's box too early? I’m sure I sound extreme, but this technology is extreme. While working in schools I’ve watched the lobotomization it renders on a generation and, it isn’t just them.

Parents line the park benches scanning furiously. Grandparents and babysitters take their children to bounce houses at odd hours so they can sit and scan their phones uninterrupted. We’ve all seen tech addiction and we’re all subject to the allure. Unchecked smartphone use is the path to a Wall-E type dystopia.

You can’t pretend smartphones don’t exist and you can’t hide them forever, but you can for a while. I highly recommend checking out the screen use recommendations of the American Academy of Pediatricians and using their Create Your Family Media Plan tool. It is very easy and will prompt you through ideas and nuances you may not have considered.

5. Not Managing Smartphone Alerts

As usual, we should start with our own model. Strong parents make strong kids. More often than not we are constantly pulled away from the moment by email dings, texts, and quick scans that turn into a 10-minute mental mindless scroll. This is only made worse by the Apple watch that now supersedes any phone away boundary to shove messages back in your face. Take that dinner time!

Simple recommendations that can help you take back control of your time and be more present for your family:

Anything urgent should require a call. Go to your settings and silence all texts and email messaging. People will learn this about you and it will recalibrate their sense of what is urgent.

Plan the times you will batch all messaging response.

Plan the times you will use social media, apps, etc. For example, maybe you can batch this to two 30-minute blocks within your day. This takes the negative out and makes the tool work for you.

While doing complex work, turn the phone on airplane mode and focus. You’ll get more done.

After work or as you come to dinner, put the phone on a charger, away from you and your bedroom.

Get an alarm clock. A single function device.

Silence all calls and notifications a couple hours before bed. You can make exceptions for people you mark as favorites. This is quite easy to do actually.

6. Buying Into a Modern Youth Sports Culture

After the smartphone, this is truly the toughest insane norm to tread in the modern world. For most of you reading, youth sports were an amazing, integral part of your upbringing. Here we learned essential social skills, how to work on behalf of a team, and how to practice to improve. We played every sport, building a broad array of physical skills that nurtured a love of moving and play. It’s probably where you first fell in love with training.

Today, these foundational experiences have been completely perverted by conmen looking for easy money and a culture of over the top bulldozer parents, willing to pay any price to convince their child they are the center of the universe. Second graders have “signing days” when their parents pay for them to join the “elite” soccer team.

Third-grade football teams put the kids' name on the back of the jersey and have a “pep-rally” every Friday night before Saturday games. Most disturbingly, at earlier and earlier ages, coaches try to convince players they are falling way behind without ridiculous travel, specialization, and expensive skills coaches.

Elementary school kids will have multiple evening practices per week, late games, and long Saturday tournaments. Family time evaporates under the guise that this is what you have to do. By middle school baseball and volleyball parents have conceded their wallets and their summer to travel ball. The family no longer has the option to vacation other than 1,000-mile trips to play athletes just like the ones in their own city.

Clearly, this is an article unto itself. The biggest take-home message is:

This is not the best way to build athletes. Athletic participation is way down, meaning our talent pool is smaller and more kids miss out on these vital experiences. Furthermore, as detailed in the Long Term Athletic Development model, optimal athleticism follows age-appropriate, balanced exposure to sports.

Youth sports should not be expensive and should not be all-encompassing. All the kids want to do is play the game with their friends. Remember that? We’d just go play sports with our friends without coaches or parents and we grew up doing it. Or, we’d go outside and play catch with mom and dad.

Resist the urge to follow the masses into this crazy debt trap. Youth sports can be an amazing experience, but they shouldn’t be the only experiences. How you spend your time matters. Family dinner matters. Family vacation matters.

“It’s no sign of health to be well adjusted to a sick society.”

Krishnamurti

As usual, any broad rambling list will be full of prescriptions that don’t accommodate or appreciate your unique constraints and needs. There are major exceptions to nearly every point I’ve made, but I will stand by the underlying principles. Our standard model is a cultural conveyor belt towards poor health and dissatisfaction.

The best thing we can do is have the courage to buck the norms and live authentically, pursuing a path we earnestly believe in. This will take strength and require you to be counter-cultural. Your efforts matter. Strong parents make strong kids.

This Week’s Mission

Apply any of the suggestions from these six unhealthy norms. If you are unsure where to start, create a family media use plan. Having boundaries tends to offer a great deal of freedom. Without them, we are constantly pulled and prodded, controlled by a constant flood of habit-inducing notifications.

http://breakingmuscle.com/fitness/6-unhealthy-norms-plaguing-us-all

http://breakingmuscle.com/coaches/shane-trotter

#shane trotter #raising kids

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theemperorsfeather · 5 years

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You want some insight into why/why not things get deleted from FB? This covers some of the details, as well as how horrible things are for the people working as moderators. It’s crushingly awful.

CW: first few paragraphs describe a murder that trainees (who are contractors, not directly hired by FB) were forced to watch.

Over the past three months, I interviewed a dozen current and former employees of Cognizant in Phoenix. All had signed non-disclosure agreements with Cognizant in which they pledged not to discuss their work for Facebook — or even acknowledge that Facebook is Cognizant’s client. The shroud of secrecy is meant to protect employees from users who may be angry about a content moderation decision and seek to resolve it with a known Facebook contractor. The NDAs are also meant to prevent contractors from sharing Facebook users’ personal information with the outside world, at a time of intense scrutiny over data privacy issues

But the secrecy also insulates Cognizant and Facebook from criticism about their working conditions, moderators told me. They are pressured not to discuss the emotional toll that their job takes on them, even with loved ones, leading to increased feelings of isolation and anxiety. . .

It’s a place where, in stark contrast to the perks lavished on Facebook employees, team leaders micromanage content moderators’ every bathroom and prayer break; where employees, desperate for a dopamine rush amid the misery, have been found having sex inside stairwells and a room reserved for lactating mothers; where people develop severe anxiety while still in training, and continue to struggle with trauma symptoms long after they leave; and where the counseling that Cognizant offers them ends the moment they quit — or are simply let go.

The moderators told me it’s a place where the conspiracy videos and memes that they see each day gradually lead them to embrace fringe views. One auditor walks the floor promoting the idea that the Earth is flat. A former employee told me he has begun to question certain aspects of the Holocaust. Another former employee, who told me he has mapped every escape route out of his house and sleeps with a gun at his side, said: “I no longer believe 9/11 was a terrorist attack.”

. . .

The use of contract labor also has a practical benefit for Facebook: it is radically cheaper. The median Facebook employee earns $240,000 annually in salary, bonuses, and stock options. A content moderator working for Cognizant in Arizona, on the other hand, will earn just $28,800 per year. The arrangement helps Facebook maintain a high profit margin. In its most recent quarter, the company earned $6.9 billion in profits, on $16.9 billion in revenue. And while Zuckerberg had warned investors that Facebook’s investment in security would reduce the company’s profitability, profits were up 61 percent over the previous year.

Since 2014, when Adrian Chen detailed the harsh working conditions for content moderators at social networks for Wired, Facebook has been sensitive to the criticism that it is traumatizing some of its lowest-paid workers. . .

Before Miguel can take a break, he clicks a browser extension to let Cognizant know he is leaving his desk. (“That’s a standard thing in this type of industry,” Facebook’s Davidson tells me. “To be able to track, so you know where your workforce is.”)

Miguel is allowed two 15-minute breaks, and one 30-minute lunch. During breaks, he often finds long lines for the restrooms. Hundreds of employees share just one urinal and two stalls in the men’s room, and three stalls in the women’s. Cognizant eventually allowed employees to use a restroom on another floor, but getting there and back will take Miguel precious minutes. By the time he has used the restroom and fought the crowd to his locker, he might have five minutes to look at his phone before returning to his desk.

Miguel is also allotted nine minutes per day of “wellness time,” which he is supposed to use if he feels traumatized and needs to step away from his desk. Several moderators told me that they routinely used their wellness time to go to the restroom when lines were shorter. But management eventually realized what they were doing, and ordered employees not to use wellness time to relieve themselves.

...

Everyone I meet at the site expresses great care for the employees, and appears to be doing their best for them, within the context of the system they have all been plugged into. Facebook takes pride in the fact that it pays contractors at least 20 percent above minimum wage at all of its content review sites, provides full healthcare benefits, and offers mental health resources that far exceed that of the larger call center industry.

And yet the more moderators I spoke with, the more I came to doubt the use of the call center model for content moderation. This model has long been standard across big tech companies — it’s also used by Twitter and Google, and therefore YouTube. Beyond cost savings, the benefit of outsourcing is that it allows tech companies to rapidly expand their services into new markets and languages. But it also entrusts essential questions of speech and safety to people who are paid as if they were handling customer service calls for Best Buy.

#hell world #facebook #online moderation #evil empires #social media

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lotusawareshare · 6 years

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The Medication Roulette Debacle

As a person who has experienced the ins and outs of the mental illness systems, I can confidently say that the issue of mental illness and how medication applies is one that is rooted in deep systemic dysfunction. This is not so farfetched when you consider the main motivation of those running the mental health industry. It is important to analyze the intent of anything (be it person, industry, etc.) when trying to determine The Why of the way things are. As will become apparent if not already, I am a huge advocate for understanding the why in order to begin implementing desired changes.

In the case of the mental illness industry (yes, it is an industry), we first need to examine the intent of what they’re trying to accomplish - which in the case of most industries, is to generate profit. Why is this problematic for those of us trying to improve our mental health? Let’s look at the different cogs of the mental illness industry machine and how they fit together.

Who Runs The Game

When we consider who “the Boss” is in any given scenario of this wonderful biased-market-competition-impersonating-as-capitalist country we have, it is usually the person/people with the most resources and subsequently, power. In the case of mental health, we’ve got our market powerhouses - the Pharmaceutical Companies and the Healthcare Industry - here we will be focusing on the mental health end of healthcare, so this means inpatient/outpatient facilities and the people who run them.

For the next attraction we have your average ride on the mental health systems tour of horrors carousel. (For those who are not so interested in participating in my whimsical backdrop-painted story telling, feel free to skip to the next paragraph for the cut-to-the chase points.) It consists of spending 72 hours in a hospital psych ward. During these 72 hours, patients are isolated from family/loved ones so they’re alone and easier to harvest. Once the rounding psychiatrist has had a two to seven minute interview with the patient, it is then determined whether they will be released with the plan of follow-up at an outpatient program or psychiatrist or transferred to an inpatient facility for further harvesting. Those who do not have health insurance are more likely to be released home after the 72 hour period than those who do. (You connect the dots with that one, it’s not rocket science). Stays at your average inpatient clinic range from four days to two weeks, depending on how much shit your insurance is willing to cover. During your stay at this lovely negative-four star blood-sucking facility, you will meet a plethora of doctors and social workers, all the while, being heavily medicated to distract you from the organs they’re funneling into their pockets. As soon as they’ve got every last drop of money - I mean, blood, milked from you, you’re passed on to an outpatient facility for a longer, extended program (read: further harvesting) or what ever psychiatrist has got connections with the facility. The purpose here is to get as much as you can from every patient (read: victim) as quickly as possible. Oh, and you’ll be billed for this later.

The primary goal of the Pharma companies and inpatient/outpatient mental health facilities is, again, to turn a profit. As a business how do you ensure that occurs?

The number one way to guarantee the continuous influx of money is demand - there have to be consumers that want the product - in this case, medication and healthcare services. The mental illness market is a bit dicey to navigate because individuals who live with these mental health challenges are often vulnerable and struggling. Most of us don’t have in-depth, applicable knowledge of mental health simply because it is not something we are taught. The help we need is then outsourced to people in power who we believe can and want to help us “get better” - this would be our Psychiatrists. (Therapy is a part of the system as well but it does not directly influence the medication aspects, we will get to that at another time.) We give our trust to doctors in power to hold our well-being and healing as a priority. Now I am not saying by any means that all doctors are corrupt, profit-driven, money-mongers, but we do have to acknowledge that this field is their career-path and their livelihood.

The problem occurs when the motivation of these pseudo-psychiatrists is rooted in money rather than the well-being and recovery of patients.

Why Big Pharma & Pseudo-psychiatrists Control The Medication Market

Let’s examine this issue logically. If a company wants to make money, it is imperative to have a large consumer base and to make sure those consumers keep coming back for your services/products. Understanding this rationale shows us why the pharmaceutical and healthcare industries never address the underlying problems of mental illness. Medications are not a cure to any mental health issue - don’t get me wrong, it can help to treat the symptoms, but medication is not the quick-fix cure that it is strategically advertised and marketed to be. It is simply a bandaid. The key is to keep the patients coming back for more.

Before we go any further, let me first state that I am not a mental health professional and that my views are based on my experiences and personal research - what worked for me may not necessary work for another person. That being said, take from this any aspects that may be relative to you and leave the rest.

At one point in my journey with mental health, I was on a cocktail of eight different medications. This was after trying countless different brands, various types of medications - SSRIs, SNRIs, benzodiazepines, antipsychotics, SARIs, mood stabilizers. After three hospitalizations, completing numerous outpatient programs, 15 rounds of electroconvulsive therapy, and several years of playing medication roulette, I was struck with the realization that none of these things were actually helping the state of my mental wellbeing.

Every time I would attempt to discuss this with my psychiatrist, the answer was to switch up the meds. The medication was no longer helping, nor was it an effective bandaid for wounds that had been festering for years. I decided I wanted to get off my medication cocktail, and I was determined not be cajoled into another round of trying new medications. As with any new subject matter, my approach was to research the shit out of it. I did my research on how to safely taper off the various medications I was taking, and went to my biweekly scheduled appointment to present my plan and findings.

At this point I had already made up my mind that the medications’ adverse effects far outweighed its limited (and that’s being generous) benefits. What I wanted from my psychiatrist was her healthcare provider stamp of approval and her expertise and supervision of my decision. I had done my research, had a sound plan in place - all I needed now was the support to help me achieve my goal. My psychiatrist made it very clear that she did not agree with my decision (as is her right as a medical health professional). She even went so far as refusing to help me, stating that if I no longer wanted to be on medication, I would have to see another doctor.

That was the last appointment I had with a psychiatrist.

This interaction with my psychiatrist (and numerous others) is an exemplary portrait of how the mental illness industry seeks to keep consumers within their grasp. The thought process behind her refusal to advise me was likely - if this patient wants to stop taking medication, I will lose this patient (read: profit) anyway, may as well nip the problem in the bud, because then there is also plausible deniability if the patient gets off the medication and ends up hospitalized again or worse yet, dead. While I understand the covering-your-own-ass logic behind that action, refusing help to patients who want to get off their medications safely and responsibly is its own special kind of malpractice in my book.

Psychiatry’s Love Affair With Happy Pills Gone Wrong

In this country, we rely heavily on pharmaceuticals to treat various health conditions. There are many benefits to life-saving medications - I am not disputing that.

BUT, where it applies to mental health, medications more often than not, only mask the symptoms of the deeper issues in play.

Medications can be useful, IF used in conjunction with a combination of other therapies. The problem occurs when medication is used as a one-size-fits-all blanket solution to be “happy". Until we get to the point of medication therapy that is tailored to each individual’s biochemistry, it is incredibly inane to think that the medications we have now are suitable treatment for mental health conditions, especially because the nature of these conditions is highly variable from person to person.

The Problem With Diagnoses-Centered Treatment

Take an individual diagnosed with generalized anxiety disorder and major depressive disorder for example, we’ll call her Jane. Jane has a history of childhood trauma and abuse, suffers panic attacks on a daily basis, and has a career she finds detestable and monotonous. Jane sees several healthcare professionals and is advised to try an antidepressant. Another individual, we’ll call him Dave, receives the same diagnoses and is put on the same antidepressant. Dave has a history of rheumatoid arthritis that negatively impacts his quality of life, a toxic marriage, and Dave’s mother has recently passed away.

Different events, especially those that cause stress and are closely tied to emotional response, will alter a person’s brain chemistry. No two people have the same brain chemistry, including identical twins. All the experiences we have continuously shape and change our brain development and all the complex biochemistry going on in there. When we look at the individual nature of each person’s experience and biology, it is impossible not to recognize the expectation that medications are going to work the same across the board as absolutely ludicrous and ineffective. We can go further and say that it is incredibly dangerous and possibly detrimental to prescribe medications like candy when we don’t know how they will effect each person.

In the case of Dave and Jane, it is sound logic to assume their issues are vastly different even though they have received the same diagnoses and medication. The medication may help Jane, but affect Dave in a negative manner. Jane may benefit greatly from medication used in conjunction with ongoing cognitive behavioral therapy. Dave however may find that therapy short-term to deal with the grieving process and a healthier lifestyle to help with his autoimmune disorder may be more effective.

The take-away from our imaginary case-study is that treatment that is tailored to the individual must be prioritized, rather than expecting a universal happy pill (or class of medications) to sufficiently heal a person’s mental state.

The Medication Trap

What does medication do? It alters the brain chemistry and the way our brains process these chemicals we have floating around.

The idea of taking medication can trick us into thinking “this will fix me/my problems/how I am feeling”. We then don’t take any further action to address the root cause of the problem because we are relying on medication to do the heavy lifting - when the medication is simply a tool to manage the symptoms, NOT a solution addressing the cause. That last bit, my friend, would be your responsibility to yourself.

We as a society too often outsource the responsibility for our well-being, physical and emotional, to other people and things. Of course there will be the need to consult professionals who specialize in certain fields, but it is important not to trust blindly and to be informed. If it is an area that you have limited knowledge in, then GET INFORMED. With the ease of obtaining information just one click, one finger-tap away, there are no more excuses people!

Mental health professionals can be crucial allies to have along the journey, but your discernment in what is right for you is crucial.

Illness Industry Over Culture of Health

The mental illness industry is a system that was supposedly designed to help people heal and yet, it has become so heavily corrupted with dysfunction and greed. Close friends who I hold near and dear to my heart who have gone through similar experiences are also baffled and outraged at the incongruence of the broadcasted intent, to heal, and the actual motivation, to capitalize and profit. There is nothing wrong with individuals in the field trying to be successful and make a living. However, we must acknowledge that there is something direly wrong with the system in place when a person/industry places their monetary success over the wellbeing of millions, and proceeds to masquerade as supporters of mental health, while capitalizing on our “illness” behind the scenes.

#mental health #mental health awareness #mental health support #awareshare #positive mental attitude #positive mental health #spreading awareness #mentally ill #lotusawareshare #mental illness #writers on tumblr #writers community #writing blog #mental disorder #depression #anxiety #bipolar #psychology

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loyallogic · 4 years

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Outsourcing Contracts: all you need to know about

This article is written by Aarti Gosavi, pursuing a Diploma in Intellectual Property, Media and Entertainment Laws from Lawsikho.com. Here she discusses “Outsourcing Contracts: all you need to know about”.

What is outsourcing?

Outsourcing means hiring someone else to do the work which was done by or your employees before. Outsourcing takes place across many industries e.g. Information technology, BPO, KPO, etc. Offshore outsourcing is the one which is most beneficial as well as popular. Companies manufacture many products for which they do not have time and the required competency. Companies outsource their work to reduce operating costs and also to use the company’s internal resources for different reasons. Another reason is to reduce the amount of work and the mental strain of the main company and obtain quality results by the specialists. The two main types of outsourcing structures that normally exist are:

1) Onshore outsourcing

2) Offshore outsourcing

Onshore outsourcing is the type of outsourcing where the work is outsourced to an outsourcing service provider which is usually located in the same country of the company’s registered office. It is also known as domestic outsourcing.

Offshore outsourcing is the type of outsourcing where the work is outsourced to an outsourcing service provider that is located outside the country of the company’s registered office.

Why India is ranked as the most favoured destination for offshore outsourcing?

The need to outsource the work arises when the company wants to concentrate on its main business. Highly skilled foreign employees can benefit the economy of any country in the long run. Organisations also outsource their work to mitigate their labour costs. Many multinational companies outsource their work to India because of many reasons like

1) Excellent quality of products

2) Competent staff

3) Excellent expertise

4) Optimization of costs

5) Quick response to queries

6) Highly secured data

7) Access to best standard of services at relatively lesser cost

8) Rise in employment and subsequently good jobs with better salaries.

Statistics of Outsourcing

According to the Deloitte 2016 Global Outsourcing Survey, 78% of business owners across the globe are satisfied with their outsourcing partner. North & South America constitutes 42% of the outsourcing buyer region. Europe, Middle East, and Africa constitute 35%. The remaining 23% comes from Oceania & Asia

According to NASSCOM:

“The IT-BPO industry in India has managed to aggregate the revenue of $154 billion in the year 2017. Over the upcoming five years, 40% of India’s workforce is expected to amplify their skills to meet the advanced requirements. “This is the statistics provided by the website yourteamindia.com. In 2017 and 2018 India is considered the best country for offshore development because of its cost-effectiveness and talented professional availability. In fact, India holds 65% of the outsourced IT jobs. Furthermore, a prediction by Forrester Research moves to global business for IT outsourcing and hardware maintenance at approximately $503 billion in 2017.

What are Outsourcing Contracts?

An outsourcing agreement is a contract made between the company and service provider where the provider has vowed to provide definite services. E.g. sorting the data by the outsourcing service provider by employing its own manpower and resources by working from their very own venue. The different sectors that use outsourcing are:-

1) Call Center Outsourcing

2) Knowledge Process Outsourcing

3) Data Entry Outsourcing

4) IT service Outsourcing

5) Healthcare BPO Services Outsourcing

6) Financial Services Outsourcing

7) Engineering Services Outsourcing

What are the different laws that govern outsourcing in India

The different laws that govern outsourcing in India are

1) Indian Contract Act, 1872

2) Specific Relief Act, 1963

3) Foreign Exchange Regulations

4) Foreign Trade (Development Regulation) Act, 1992

5) Department of Telecommunications (DoT) policies and guidelines.

6) Information Technology Act, 2000

7) Companies Act, 2013

8) Intellectual Property Laws

9) Labour laws

10) Transfer of Property Act, 1882

11) Competition Act, 2000

12) Income Tax Act, 1961

13) Indian Evidence Act, 1872

14) The Code of Civil Procedure 1908

The judicial system in India has always supported choice of proper law which if mentioned in the outsourcing agreement then the courts in India will always support it. When any work is outsourced to India you have the freedom to choose which law will regulate the contract. The freedom to choose to which court will have jurisdiction over the case is also given. Sections 13, 15 and 44 A of the Indian Civil Procedure Code and Section 41 of the Indian Evidence Act regulate the authority and implementation of foreign judgments in India.

What are the advantages and disadvantages of outsourcing your work?

The advantages of outsourcing the work are:-

1) Access to competent people and quick completion of work

2) Outsourcing other projects of the company gives the company quality time to focus on main business areas.

3) It helps to reduce the risks involved when taking any business decisions.

4) It helps to reduce the costs involved in setting up the business and the necessary infrastructure for it, the costs involved in retaining the organization and the costs involved in hiring the staff for the outsourced work.

The disadvantages of outsourcing the work are:-

1) There is always a fear of your confidential data and automation being shared and used by everyone due to which there can be increased duplication of your products in the market.

2) There is always a risk of late delivery of result, low quality of services and incorrect delegation of responsibilities by the service provider which can be reduced if it is done by the outsourced organization itself.

3) There are many costs which remain suppressed while outsourcing your work in international boundaries which can be very dangerous.

4) The service provider cannot focus on the primary tasks which results in low productivity.

Cases on outsourcing of contracts

Nabha Power Limited v/s Punjab State Power Corporation Limited talks about the terms which are not clear in outsourcing contracts should not be assumed. In another case Sh. Sunderarajan, Bangalore vs. United India Insurance Co. it was held that if the public authority has outsourced its work to another private company then it should take care that to fulfil its main responsibilities of providing the answer scripts even if the work has been outsourced to another private company.

Click Above

What and which jobs are outsourced?

The jobs that are normally outsourced are

1) Bookkeeping

2) Administrative tasks

3) Web design and development

4) Customer service

5) Customer billing

6) Business processes

7) Information Technology

8) Knowledge processes

Types of business models in outsourcing agreements

A business model which will be used for outsourcing of contracts depends on the ultimate aim of what the business wants to achieve from its target customers. They are as follows

1) Services agreement – This agreement is based on the basic model where the third party will perform a particular task for the customer. The company may dispatch its resources e.g. I.T. resources and its workers to another location where the outsourcing service provider is based by entering into a contract for the same. The workers will be working from that location till the agreement is in force but this usually happens in a joint venture or captive outsourcing model.

2) Joint venture– In this type of business model the outsourced company and the outsourcing service provider form a separate legal institution for performing the necessary functions. It could be of several types where in one instance the outsourcing company can form a joint venture with many dealers. This usually happens when one service provider does not have the resources to perform the various tasks of the customer. In such a case the outsourcing company may form many legal institutions where these institutions will then complete the necessary tasks in a well synchronized manner.

3) Captive outsourcing entity – In this type of business model the outsourcing company completely controls all the assets of the outsourcing service provider. The outsourcing service provider then performs functions of the customer itself and not of any other customer. In this type of model some workers may be employed but the outsourced company is in complete charge of the outsourcing service provider.

What are the precautions to be taken while outsourcing?

The company that is outsourcing its work must scrutinize the current third party contracts of the service provider to understand its efficiency. It is a common practice that the outsourcing company goes through the whole lifecycle of contract management. The usual terms that come up in third party contracts are

1) Term of the Contract

2) Third party usage and its limitations

3) Existence of any assignment clause in the contract

4) Costs to be paid before or on yearly basis

5) The right to cancel the contract

6) Fees if any to be paid

The company that is outsourcing its work to another company whether completely or partly must also always keep in mind as to how to optimize the company’s profits and economic cost by making best use of the laws and regulations to protect intellectual property rights of the parent company i.e. outsourced company. The parent company must do a thorough background investigation of the company’s past records as to whether the company to whom it is going to outsource the work is able to protect the trade secrets of the parent company. Other precautions that need to be taken while outsourcing are data protection, rules and regulations on the level of operations and quality of standards, the process of solving disputes between the parties and exit formalities.

Here is the link to statistics provided by website yourteamindia.com

Sample Outsourcing agreement

Here is one sample outsourcing agreement which has been included for the readers’ reference.

References

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

https://www.outsource2india.com

https://www.forbes.com/sites/deeppatel/2017/07/17/the-pros-and-cons-of-outsourcing-and-the-effect-on-company-culture/#38692817562d

https://www.upcounsel.com/outsourcing-agreement-replace

https://www.outsource2india.com/why_india/articles/legal_aspects_outsourcing.asp

https://www.quora.com/Why-is-it-necessary-to-outsource

https://www.business2community.com/strategy/should-you-outsource-your-work-5-things-to-consider-02132866

https://neilpatel.com/blog/outsource-work/

https://www.themuse.com/advice/7-tasks-you-should-outsourceimmediately

https://www.nimble.com/blog/why-outsourcing-is-a-good-thing-for-your-business/

https://www.forbes.com/sites/katevitasek/2017/10/31/five-scary-outsourcing-practices/#5d6ef20b256f

https://indiacorplaw.in/2018/04/subjectivity-objectivity-supreme-court-implied-terms-commercial-contracts.html

https://www.lexology.com/library/detail.aspx?g=e8fd6698-e45d-4abc-b503-f713017b640d

http://www.abrmr.com/myfile/conference_proceedings/Con_Pro_32717/conference_21121.pdf

https://rbidocs.rbi.org.in/rdocs/notification/PDFs/88930.pdf

https://www.irdai.gov.in/ADMINCMS/cms/frmGeneral_Layout.aspx?page=PageNo1051&flag=1&mid=Insurers%20%3E%3E%20Reinsurance%20%3E%3E%20Guidelines

https://rbidocs.rbi.org.in/rdocs/Notification/PDFs/73713.pdf

http://www.mondaq.com/india/x/396480/International+Courts+Tribunals/Contribution+Of+Ip+In+Growth+Of+Fdis+In+India

www.iosrjournals.org

https://talonholder.wordpress.com/2014/12/09/india-an-evergreen-outsourcing-destination-in-the-world-for-software-outsourcing-industry

https://blog.ipleaders.in/outsourcing-in-india-things-you-should-know-before-signing-the-outsourcing-agreement/

www.indiakanoon.org

https://tallyfy.com/onshore-outsourcing/

https://ift.tt/2TJwfFE

https://blog.ipleaders.in/key-features-outsourcing-agreement/

https://ift.tt/2wAdWL5

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lauramalchowblog · 4 years

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9 Healthcare Companies Who Changed the 2010s

By ANDY MYCHKOVSKY

In order to celebrate the next decade (although the internet is confused whether its actually the end of the decade…), we’re taking a step back and listing our picks for the 9 most influential healthcare companies of the 2010s. If your company is left off, there’s always next decade… But honestly, we tried our best to compile a unique listing that spanned the gamut of redefining healthcare for a variety of good and bad reasons. Bon appétit!

1. Epic Systems Corporation

The center of the U.S. electronic medical record (EMR) universe resides in Verona, Wisconsin. Population of 13,166. The privately held company created by Judith “Judy” Faulkner in 1979 holds 28% of the 5,447 total hospital market in America. Drill down into hospitals with over 500-beds and Epic reigns supreme with 58% share. Thanks to the Office of the National Coordinator for Health Information Technology (ONC) and movement away from paper records (Meaningful Use), Epic has amassed annualized revenue of $2.7 billion. That was enough to hire the architects of Disneyland to design their Google-like Midwestern campus. The other amazing fact is that Epic has grown an average of 14% per year, despite never raising venture capital or using M&A to acquire smaller companies.

Over the years, Epic has been criticized for being expensive, non-interoperable with other EMR vendors, and the partial cause for physician burnout. Expensive is probably an understatement. For example, Partners HealthCare (to be renamed Mass General Brigham) alone spent $1.2 billion to install Epic, which included hiring 600 employees and consultants just to build and implement the system and onboard staff. With many across healthcare calling for medical record portability that actually works (unlike health information exchanges), you best believe America’s 3rd richest woman will have ideas how the country moves forward with digital medical records.

My very first interview out of undergrad was for a position at Epic. I chose a different path, but have always respected and followed the growth of the company over the past decade. In a world where medical data seems like tomorrow’s oil, a number of articles have speculated whether Apple or Alphabet would ever acquire Epic? I don’t buy it. I’m thinking it’s much more likely that 2020 is the first year they acquire a company. How you doing Athenahealth?

2. Theranos

No one can argue Theranos didn’t change the game in healthcare forever… for the worse. I do my best to give all healthcare founders the benefit of a doubt, but Elizabeth Holmes and Ramesh Balwani make that nearly impossible. Turns out that an all-star cast of geopolitical juggernauts on your Board of Directors and the black turtleneck of Steve Jobs is not the recipe for success. Founded by 19-year Elizabeth Holmes, Theranos raised over $700 million at a peak valuation of $9 billion. In retrospect, they have become the poster-child for Silicon Valley’s over-promise and under-deliver mantra. The only problem is that instead of food delivery, their failures resulted in invalid blood testing that could’ve really hurt people.

Despite this failure, the mission and purpose would’ve been tremendously impressive. Cheaper blood tests that require only 1/100 to 1/1,000 the amount of blood that LabCorp or Quest Diagnostics needed. I think the craziest part of the whole saga was that seemingly sophisticated healthcare leaders thirsted for the new technology to beat competitors and improve patient convenience. Before the technology was proved defunct, Theranos convinced Safeway to invest $350 million to retrofit 800 locations with clinics that would offer in-store blood tests. Theranos convinced Walgreens to invest $140 million to develop a partnership that would help beat CVS. Theranos partnered with Cleveland Clinic to test its technology and was working with AmeriHealth Caritas and Capital BlueCross to become their preferred lab provider.

To be clear, they weren’t the first, and won’t be the last healthcare company to fail. I only hope that this extremely well documented (thanks Hollywood) experience has re-focused founders and investors towards building sustainable growth companies that actually help patients live higher quality lives, not just make people money as quickly as possible.

3. One Medical

Thanks to Tom Lee and the One Medical crew, primary care is now investable. Whether you’re talking about private equity or venture capitalists, many have dived head first into the space in search of value-based care treasure. One Medical is the most well-known tech-enabled primary care practice, with 72 clinic locations across seven states, and new locations opening in Portland, Orange County, and Atlanta. The Carlyle Group liked the company so much that it invested $350 million in August 2018, at a reported $1.5 billion valuation. This has led to a number of primary care focused companies (ChenMed, Iora Health, Forward) to amass significant valuations that historically would’ve seemed optimistic. However, the elevation of the primary care provider from the “punter” to the “quarterback” of a patient’s medical journey has lifted all boats.

Interestingly, One Medical has unique differentiators over the traditional primary care competitors. For example, One Medical limits doctors to seeing 16 patients a day, versus the average physician seeing 20-30 patients a day. One Medical also built its own medical records in hopes of a more user friendly experience, instead of outsourcing to practice-based EMRs. One Medical charges $199 annually to each patient to help make up for lower volume, and in return provides same-day appointments, onsite lab draws, and a slick app that allows online appointment scheduling and telehealth consults with providers 24/7. They are also adding capabilities and services to cover mental health and pediatric services to increase revenue.

This change is remarkable. Historically, primary care has been a low-margin business with high administrative and staffing costs, along with physician burnout and regulatory burden. One Medical pioneered the concept of a more modern primary care experience, and I am looking forward to their initial public offering (IPO) targeted for early 2020 and whatever Tom Lee is cooking up at Galileo.

4. Centene

Centene is my favorite health plan to study over the past decade. You would never know that the second largest publicly-traded company headquartered in Missouri was originally started by Elizabeth “Betty” Brinn in Milwaukee, Wisconsin. Under-hyped, which is rare in healthcare nowadays, Centene has quietly grown to become the largest player in both the Medicaid managed care and Affordable Care Act (ACA) exchanges. Under Michael Neidorff’s leadership, Centene now serves 32 states with over 15 million lives and 53,600 employees. They were most recently ranked #51 on the Fortune 500 list. In addition, they are about to grow with the $17.3 billion acquisition of WellCare. Here’s a brief rundown of some major events that demonstrate why I’m so bullish on Centene dominating another decade:

April 2018: WellCare and Centene awarded Medicaid managed care contracts in Florida.

July 2018: Centene acquires Fidelis Care and their 1.6 million New Yorkers for $3.75 billion. This single-handedly gives Centene the leading Medicaid share in the state.

September 2018: WellCare acquires Meridian Health Plan and their 1.1 million lives in Michigan, Illinois, Indiana, and Ohio, for $2.5 billion.

February 2019: Centene and WellCare awarded Medicaid managed care contracts in North Carolina.

December 2019: WellCare awarded Medicaid managed care contract in WellCare (re-procurement underway)

In addition, Texas Medicaid is set to award their STAR contracts for 3.4 million lives between Medicaid and CHIP, of which Centene already won a contract to serve the STAR+PLUS (aged, blind, and disabled population). Seems like a pretty solid guess that Centene will fair pretty well in the STAR RFP rankings. Next decade, I look for Centene to significantly increase their efforts to recruit Medicare Advantage (MA) lives, and I wouldn’t bet against them.

5. Mylan

One word. EpiPen. Mylan, the $10 billion market cap pharmaceutical manufacturer and producer of the epinephrine auto-injector product, EpiPen, became the lightning rod in a consumer and political drug pricing debate in 2016. For those who were living under a rock, here’s the quick recap. Epinephrine auto-injectors are used to treat anaphylaxis (severe allergic reaction). Prior to 2016, Mylan held absolute dominant share of the auto-injector market, hovering around 90% for the first half of the 2010s. The only real competitor was Adrenaclick, produced by Lineage Therapeutics, but they were barely considered a competitor despite having cheaper prices. In 2016, news outlets caught wind of Mylan’s 500% list price increase over a decade ($100 to $600) and a nationwide discussion about drug prices began.

If you asked the Mylan CEO, Heather Bresch, she would tell you that the reason brand EpiPen’s list price increased 500 percent over 7 years is because they invested billions of dollars to significantly increase access in schools and employers across America. These efforts increased the number of EpiPen prescriptions in the U.S. from 2.5 million to more than 3.5 million between 2011 and 2015. She would also tell you that there is a big difference between wholesale acquisition cost price (list price) and net price. This part is often misunderstood by media. The net price takes into account discounts, prescription savings cards, and rebates that Mylan provides to purchasers (PBMs, Employers, Plans). The exact negotiated rebate or discount is different by line of business and organization. However, safe to say that Mylan made a good amount of profit with increasing volume.

At the end of the day, Mylan settled with the U.S. Justice Department for $465 million over claims it overcharged the government. Mylan kept their $600 list price brand EpiPen product with rebates, and added a generic version of EpiPen for $300 list price without rebates and requiring commercial insurance. According to a GoodRx analysis in 2018, the epinephrine auto-injector market now looks much different, with 60% of the market moving to the generic version of EpiPen, 10% of the market remaining with brand EpiPen, and 30% of the market switching to the generic version of Adrenaclick. However, whether generic or brand EpiPen, Mylan makes strong profits and American will continue to discuss the best strategy forward to control drug spend.

6. Evolent Health

First let me caveat. I’ve worked for Evolent Health for the past 5 years and seen it grow from a Series B startup to a publicly-traded company (NSYE: EVH). However, the reason they’re on this list is because Evolent Health has forever changed the game for future value-based care startups. When Frank Williams, Seth Blackley, and Tom Peterson founded the company in 2011 with the help of UPMC Health Plan and The Advisory Board Company, concepts like the Medicare Shared Savings Program (MSSP) did not even exist. Fast forward a decade later, and Evolent Health now serves approximately 3.7 million lives across 35 different U.S. healthcare markets. The mission of Evolent Health is to, “Change the health of a nation, by changing the way healthcare is delivered.” To do this, you need both the technology, clinical, financial, and operational capacity to empower providers to confidently move away from fee-for-service towards fee-for-value.

With the implementation of MACRA and the continued perseverance of CMS under this new administration, value-based care is still full steam ahead (good luck incoming CMMI Director, Brad Smith). Despite the naysayers of value-based care, find me a better way to control medical inflation that is accepted by nearly all healthcare institutions and doesn’t negatively impact patient outcomes, and we can talk. I will mention the importance of “significant” downside risk to actually change provider culture, strategy, and operations. I don’t want the primary purpose of setting up a clinically integrated network (CIN) to be negotiating higher fee-for-service commercial rates for independent physicians aligned to tertiatiary academic medical centers.

I wholeheartedly believe that providers will continue to seek partner options (not vendors with high fees independent of performance) who are not wholly-owned by the large for-profit health plans (Optum…). Of all the available options, Evolent Health is the market leader across a variety of areas. In 2020, I look forward to watching how the 3,000+ Evolenteers push the boundaries of downside risk value-based care with both payers and providers.

7. Livongo

To me, Livongo represents Daenerys Targaryen in Game of Thrones. Not the blood-thirsty character towards the end, but the only person to bring back dragons to the world of Westeros. Except in this example, the dragon is a successful digital health IPO. This was a big deal. Going public rewarded early investors who believed in the nascent digital health and chronic condition space. It allowed public investors an opportunity to peak under the hood of the financials and get comfortable with future economics of the industry. And it provided a legitimacy and a peer valuation to other leading digital health companies like Omada Health. All-in-all, 207,000 members use Livongo for Diabetes management solutions, including a connected glucose monitor, unlimited test strips, and personalized health coaching. This number is expected to grow significantly, with the announcement of a new, two-year diabetes contract with the BlueCross BlueShield Federal Employee Program (FEP). They anticipate the partnership will add an additional $50-60 million in revenue across 2020 and 2021

Livongo has done a brilliant job marketing itself as building a full-stop solution for the 147 million Americans with a chronic condition. According to their estimates, their immediately addressable markets for managing diabetes and hypertension represents a $46.7 billion opportunity. Digging into the unit economics, Livongo estimates that diabetes is worth $900 per patient per year and $468 per patient per year. Since they’re focused on chronic conditions, the business model is subscription-based. In the Q3 quarterly report, Livongo provided full year guidance of $168.5 million on the low end and $169 million on the high end. In either scenario, FY2019 Adjusted EBITDA is projected to lose around $26 million for the year.

Livongo has smartly started with addressing diabetes, given the downstream health impacts of mismanagement of blood sugar and the ability to impact spend with regular insulin, diet, and exercise. They also are very smart to efficiently sell into self-funded large employers using existing channel partners like Express Scripts, CVS, Health Care Services Corporation (HCSC), Anthem, and Highmark BCBS. I know that the stock is down 35% since IPO, but I fundamentally believe chronic conditions are not going away and over time, Livongo will add supplementary clinical programs to expand revenue growth.

8. Optum

UnitedHealth Group is the single largest healthcare company in the world with a $280 billion market cap. It owns UnitedHealthcare, the country’s largest private insurer serving Medicare Advantage, managed Medicaid, employer-sponsored insurance, and ACA exchanges. And yet in 2020, more than 50% of the company’s earning and $112 billion in revenue will come from the lesser known side of the business, Optum. It is difficult to describe Optum because they do so much, but they technically split their business into three units: OptumHealth, OptumInsight and Optum Rx. OptumHealth provides care delivery (primary, specialty, urgent care) and care management to address chronic, complex, and behavioral health needs. OptumInsight utilizes data, analytics, and clinical information to support software, consulting, and managed services programs. OptumRx is a pharmacy benefit management (PBM) to create a more streamlined pharmacy system. In total Optum estimates the U.S. addressable market for its services to exceed $850 billion. If that wasn’t enough, here’s some fun facts why they made the list:

Works with 9 out of 10 U.S. hospitals, more than 67,000 pharmacies, and more than 100,000 physicians, practices, and other providers.

Added 10,000 physicians in the past year, growing its network to 46,000 physicians.

Includes 180,000 team members and serves 120 million customers.

Serves 80% of health plans to reduce total cost of care.

Works with 9 out of 10 Fortune 100 companies.

Pretty remarkable for a business unit that was only technically created in 2011, by merging existing pharmacy and care deliver services into one brand. As chronic disease increases and value-based care is here to stay, Optum is focused on comprehensively treating patients and coordinating their care to improve quality and lower costs. With UnitedHealthcare under the corporate umbrella, Optum has the adequate scale to test any new clinical initiatives before rolling out to other health plans.

9. Purdue Pharma

Purdue Pharma is a privately owned drug company owned by the Sackler Family and most well known for creating OxyContin in 1996. OxyContin represents 90% of Purdue Pharma’s revenue and was aggressively marketed to doctors for use in patients with chronic pain. According to court records, Purdue Pharma has grossed an estimated $35 billion. This is the same prescription painkiller that many experts say fueled the U.S. opioid crisis that has resulted in more than 130 deaths each day after overdosing on opioids. To be clear, the deaths are caused by prescription pain relievers, heroin, and synthetic opioids (fentanyl), however, the initial addiction to opioids is often caused by OxyContin and other prescription drugs. All but two U.S. states and 2,000 local governments have taken legal action against Purdue, other drug makers and distributors.

The Sackler family is the 19th richest family and is well known for supporting the fine arts, including the Sackler Wing at the Metropolitan Museum of Art in New York City where the Ancient Egyptian Temple of Dendur sits. I’ve seen a number of articles persecuting the entire Sackler family, but I want to be a little more nuanced. In 1952, three Sackler brothers (Arthur, Raymond, and Mortimer) bought a drug company called Purdue Frederick. Arthur’s branch of the family got out of the company after his death in 1987. The Raymond and Mortimer branches of Sacklers, who own it, founded affiliate Purdue Pharma in the early 1990s. According to a 2017 article from The New Yorker, there are 15 Sackler children in the generation following the founders of Purdue. Some family members have served on the Board of Directors, while others (most notably descendants from Arthur Sackler who died before OxyContin was invented), have distanced themselves from the company and condemned the OxyContin-based wealth.

Purdue Pharma filed for bankruptcy in September 2019 as part of a tentative settlement related to misleading marketing of the controversial painkiller. The settlement requires the owners of Purdue Pharma and the Sackler family to pay out $3 billion of their own fortune in cash over the next seven years. The only problem is that some family members have reportedly moved $10.7 billion from Purdue Pharma to trusts and holding companies across the world between 2008 and 2017. And all we’re left with is a complicated web of holding companies and offshore bank accounts, ravaged communities, and the leading cause of injury-related death in the U.S.

Andy Mychkovsky is a Director at Evolent Health and the Founder of a healthcare startup and innovation blog, Healthcare Pizza. This post originally appeared on Healthcare Pizza here.

The post 9 Healthcare Companies Who Changed the 2010s appeared first on The Health Care Blog.

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kristinsimmons · 4 years

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9 Healthcare Companies Who Changed the 2010s

By ANDY MYCHKOVSKY

1. Epic Systems Corporation

2. Theranos

3. One Medical

4. Centene

April 2018: WellCare and Centene awarded Medicaid managed care contracts in Florida.

July 2018: Centene acquires Fidelis Care and their 1.6 million New Yorkers for $3.75 billion. This single-handedly gives Centene the leading Medicaid share in the state.

September 2018: WellCare acquires Meridian Health Plan and their 1.1 million lives in Michigan, Illinois, Indiana, and Ohio, for $2.5 billion.

February 2019: Centene and WellCare awarded Medicaid managed care contracts in North Carolina.

December 2019: WellCare awarded Medicaid managed care contract in WellCare (re-procurement underway)

5. Mylan

6. Evolent Health

7. Livongo

8. Optum

Works with 9 out of 10 U.S. hospitals, more than 67,000 pharmacies, and more than 100,000 physicians, practices, and other providers.

Added 10,000 physicians in the past year, growing its network to 46,000 physicians.

Includes 180,000 team members and serves 120 million customers.

Serves 80% of health plans to reduce total cost of care.

Works with 9 out of 10 Fortune 100 companies.

9. Purdue Pharma

Andy Mychkovsky is a Director at Evolent Health and the Founder of a healthcare startup and innovation blog, Healthcare Pizza. This post originally appeared on Healthcare Pizza here.

The post 9 Healthcare Companies Who Changed the 2010s appeared first on The Health Care Blog.

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manojgangaiah · 4 years

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jthatoi · 4 months

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Elevating Mental Health: The Impact of Outsourced Support

Introduction:

The surge in mental health challenges stemming from workplace stress, personal struggles, and the global pandemic has escalated the need for mental healthcare services. Outsourcing emerges as a transformative solution, revolutionizing patient care, guaranteeing HIPAA compliance, and empowering mental health practitioners to deliver unparalleled support.

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dinafbrownil · 5 years

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Bruising Labor Battles Put Kaiser Permanente’s Reputation On The Line

Kaiser Permanente, which just narrowly averted one massive strike, is facing another one Monday.

The ongoing labor battles have undermined the health giant’s once-golden reputation as a model of cost-effective care that caters to satisfied patients — which it calls “members” — and is exposing it to new scrutiny from politicians and health policy analysts.

As the labor disputes have played out loudly, ricocheting off the bargaining table and into the public realm, some critics believe that the nonprofit health system is becoming more like its for-profit counterparts and is no longer living up to its foundational ideals.

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Compensation for CEO Bernard Tyson topped $16 million in 2017, making him the highest-paid nonprofit health system executive in the nation. The organization also is building a $900 million flagship headquarters in Oakland. And it bid up to $295 million to become the Golden State Warriors’ official health care provider, the San Francisco Chronicle reported. The deal gave the health system naming rights for the shopping and restaurant complex surrounding the team’s new arena in San Francisco, which it has dubbed “Thrive City.”

Kaiser Permanente reportedly bid up to $295 million to secure the naming rights for a shopping and restaurant complex surrounding the Golden State Warriors’ new arena in San Francisco, which it dubbed “Thrive City.” (Hannah Norman/KHN)

The organization reported $2.5 billion in net income in 2018 and its health plan sits on about $37.6 billion in reserves.

Against that backdrop of wealth, more than 80,000 employees were poised to strike last month over salaries, retirement benefits and concerns over outsourcing and subcontracting. Nearly 4,000 members of its mental health staff in California are threatening to walk out Monday over the long wait times their patients face for appointments.

“Kaiser’s primary mission, based on their nonprofit status, is to serve a charitable mission,” said Ge Bai, associate professor of accounting and health policy at Johns Hopkins University. “The question is, do they need such an excessive, fancy flagship space? Or should they save money to help the poor and increase employee salaries?”

Lawmakers in California, Kaiser Permanente’s home state, recently targeted it with a new financial transparency law aimed at determining why its premiums continue to increase.

There’s a growing suspicion “that these nonprofit hospitals are not here purely for charitable missions, but instead are working to expand market share,” Bai said.

Therapists, psychologists and other mental health providers rallied in Oakland in October to protest the long wait times their patients face. About 4,000 mental health providers in California who belong to the National Union of Healthcare Workers threaten a five-day strike starting Monday. (Credit: Chris Joel)

The scrutiny marks a disorienting role-reversal for Kaiser, an integrated system that acts as both health insurer and medical provider, serving 12.3 million patients and operating 39 hospitals across eight states and the District of Columbia. The bulk of its presence is in California. (Kaiser Health News, which produces California Healthline, is not affiliated with Kaiser Permanente.)

Many health systems have tried to imitate its model for delivering affordable health care, which features teams of salaried doctors and health professionals who work together closely, and charges few if any extraneous patient fees. It emphasizes caring and community with slogans like “Health isn’t an industry. It’s a cause,” and “We’re all in this together. And together, we thrive.”

Praised by President Barack Obama for its efficiency and high-quality care, the health maintenance organization has tried to set itself apart from its profit-hungry, fee-for-service counterparts.

Now, its current practices — financial and medical — are getting a more critical look.

As a nonprofit, Kaiser doesn’t have to pay local property and sales taxes, state income taxes and federal corporate taxes, in exchange for providing “charity care and community benefits” — although the federal government doesn’t specify how much.

As a percentage of its total spending, Kaiser Permanente’s charity care spending has decreased from 1.29% in 2012 to 0.8% in 2017. Other hospitals in California have exhibited a similar decrease, saying there are fewer uninsured patients who need help since the Affordable Care Act expanded insurance coverage.

CEO Tyson told California Healthline that he limits operating income to about 2% of revenue, which pays for things like capital improvements, community benefit programs and “the running of the company.”

“The idea we’re trying to maximize profit is a false premise,” he said.

The organization is different from many other health systems because of its integrated model, so comparisons are not perfect, but its operating margins were smaller and more stable than other large nonprofit hospital groups in California. AdventHealth’s operating margin was 7.15% in 2018, while Dignity Health had losses in 2016 and 2017.

Tyson said that executive compensation is a “hotspot” for any company in a labor dispute. “In no way would I try to justify it or argue against it,” he said of his salary. In addition to his generous compensation, the health plan paid 35 other executives more than $1 million each in 2017, according to its tax filings.

Even its board members are well-compensated. In 2017, 13 directors each received between $129,000 and $273,000 for what its tax filings say is five to 10 hours of work a week.

And that $37.6 billion in reserves? It’s about 17 times more than the health plan is required by the state to maintain, according to the California Department of Managed Health Care.

Kaiser Permanente said it doesn’t consider its reserves excessive because state regulations don’t account for its integrated model. These reserves represent the value of its hospitals and hundreds of medical offices in California, plus the information technology they rely on, it said.

Kaiser Permanente is spending $900 million on a new headquarters in Oakland, which the company says will save at least $60 million a year in operating costs by bringing all of its Oakland staffers together under one roof. (Credit: Kaiser Permanente)

Kaiser Permanente said its new headquarters will save at least $60 million a year in operating costs because it will bring all of its Oakland staffers under one roof. It justified the partnership with the Warriors by noting it spans 20 years, and includes a community gathering space that will provide health services for both members and the public.

Kaiser has a right to defend its spending, but “it’s hard to imagine a nearly $300 million sponsorship being justifiable,” said Michael Rozier, an assistant professor at St. Louis University who studies nonprofit hospitals.

The Service Employees International Union-United Healthcare Workers West was about to strike in October before reaching an agreement with Kaiser Permanente.

Democratic presidential candidates Kamala Harris, Bernie Sanders, Elizabeth Warren and Pete Buttigieg, as well as 132 elected California officials, supported the cause.

California legislators this year adopted a bill sponsored by SEIU California that will require the health system to report its financial data to the state by facility, as opposed to reporting aggregated data from its Northern and Southern California regions, as it currently does. This data must include expenses, revenues by payer and the reasons for premium increases.

Other hospitals already report financial data this way, but the California legislature granted Kaiser Permanente an exemption when reporting began in the 1970s because it is an integrated system. This created a financial “black hole” said state Sen. Richard Pan (D-Sacramento), the bill’s author.

“They’re the biggest game in town,” said Anthony Wright, executive director of the consumer group Health Access California. “With great power comes great responsibility, and a need for transparency.”

Patient care, too, is under scrutiny.

California’s Department of Managed Health Care fined the organization $4 million over mental health wait times in 2013, and in 2017 hammered out an agreement with it to hire an outside consultant to help improve access to care. The department said Kaiser Permanente has so far met all the requirements of the settlement.

Ann Rivello, a therapist who works at Kaiser Permanente Redwood City Medical Center, says she’s frustrated that Kaiser Permanente markets itself as a leader in mental health care. Her patients have to wait about two months between appointments for individual therapy, she says. (Credit: Chris Joel)

But according to the National Union of Healthcare Workers, which is planning Monday’s walkout, wait times have just gotten worse.

Tyson said mental health care delivery is a national issue — “not unique to Kaiser Permanente.” He said the system is actively hiring more staff, contracting with outside providers and looking into using technology to broaden access to treatment.

At a mid-October union rally in Oakland, therapists said the health system’s billions in profits should allow it to hire more than one mental health clinician for every 3,000 members, which the union says is the current ratio.

Ann Rivello, 50, who has worked periodically at Kaiser Permanente Redwood City Medical Center since 2000, said therapists are so busy they struggle to take bathroom breaks and patients wait about two months between appointments for individual therapy.

“Just take $100 million that they’re putting into the new ‘Thrive City’ over there with the Warriors,” she said. “Why can’t they just give it to mental health?”

from Updates By Dina https://khn.org/news/bruising-labor-battles-put-kaiser-permanentes-reputation-on-the-line/

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coolgauravkashyap7800-blog · 5 years

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Top Surrogacy Clinic in Pune | ElaWoman

Oyster and Pearl Hospital

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Top Surrogacy Clinic in Pune | ElaWoman

The Peace Point Hospitals Group is the pioneer of integrated healthcare delivery in Varanasi. This vision led the group to earmark time and resources to strengthen each vital cog in the process of healthcare delivery. The Peace Point Hospitals is one of the IVF Centres in Varanasi. As a result of these efforts, the group today is in a unique position to exponentially increase its healthcare cover. This will be critical in order to meet future requirements.

Peace Point Hospitals Group, today, is an integrated healthcare organization with owned and managed hospitals, diagnostic clinics, dispensing pharmacies and consultancy services. In addition, the group’s service offerings include healthcare at the patient’s doorstep, clinical & diagnostic services, medical business process outsourcing, third party administration services and health insurance. To enhance performance and service to customers, the company also makes available the services to support business, telemedicine services, education, training programs & research services and a host of other non-profit projects.

Surya Super Speciality Hospital

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Surya Infertility and IVF Unit- A unit of G.V. Meditech Ltd. is the pioneer infertility and IVF centre in Eastern Uttar Pradesh. It was the first IVF Clinic in this region and is still the most successful hospital in the region. The hospital aims at providing world-class facilities to its patients with the help of its professional medical staff. The hospital caters to the medical needs of the patient with full dedication, precision, and care. To expand the reach and to help patients from every corner of the country Surya Super Speciality Hospital have joined hands with Max Super Speciality Hospital in opening a Max Heart command Center in Saket and New Delhi.

Dr Mamta Singh

Dr Mamta Singh is an outstanding doctor. She has been practising as a Gynaecologist, Oncologist and Perinatologist in Bhelupura, Varanasi. She has a substantial experience of 19 years as a practitioner. She completed her MBBS in 1997 from Patna Medical College and later earned an MS in Obstetrics and Gynaecology from Banaras Hindu University (IMS-BHU) (2003 BATCH). She is also an M.Sc in Value Education and Spirituality from Annamalai University.

Apart from academia, she is the member of several notable organisations such as Indian Medical Association (IMA), Indian Menopause Society (IMS) and Federation of Obstetrics and Gynaecological Societies of India (FOGSI). She has expertise mainly in Hysterectomy (Abdominal/Vaginal), Natural Cycle IVF, In Vitro Fertilisation (IVF), Intrauterine Insemination (IUI), Mirena (Hormonal Iud), Normal Vaginal Delivery (NVD), ICSI (Intracytoplasmic Sperm Injection), Infertility Evaluation / Treatment and few more.

In vitro Fertilization (IVF) Cost in Varanasi

Having one's own baby and starting a family is a dream common to every couple. All the moments, beginning from the time a baby is conceived and born into the world forms a memorable part of the parents lives. Creating and nurturing a new life is an experience worth living as it includes all the beautiful memories of one's precious child and a feeling of contentment unlike any other life event can offer. Most of the couples conceive their first baby during the initial year of their marriage, yet there are many who are not as lucky. Trying for a baby with constant failures can be a depressing and exhausting process that drains at physical, emotional and mental levels.

The pain of not being able to bear a child can get intolerable with time however seeking help from a good infertility doctor in Varanasi could be of great help. It is a well-established fact that IVF cost in Varanasi is considered to be high but with a little research and analysis done at your part, you always have the option to reach out the best IVF doctors in Varanasi at a reasonable price. Noticeably, the IVF cost in Varanasi varies widely between Rs.95885.4 to Rs.212798.3 for high-end IVF centres.

The cost of the treatment varies from clinic to clinic. The FTC calculator on Elawoman website is a one reliable way to have a general idea about the IVF cost in Varanasi. The calculator uses an algorithm to give nearly accurate calculations of the cost concerning different types of infertility treatments. It provides an estimation ranging from high, good to fair cost treatment that one can pick from depending on their budget.

For more information, Call Us: +91 – 8929020600

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jordblorg · 6 years

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two months ago, i wrote something i intended to write four months ago

in early march, i did my belated 2017 recap post, mostly (no, let’s be honest: entirely) for my own edification, but then i kept forgetting to post it on here because i live in a house without wifi and when i do have wifi i don’t have my laptop, but i spent the weekend housesitting and so i’ve been aimlessly on my laptop for an hour and i just remembered, oh, hey, that thing! i should do that thing.

so. anyway. 2017:

from 2013 to 2016, i ended each year (or started the new one) with a recap post in some form. there were years where i didn’t feel much like doing it, but i always felt like the act of forcing myself to sit down and reflect, or at the very least remember and record, would be a useful one, if not in the present moment then certainly later. and it’s already proven true: every so often, bored and scrolling my own tumblr to try and see what it tells me about myself, i stumble upon these yearly recaps and remember something about the year that i had forgotten. sometimes it’s a specific event. other times it’s a feeling or something as specific as a food. and on a few occasions it’s been particularly delightful to see a self who has no idea what’s to come -- in 2013, for example, i visited d.c. with a friend. we spent hours walking around the supreme court building, hoping to spot a justice, to no avail -- until the moment we left, at which point we saw clarence thomas from a distance, and mainly just the back of his head. and it was thrilling.

(a year and a half later, i would spend an entire semester working at the supreme court. it was one of the happiest semesters i’ve ever had. on the first snow day of that winter, i talked about the weather with the justice standing in front of me in the cafeteria line.)

so for all these reasons, i wanted, or felt that i should want, to write a brief post recapping my 2017, in words or in photos or in memes, watercolors, you name it. and i never did. and since the new year began, every week or so, i’ve thought to myself, well, hey, this one in particular is kind of an arbitrary deadline, you should still do a lil recap. and i’ve also spent a few evenings reading the super-old entries of bloggers i’ve followed for a few years - not even people i know well personally! - because watching people learn and grow online, if that’s how they should choose to do it, can be fun.

perhaps at the end of 2018 i’ll write a post about this being the year i simultaneously wanted to bloviate endlessly about all of my opinions, and also wanted to take myself off the radar screen completely, where every day i want to quietly delete all of my social media apps from my phone but haven’t as of this writing because of some vague fear that something will happen? that i will want to know about right away? or that if i take my ear away from the ongoing conversation of smart and angry people on my twitter feed, i’ll lose learning opportunities, and then say something i should know better than to say, but not know better, because i deleted my twitter account? i tried to download two apps yesterday that severely curb one’s ability to access other apps, the Bad Apps, on one’s phone, but neither had the functionality i desired unless i paid for premium, which, at that point, can i justify paying to outsource my self-control when reality i feel like i should be able to do that myself? (is this a healthy framing? i don’t think i’m wrong, but i could probably stand to be more generous to myself, except that i don’t want to be generous, i want to have the willpower of teddy roosevelt, he who cured his own asthma basically through sheer force of will, absent all of the historic toxicity and baggage with which he must also be inextricably associated? except i also know better than to frame recovery/health narratives as a matter of willpower?) i’ve lost the thread completely at this point, assuming i was ever holding a thread in the first place?

one time, years ago, an older male relative asked me if i exhaust myself. and oh my god. i do.

anyway. here’s some free association about 2017, the year i keep accidentally thinking it is, after reminding myself that it is not 2016, which is the year in my heart that i believe it to be.

i. the beginning of 2017 feels like it was a hundred thousand years ago, and at this point last year i had no idea that i’d be in alaska and out of my old field completely, and at this point this year everything that happened to me in the first half of the last one feels like a dream.

when i think about the months of january through may, i remember the weeks on end where each day i woke up and felt a void in the center of my stomach where normally the feelings that motivate me go. i had a hard time with basic self-care. on more days than i am comfortable admitting, i would go home at the end of a workday where i’d achieved nothing, sit on the couch in my living room, surf the internet until i fell asleep, and then wake up, only to do it all again. i felt empty and blank, and underneath those thick layers of emptiness and blankness i felt the licking flames of self-hatred and terror, and so there i would sit, watching the hours go by, on my couch.

sometimes i saw my friend nathalia, and we would laugh, and that would take some of the edge off of the tension that was winding its way around my stomach and my throat.

(eventually, i saw a psychiatrist, and started treatment - and medication, which, by the way, please talk to me if you’re reading this and feel some weird internal resistance to taking medication for mental health issues, because i get it and i’ve been there, and your feelings are valid, but oh my god it was absolutely the right decision to start taking medication and i will gladly tell anyone why - but the point is that eventually, i broke down, and my dad got me into an appointment. i have never felt more exhausted than when i was trying to navigate health insurance and the mental healthcare system in this country while mired in a particularly vicious period of anxiety and depression. and yet: i could afford it. and yet: i had a parent to call, who had the time and energy and means to help, who had a friend in D.C. who made a recommendation, who was able to get me an appointment two weeks after i finally broke down to another person on the phone. i cannot imagine how i would’ve gotten through the past year without the many, immense privileges and outside support systems that i so often take for granted. i’m fighting with my own brain every day, still, and yet i am still luckier than i will ever know.)

i can still picture my short walk from the metro stop nearest my office to the building where i worked. my stomach sunk every day.

but there were some good days, too, where i didn’t have to go to the office, or even worse, the capitol, and instead got to go to my favorite building in the city, and do something i knew i was good at. they don’t let you keep the tickets you get when you’re admitted to the supreme court as a member of the press corps, because you have to turn them back in to the security guard once you’re seated, but after my first visit i tried to remember to take pictures. i knew what i was doing, and i felt like it mattered. i got some work linked by a website i admire. on at least one occasion, i wrote a story that included the voice of a source none of the national reporters on the case had chosen to include, and it was an important voice, and i felt pride in the story and in myself. in february, rupsha came and visited me and the rest of her friends on her birthday, and mollie flew into town for the celebration. we got day drunk at a local bar, and successfully begged off a slice of birthday cake from the strangers who were celebrating their own camaraderie at a different table. i found a framing co-op near my neighborhood, and it felt very adult to know how to get to the place where i could get nice things framed. nathalia and i fell in love with an exhibit at the hirschorn about ragnar kjartansson, so we went twice and stayed for hours, and both times it mattered less that i’d spent so many nights and weekends unable to muster the willpower or even desire to leave my apartment, to explore the city where i lived. sometimes, often, i felt afraid. i never went to the monuments at night. the first five months of 2017 proceeded apace.

another shiny moment in the muck: i spent new year’s eve and new year’s day in brooklyn, first at a neighborhood bar and later on a rooftop and eventually in my best friend’s apartment. i made nathalia laugh so hard with a joke about potatoes that she snorted champaign out of her nose. i slept in a tent set up on the kitchen floor, and did almost nothing, but very happily. we had a spontaneous bachelorette lunch at the MoMA. i spent the night of january 2nd curled up on a tiny loveseat in a tiny apartment, with my college roommate and her boyfriend, and the next day i borrowed a blue dress, and the three of us took the bus to city hall and bought flowers on the way, and then we helped another of our old roommates get married. i could write about my memories of this day for a very long time. it was easily one of my happiest memories of the year. after the vows, we went and ate italian food in a near-empty restaurant. after we parted ways, i went to books of wonder, made my way to the bus that would take me back to dupont circle, and read a book bobby gave me for graduation, and cried and cried and cried.

later in january i covered the protest beat at the inauguration, and watched about 50 reporters swarm a single burning trash can, and later one single burning car. i wondered how many other cars were burning in the city for reasons less obviously political. speaking of, i read this poem about four billion times. the things that bothered me at the end of 2016, including but not limited to the privilege of perceived neutrality, continued to bother me well into the new year. they bother me still. on the day in the present that i am writing this, it is international [working] women’s day, according to whoever decides these things.

also in january: after five reporters covered every conceivable angle of the inauguration, i was sent alone to cover the women’s march. i made the front page and i thought the print headline was weird and off-putting. i don’t think back on any part of january with fondness, except for the part where i saw a drunken astronaut give an amazingly concise speech. the president tried, and mostly succeeded, to ban refugees from entering the country. my brother slept over in DFW airport, passing out water bottles and screaming at the top of his lungs. my parents got home, weren’t sure where he’d gone, and then spotted him in the background of the coverage on the TV news. my cousin got her first period at the women’s march.

in february, zach was deciding where to go to college, and we gathered in austin on the flimsy pretense of data-gathering. it rained the whole time. most nights, on my walk home, i’d pass by protests. i went on a handful of unmemorable dates. rupsha’s aforementioned birthday, the best weekend of the month by far. more work.

in march and april: coverage of a new supreme court justice. some watercoloring and some beautiful weather with nathalia, and some time, but nowhere close to enough, with others. three different passover seders, many hours spent listening to aimee mann. the white house press secretary referred to concentration camps as “holocaust centers” and said, out loud, to other educated adults, that hitler “didn’t even sink to the level of using chemical weapons.”

just kidding: four different seders, including the best one, with rupsha, in new jersey. boo wore pink and miles found the afikomen. the anchor stayed in my stomach until the very end, but i saw more live music: overcoats with liz, the wild reeds with nathalia, where we stood right in the front, holding a plate of nachos and singing along.

in may i could see the light at the end of a tunnel and i flew to san francisco and i wanted to stay forever. at brunch, the young couple to our immediate left let us hold their sweet baby while they ate chicken biscuits. we went into a pirate-themed store and the department of imagination and we found a man in a storefront at the alleyway, embroidering at the end of the world. my stomach was hurting but it felt inevitable and fine.

i left my job two weeks early and drove home and didn’t feel better, and my brothers graduated high school. josh spent the week wearing dresses that suited him and walked the stage at graduation in well-fitting black heels.

the summer was a mixed bag. i sat and felt anxious in a workplace in which i felt i was not thriving, and sometimes i went home and had panic attacks. but my roommate was a comical nightmare, and i felt loved and embraced by a community that spread its arms in all directions. i crashed on couches and in beds every night of the last three weeks. i went to museums with my college roommates. we went to clubs and stayed out all night. K, still happily married, prodded me onto a surfboard. we went to lake placid and it was wonderful; we were in brooklyn and it was wonderful; i studied for the LSAT i still thought i would eventually take and stayed out late and it was wonderful. S visited and it was sometimes wonderful, and we had a conversation we had needed to have for a long, long time. by the time he reached the point he’d been avoiding, two days later, we were separated on the phone, and i stood on the street outside of rupsha’s apartment. i took notes and cried.

and then...what? i spent a week in malala, oregon, sleeping outside and flinging myself as far away from everything as i possibly could. i cried again in the airport and i wasn’t sure why. i moved to anchorage, alaska, and gradually fell in love, and maybe a post about this city is coming another day. i wrote a tiny bit about my job. i take two buses to work every day, and two buses home. i decided to run a 5k, and i half-walked half-ran with some regularity, and felt good about my body and also weird about my body. i ran the 5k. i went on more dates. i felt happy and unhappy. i went on a handful of hikes before the snow came down. i slept in a freezing cold and wind-battered tent. i made toddlers laugh and then i learned their names. we threw a birthday party for avril lavigne and watched old meg ryan movies on VHS. i listened to more great music. i made latkes and sufganiyot for hanukkah. one day erin and i came home from the gym one frosty morning only to find everyone standing on the back porch, watching two moose, a mama and a baby, taking a nap in our back yard.

on the last week of the year, i house-sat for a family with two high-energy dogs and one low-energy cat. i took allergy medicine and made good use of the borrowed car. i walked the dogs past streets named after the solar system and i drove the car down the highway and to frozen patches of beach along the coast. i spent new year’s eve in sweatpants at the blue fox. none of us wore any makeup and erin sang three karaoke songs with gusto. the countdown to 2018 took us all by surprise. i started reading more often. that was also very good.

#2017 #year in review #very belated #i'm not even bothering to reread this NOW

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jthatoi · 4 months

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Beyond Borders: How Contact Center Outsourcing Boosts Business

Outsourcing contact center operations emerge as a strategic imperative for organizations aiming to achieve exceptional customer service while effectively managing costs.

In this article, we delve into the diverse array of benefits associated with outsourcing, encompassing not only significant cost savings but also enhanced customer experiences, a concentrated emphasis on core competencies, risk mitigation, and the invaluable acquisition of data-driven insights.

Our exploration seeks to articulate the pivotal reasons why contact center outsourcing stands as an indispensable strategy for contemporary businesses navigating the challenges of today's fiercely competitive business landscape.

Cost Savings:

Embarking on the journey of outsourcing contact center operations unfold a myriad of advantages, notably encompassing diminished infrastructure costs, decreased labour expenses, predictable monthly expenditures, and heightened scalability.

In contrast, in-house contact centers frequently grapple with substantial financial obligations arising from infrastructure investments. Outsourcing providers adeptly shoulder this burden by overseeing the acquisition and maintenance of essential infrastructure components.

Moreover, the flexibility inherent in outsourcing facilitates swift adjustments to staffing levels and resource allocation, seamlessly adapting to fluctuations in call volume, evolving business requirements, and dynamic market conditions.

This agility mitigates the necessity for overstaffing during periods of reduced demand, ensuring optimal operational efficiency.

Enhanced Focus on Core Competencies:

The strategic decision to outsource contact center operations empower organizations to concentrate on core competencies and strategic initiatives, fostering innovation, market expansion, strategic alliances, an enriched customer experience, and a distinct competitive advantage.

Outsourcing providers, with their dedicated focus on customer service, make substantial investments in training, technology, and industry best practices. This specialized workforce not only guarantees consistency and efficiency but excels in problem resolution and personalization, culminating in an elevated standard of service quality and heightened customer satisfaction.

This approach proves particularly advantageous in sectors such as mental healthcare, where outsourcing becomes a catalyst for enhancing customer loyalty and satisfaction.

Improved Customer Experience:

Outsourcing provides businesses with a range of benefits, such as 24/7 availability, cost-effective operations, and global reach. It addresses staffing challenges, reduces customer wait times, and fosters enhanced customer loyalty through multilingual support and access to linguistic talent.

Additionally, outsourcing ensures consistent service quality across languages, while investments in advanced technology like AI-powered chatbots and omnichannel support further elevate customer experiences, allowing businesses to stay competitive in the evolving customer service landscape.

Risk Mitigation:

Outsourcing providers deliver business continuity and disaster recovery with robust plans, redundant infrastructure, and experienced staff. They prioritize compliance with industry regulations like GDPR and HIPAA, relieving organizations of burdens and minimizing the risk of data breaches.

For organizations seeking reliable customer support, outsourcing emerges as an attractive and secure option.

Metrics and Analytics:

Outsourcing contact center operations provide specialized expertise, advanced analytics tools, scalability, and access to a diverse customer base, fostering data-driven insights.

This empowers organizations to make informed decisions, enhance customer experiences, and improve operational efficiency. Key performance indicators (KPIs) such as resolution rates, handle time, and customer satisfaction serve as valuable metrics, pinpointing areas for improvement and contributing to heightened service quality.

Contact center outsourcing not only streamlines operations but also grants access to cutting-edge technology and delivers valuable data-driven insights.

Dive deeper into the world of contact centers by exploring our dedicated blogs!

Uncover the secrets of streamlined operations, the latest in technology, and glean valuable insights that will keep you ahead of the curve. Let our engaging content be your guide to unlocking the full potential of contact center outsourcing! Read the blog: Benefits of Contact Center Outsourcing

#call center #call center outsourcing #contact centre #contact center solutions #contact center outsourcing #outsourcing #outsourcing partner

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kristinsimmons · 4 years

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9 Healthcare Companies Who Changed the 2010s

By ANDY MYCHKOVSKY

1. Epic Systems Corporation

2. Theranos

3. One Medical

4. Centene

April 2018: WellCare and Centene awarded Medicaid managed care contracts in Florida.

July 2018: Centene acquires Fidelis Care and their 1.6 million New Yorkers for $3.75 billion. This single-handedly gives Centene the leading Medicaid share in the state.

September 2018: WellCare acquires Meridian Health Plan and their 1.1 million lives in Michigan, Illinois, Indiana, and Ohio, for $2.5 billion.

February 2019: Centene and WellCare awarded Medicaid managed care contracts in North Carolina.

December 2019: WellCare awarded Medicaid managed care contract in WellCare (re-procurement underway)

5. Mylan

6. Evolent Health

7. Livongo

8. Optum

Works with 9 out of 10 U.S. hospitals, more than 67,000 pharmacies, and more than 100,000 physicians, practices, and other providers.

Added 10,000 physicians in the past year, growing its network to 46,000 physicians.

Includes 180,000 team members and serves 120 million customers.

Serves 80% of health plans to reduce total cost of care.

Works with 9 out of 10 Fortune 100 companies.

9. Purdue Pharma

Andy Mychkovsky is a Director at Evolent Health and the Founder of a healthcare startup and innovation blog, Healthcare Pizza. This post originally appeared on Healthcare Pizza here.

The post 9 Healthcare Companies Who Changed the 2010s appeared first on The Health Care Blog.

9 Healthcare Companies Who Changed the 2010s published first on https://wittooth.tumblr.com/

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