Risk Management Series: Individual Accountability in Corporate Wrongdoing

data offWelcome to MD Ranger’s five-part blog series on risk management! We hope that these articles will help both you and your organization understand the ever-increasing need for strict, internal compliance procedures. This week, we delve into the circumstances surrounding a policy change over at the Department of Justice (DOJ) and how it affects both physicians and medical directors. 

Late last year, former US Deputy Attorney General Rod J. Rosenstein announced the Department of Justice’s (DOJ) intent to focus on individual wrongdoers in corporate investigations. The DOJ has made fighting white-collar crime a priority, going as far as to establish a Task Force on Market Integrity and Consumer Fraud. 

Rosenstein emphasized that “the most effective deterrent to corporate criminal misconduct is identifying and punishing the people who committed the crimes.” It can be difficult to prosecute white-collar crime. The individual perpetrators of these crimes have nothing to fear. A fine and a slap on the wrist mean little to executives and administrators protected by corporate culpability. Corporate criminal prosecutions rarely deter crime–the decision-makers walk free, while employees and investors bear the brunt of the financial penalty. 

Recent changes to DOJ policy reflect the gravity of this situation. Rosenstein explains that companies are now incentivized to identify individual wrongdoing. If an organization wants credit for cooperation, they must identify individuals both behind and aware of the wrongdoing. This revised policy will still impose penalties on the corporations themselves–corporate resolutions offer greater opportunity for restitution and funding toward compliance programs. 

These resolutions, however, should not exempt the individual perpetrator from criminal liability. The nature of corporate crime can be likened to that of the many-headed Hydra. When one head is cut off, two more take its place; penalizing a company only as an entity does nothing to deter further criminal activity. DOJ has taken a play out of Hercules’ book, deeming it necessary to cut the head off the beast and then cauterize the stump. 

Physicians and medical directors should be wary of these new circumstances. DOJ does not discriminate between corruption and noncompliance. If brought to their attention, organizations that repeatedly violate Stark Law and the Anti-Kickback Statute will be treated with the same prejudice as corporations implicated in criminal behavior. Don’t put yourself or your organization in jeopardy. Questions or concerns? Read Rosenstein’s full address here, and feel free to email This email address is being protected from spambots. You need JavaScript enabled to view it. for further inquiry.

Moody's : UnitedHealth Group and TeamHealth Dispute could indirectly affect hospitals and other providers

data offLast week, Moody’s Investor Service reported that a contract dispute between UnitedHealth Group and physician staffing company TeamHealth could indirectly affect hospitals and other providers.

TeamHealth revealed in their second quarter earnings that UnitedHealth Group is planning to cancel in-network agreements in October, impacting their business in 18 states. Moody’s is speculating that if staffing companies such as TeamHealth receive lower reimbursements from payers, firms would likely seek higher subsidies from hospitals. Their analysts are drawing parallels to a similar dispute that UnitedHealth had with Envision Healthcare and are speculating that TeamHealth will eventually agree to lower reimbursements, resulting in lower earnings for TeamHealth.

Why should healthcare organizations with physician staffing company contracts pay attention to this?  The financial impacts could be significant for hospitals already operating on razor-thin margins.  According to MD Ranger data, hospitals pay $825,180 at the median for annual anesthesia stipends, $1,222,160 for hospitalist stipends, and $488,240 for emergency physician stipends.  We’ve observed that hospitals absorb the costs of poorly negotiated payer contracts with physician groups by paying commercially unreasonable stipends. Not only is this financially risky, it may not be compliant.

Moody’s additionally stated that, "Disagreements between insurers and staffing companies could also disrupt hospitals if staffed physicians are no longer in-network. Unless legislation to curb surprise billing is implemented, patients could be on the hook for out-of-network charges, raising reputational and social risk for hospitals".

Already paying high subsidies to your hospital-based groups and want to see how inline with peers you are?  Check out our hospital-based stipend benchmarks today.

Feds Charge Amity Home Health Care and Advent Care in $115M Medicare Kickback Scheme

GavelBig news out of the San Francisco Bay Area Thursday as federal prosecutors charged Amity Home Health Care and Advent Care with paying doctors over $8 million in kickbacks while defrauding Medicare for $115 million.

The FBI alleges that the two companies, both operated by Ridhima Singh, paid doctors in the form of NBA basketball tickets, designer handbags, and envelopes of cash for referring patients. Craig Fair, FBI Deputy Special Agent stated “These doctors and healthcare professionals sold patients like commodities, placing their own financial gains over the wellbeing of their patients and betraying the basic principles of their profession”.

If convicted of violating the Anti-Kickback Statute, the 28 doctors charged along with Singh face a maximum sentence of 10 years and prison and a maximum $100,000 fine. Singh also faces steeper penalties due to facing additional charges.

Even healthcare organizations acting in good faith can sometimes run into issues with the Anti-Kickback Statute, so it’s always important to document your physician contract compliance.  Just remember that paying for referrals is always illegal and that the DOJ is focused on pursuing individual accountability for executives and physicians in these illegal kickback schemes in addition to levying fines on the organizations.

In wake of Wheeling lawsuit, two hospitals to close in Ohio, West Virginia

GavelLate last week, Ohio Valley Medical Center (OVMC) in Wheeling, West Virginia and East Ohio Regional Hospital (EORH) in Martins Ferry, Ohio announced their impending closure. The two facilities are set to close in a few months, putting nearly 1,200 employees out of work.

President and CEO Daniel C. Dunmyer’s statement reads: “OVMC, EORH and their physician practices have lost more than $37 million over the past 2 years as they struggled to overcome declining volumes, declining reimbursement, and the substantial harm caused by the conduct alleged by the government in United States of America ex. rel. Louis Longo v. Wheeling Hospital, Inc., R&V Associates, LTD., and Ronald L Violi.”

Back in March, the Department of Justice (DOJ) entered a federal whistleblower lawsuit alleging that West Virginia’s Wheeling Hospital was in violation of the Stark Law, Anti-Kickback Statute, and the False Claims Act. 

Louis Longo, Wheeling’s former executive vice president, claimed that the hospital nurtured a relationship with R&V Associates founded on overcompensation and kickbacks. The duration of Wheeling’s relationship with R&V saw the hospital a $90 million profit. 

For the most part, Stark, AKS, and FCA violations are seen only as harmful to the government–faceless men in suits. The phrase ‘defrauding the government’ hardly elicits an emotional response. 

Your organization’s compliance–or lack thereof–can affect people just like yourself. Questions or concerns? Click here for the latest insights into physician contracting compliance, or reach us at This email address is being protected from spambots. You need JavaScript enabled to view it. to speak with one of our experts. 

Broward Health Settles With Former CEO

GavelBig news from Florida as Broward Health approved a $975,000 settlement with former CEO Pauline Grant after she was fired for unproven kickback allegations. “It’s time to close this chapter in a way that’s as amicable as possible,” Broward Health Commissioner Christopher Ure said at a board meeting last week announcing the settlement. Broward Health operates four hospitals and additional outpatient and urgent care centers in the South Florida area. They are now under new leadership and pledging their full cooperation with the ongoing federal investigation. 

According to the South Florida Sun-Sentinel, the settlement ends all pending legal matters involving Broward Health and Grant and also includes an agreement from Grant to cooperate and assist the hospital system in a pending federal investigation into potential anti-kickback violations. 

The kickback allegations are in relation to orthopedic surgeon contracts for on-call emergency department rotation. Grant denied ever being aware or participating in the scheme, which is why she decided to fight back against allegations of her involvement. Her brief tenure as CEO lasted less than a year, from late January to December 2016. 

MD Ranger provides fair market value benchmarks for more than 300 physician services, including call coverage benchmarks for orthopedic surgery. If you need access to these rates, email This email address is being protected from spambots. You need JavaScript enabled to view it..

MD Ranger Spotlight: Lauren

LaurenLauren is a Senior Sales Executive at MD Ranger.  She has worked with legal and compliance teams in healthcare organizations for nearly a decade. She has refined physician contracting processes, assisted with audits, and helped guide overall contracting strategy. She has worked with companies under Corporate Integrity Agreements as well as healthcare organizations that have no pre-existing formal contracting process.  Lauren particularly relishes partnering with teams that strive to put compliance front and center. 

Tell me how you first got involved with MD Ranger.
I was looking for an organization whose product I truly believed could transform the healthcare industry, as well as an organization that internally promotes culture and growth.  MD Ranger has this mindset, and it results in a fantastic experience for our subscribers.

I have always loved working with hospital legal and compliance departments, specifically with contracting processes. I have seen the challenges hospitals face in relation to cost management as well as physician contracting, so MD Ranger was a great fit. The opportunity to impact the healthcare community and help develop products that make our subscribers’ jobs easier was a big driver to join MD Ranger.

What do you love about MD Ranger?
The teamwork, culture, and respect everyone has for each other. This resonates throughout the company and motivates everyone to work harder and serve our subscribers better. The collaboration that the team participates in is very encouraging and insightful.

What do you find most challenging about your work?
Being new, the learning curve is challenging. It’s incredibly satisfying because there’s a lot of self education that you can do to prepare yourself but there is so much organizational knowledge that will take time to learn. I’m ready to be a subject matter expert!

In your opinion, what are some of the greatest challenges that healthcare organizations face when it comes to physician contracting?
Poor survey data is something we frequently hear about. Another common theme is not knowing where to start or where to focus with their physician contracting process. It’s unfortunate, but we hear about lack of support for implementation of physician compensation processes and documentation a lot.

How would you describe a typical “day in the life”?
Every day is completely different in my role and my ‘to do’ list is growing. One of my top priorities is to ensure to follow up with potential subscribers and making sure that all action items from discussions have been resolved. The next priority is strategizing on how to best help grow the business while maintaining the utmost care of our current subscribers. Lastly, I try to learn something new about the industry or business each day. Understanding the regulations that govern the industry is challenging and an ever growing task. 

Who have been the most influential people in your career?
I’m fortunate to have mentors that impact their organizations in a positive way for the clients and employees. Strong leaders who focus on expanding their team’s growth through empowerment and independence have also had a significant impact. Also, professionals that can balance work life and home life while still pursuing their goals and not losing sight of  any of these aspects. 

What do you do in your spare time?
I love reading, cooking, and anything outside including hiking, jogging, and kayaking! I also love my animals and getting to spend my free time with them. 

What might someone be surprised to know about you?
I have never broken a bone and I love target shooting. And I’m a better shot than my husband.

MD Ranger Spotlight: Noah

NoahFor our third installment of MD Ranger's 10-year anniversary spotlight series, we are highlighting our Summer Intern, Noah Galper.

We have been thrilled having Noah join us as our Summer Intern. In a short period of time, he has immersed himself in the world of physician contracting and is someone that we enjoy having around the office. As you'll read in our conversation below, he is a very driven induvidual and has a bright future ahead of him. 

Where are you going to college and what is your major?
I go to Claremont McKenna College and I plan to major in Applied Math. 

What has surprised you the most about working at MD Ranger?
For my brief tenure at MD Ranger, the team designed an 8-week plan intended to educate me in the world of physician contracting compliance. I was–and continue to be–surprised by the team’s investment in my experience. I think that it’s rare for an intern to be afforded both responsibility and educational opportunity. I’m so grateful for the thought the team has put into my professional development. 

What do you find most challenging about the internship?
MD Ranger inhabits an extremely unique niche. Healthcare organizations subscribe to MD Ranger because even industry professionals struggle with the intricacies of physician contracting. Individually, healthcare and business terminology can be daunting to the uninitiated; this combination of the two is a whole different animal. Understanding the full scope and function of MD Ranger’s product in such a short period of time has been difficult, but manageable. It gets easier every day. 

What have you enjoyed the most about working at MD Ranger? 
Learning about MD Ranger’s niche has been fascinating. Don’t get me wrong–it’s difficult, but I feel like this internship has doubled as a summer class. I’m going to walk away from this experience with tangible knowledge of hospital organizations and their compliance regulations. 

How would you describe a typical “day in the life”?
It’s difficult for me to describe a “typical” day on the job. Although I have several long-term projects, I have yet to spend a day plugging away at the same task. I think that this is part of what makes working at MD Ranger so rewarding. Between answering customer service calls, attending team meetings, and working on a slew of day-to-day assignments, I’m kept on my toes.

What do you do in your spare time?
I am an avid Redditor, gym-goer, and concert attendee. I enjoy listening to music, watching movies, and reading science fiction. 

What might someone be surprised to know about you? 
This usually elicits a strange response–I love driving long distances. There is something incredibly cathartic about peeling down an interstate highway and watching the scenery change alongside you. I especially enjoy driving in the Pacific Northwest.  

MD Ranger Spotlight: Penny

IMG 5721 2To celebrate our 10-year anniversary, MD Ranger is going to spotlight team members who have played an integral role in the growth of our company. In our second installment, we are highlighting our Founder and Chief Executive Officer, Penny Stroud.

Penny is the Chief Executive Officer and a Co-Founder of MD Ranger.  Her areas of expertise include a broad range of strategic business planning and market analysis for health care organizations, including hospitals, medical groups, health systems, other types of providers and organ procurement organizations. She is a trusted advisor to boards, management and physician leaders as they position for the future and identify market opportunities. 

Penny began consulting for health care providers in 1978 and has extensive experience in the development of detailed business plans for health services that analyze financial and market performance and define strategies for future performance or size adjustments.  Some of her skills include market research, physician-hospital integration, reimbursement analysis and an understanding of the financial and staffing operations of hospitals, physician practice and health services. 

In 2009, Penny co-founded MD Ranger, which provides high quality benchmarks for physician contracts with health care providers.  Some of the benchmarks include medical direction, call coverage, hospital-based services, diagnostic services and medical staff leadership position.  She has led the continuous growth and expansion of MD Ranger with subscribers nationwide. In 2015 she oversaw the launch of our web-based community physician need and demographic tool to help assess community need and to understand payer dynamics.

Why did you found MD Ranger?
I started my career in strategic and business planning for health care facilities and had a successful practice with wonderful clients.  Fifteen years ago I, and my clients, began to be consumed by Stark compliance and FMV requirements.  I got tired of begging clients for data for opinions and decided to exit the business, but thought that there had to be a better way  to document FMV.  Fortunately, many of my clients, including Dignity Health, agreed, so my partners and I joined with Michael Heil, another FMV consultant, to found MD Ranger. Ten years ago we issued our first set of about seventy call and direction benchmarks. We just released our tenth edition with more than 320 benchmarks used by hospitals, health systems, medical groups, LTACs, home care, consultants and associations across the country!   

What makes you most proud when you think of MD Ranger?
My amazing team, co-founders and wonderful clients who are dedicated to exceptional customer service and production of high quality tools and benchmarks to simplify and improve compliance.

How has MD Ranger grown over the past 10 years?
We started with one full-time staff and about fifty hospitals, producing seventy benchmarks for call coverage and medical direction.  Now we have nine staff and 160 facilities and we produce more than 320 benchmarks in call coverage, medical direction, physician leadership, diagnostic and testing, uncompensated care, and even clinical hourly rates. We also offer a comprehensive set of analytic tools that clients can use to summarize and benchmark all of their physician contracts against comparable providers. Finally, we’ve moved from published books to a fully supported online portal that allows easy look-ups and market rate documentation.

What types of hospital/physician agreements have changed the most over the past 10 years?
The number and scope of physician contracts has changed significantly over the last ten years, but I think the scope of hospital-based physician services presents the most striking change. When we started it was mainly large hospitals that engaged general hospitalists and intensivists.  Now half of our clients engage general hospitalists and almost a third engage OB laborists to manage inpatients. The number of orthopedic, neurology, psychiatric, acute care surgery and other hospitalist arrangements is also rising.

When you look at physician contracting over the past decade, what surprises you the most?
I continue to be surprised at how many hospitals continue to struggle with documenting fair market value, and how labor intensive and expensive the compliance process can be. Most of our MD Ranger subscribers have been able to streamline their contract approval and compliance documentation process.  For systems, it has enabled a consistent foundation with standardized policies and procedures across facilities.  For individual facilities, it has provided a simple but broad platform for FMV documentation and an invaluable tool for monitoring and budgeting physician costs.

What do you see as the most challenging aspect of physician contracting for hospitals? For physicians?
For hospitals, the challenge is dealing fairly with physicians across the organization and balancing cost/benefit. For physicians, it’s ensuring they get a fair deal, and deciding on how working for and in a hospital fits into their life and practice.

What do you think will change in hospital/physician agreements over the next 5 years? What won’t change?
The structure and scope of hospital-based physician agreements will continue to evolve as staffing needs and revenues become more predictable.  However, the complexity of these agreements will remain due to the multi-dimensional demands and expectations of the positions.  If we move toward broader coverage by fewer payers, there will have to be major changes in how providers are paid.  Health care is an industry that is ripe for disruption.

Do you volunteer or do any philanthropic work?
I am on the board of two organizations, the regional board for the Cystic Fibrosis Foundation and the Myanmar Foundation for Analytic Education.  One of my daughters has CF and the challenge remains to find a cure and improve quality of life for the many people who suffer with CF.  MFAE supports a small private school in Yangon that provides a rigorous pre-collegiate program for young people.  I’ve had a lifelong interest in Burma and this is one small way to help that country transition to an informed, skilled populace.

What do you do in your spare time?
I love to hike, travel, and spend time with my children and grandson.  I’m also an avid gardener – it’s my psychotherapy.

What might someone be surprised to know about you?
That’s a tough one, but my kids might say that the surprise is being the CEO and co-founder of a SAAS company.

MD Ranger Spotlight: Allison

apullins1To celebrate our 10 year anniversary, MD Ranger is going to spotlight team members who have played an integral role in the growth of our company. In our first installment, we are highlighting our Chief Marketing Officer, Allison Pullins.

Allison is a healthcare technology executive with more than 12 years of industry experience. As CMO of MD Ranger, Inc, Allison is leading the charge to help make physician contracting more data-driven and less of a headache. She has experience guiding and executing corporate strategy, building teams across marketing, sales, and customer success, and cross-functional collaboration.

Prior to joining MD Ranger, Allison was on the leadership team of Crimson Market Advantage, a business intelligence platform that helps hospitals better understand physician relationships and referral patterns.  She also served as a Senior Manager in the Research and Insights division of The Advisory Board Company.

Allison has domain expertise in physician contracting, compensation, and hospital-physician relationships.  She has been the lead speaker in more than 60 educational webinars to thousands of healthcare professionals across the US and has been published in Becker’s Healthcare. She has advised clients from over 200 healthcare organizations.

Allison’s enthusiasm and passion for personal and professional growth has inspired her commitment to mentoring and coaching.  As a women’s college graduate, she is especially interested in mentoring up-and-coming female leaders and helping women navigate career and parenthood.

Tell me how you first got involved in with MD Ranger.
I first heard about MD Ranger from my husband, who at the time worked with one of the MD Ranger founders at a market research company.  They needed someone with a strong background in sales and client services, who understood hospitals and the healthcare industry. My roles at The Advisory Board and Crimson Market Advantage fit the bill, and I started working at MD Ranger in July of 2012...nearly seven years ago.

Did you ever imagine you’d end up where you are professionally?
Definitely not!  When I was a little girl, I wanted to be a princess.  Seriously, though, I come from a family of teachers, doctors, cooks, and pastors--all professions that are ultimately in the service of others.  Getting into healthcare at the start of my career thirteen years ago was absolutely influenced by my family.

What has surprised you most about working at MD Ranger?
How difficult executing a compliant physician contracting policy can be.  Even the most progressive organizations we work with still struggle with documenting FMV for all arrangements. Another thing that surprised me is the manpower it takes to produce our benchmarks each year.  With over 36,000 agreements in our database that generates over 300 benchmarks a year, you can imagine what an effort it takes to report our benchmarks.

What do you find most challenging about your work?
I wear a lot of hats at MD Ranger, which both challenges and delights me.  My days are often unpredictable and as a company that’s expanding fast, we experience our share of growing pains.  But at the end of the day, I always remember that our subscribers have much harder jobs than I do! I hope we’re able to make their lives just a little bit easier with MD Ranger.

The focus on physician spending seems to be growing.  Why do you think that is?
There is growing pressure to tackle exploding health care costs in this country, and for good reason.  Physician spend is a meaningful piece of this (gigantic) pie. The average hospital in our database spends just about 8.5 million dollars a year on non-employed physician contracts each year--and these are for providing non-clinical services!  

What do you think will change in hospital/physician agreements over the next five years?
We’re already seeing changes in compensation to incentivize physicians on quality and patient satisfaction.  We’re also seeing the evolution of arrangements like co-management agreements that are meant to give physicians accountability for performance across both care quality and cost. I believe we will continue to see these relationships evolve.  I also see physician employment here to stay, and will probably even increase despite the losses that hospital organizations take by employing doctors.

What's it like to work at MD Ranger?
No two days are ever alike.  We’re helping our subscribers solve complex problems, so there’s a lot of intellectual stimulation and continuous learning.  I love that part of my job. I feel like I am helping produce something so important to hospital operations that our subscribers can’t do their jobs without us.  Talk about being needed and appreciated in a great way!

Who have been the most influential people in your career?
I have been lucky in my career to have received some fantastic mentoring.  My first mentor was a boss of mine at the Advisory Board who changed the way I thought about “managing” people to “leading” people.  Her no-nonsense but kind approach to coaching has inspired me so much. I am very close with a group of eight other full time professional women who are also mothers of small children.  We are senior marketing/communications executives, doctors, venture capitalists, attorneys--it’s an eclectic and ambitious group. I turn to them for advice and support, especially with matters that intersect career and family.  Having a “squad” of women to support you is so important for working mothers.

Do you volunteer or do any philanthropic work?
I do.  I am involved in the fundraising arm of my children's' school whose mission it is to ensure that children have the opportunity to access quality early childhood education.  We just raised $41,000 at a Star Wars themed Gala this spring--not too shabby for a 90 child preschool. The second organization I work with is extremely dear to my heart, and that’s the Marfan Foundation.  Marfan Syndrome is a life-threatening genetic condition that affects the way the body makes connective tissue. My son was diagnosed with Marfan Syndrome when he was two years old, and since then, I have been fundraising and volunteering my time to advance research, advocate for those affected by connective tissue disorders, and educate people about this condition.  Last year I raised over $11,000 for the Foundation; I will never stop fighting for my son and I have a lot of work to do, but am proud of what I’ve already accomplished.

What do you do in your spare time?
I’m the mom of a three-year-old and a one-year-old, so I don’t have a lot of spare time!  In all seriousness, though, I spend most of my time out of the office with my family. We love exploring the Bay Area, particularly children’s museums like the Exploratorium, the Randall Museum, or the Bay Area Discovery Museum.  When my husband and I sneak away, we love grabbing sushi and going rock climbing--or sometimes just relaxing over a bottle of (preferably Italian) wine. If I had an entire day to myself, I’d ride my bike (I’m a huge FlyWheel devotee), do some yin yoga, read a novel, eat a big rare New York Strip … and be asleep by 9pm.

Tell me something you’ve learned about being a professional from being a mother.
I’ve learned so much from being a parent that has carried into my professional life.  If I had to pick just one thing, it would be perspective. As a parent, you are constantly making decisions and changing course and you have to be ruthless about focusing on what truly matters and forgetting about what doesn’t.  Having that skill in the professional setting is invaluable because it makes you a good decision-maker.

What might someone be surprised to know about you?
I had both of my kids at home … on purpose!  Being in healthcare and having clinicians as parents, many people assumed that I would have a hospital birth, like more than 99% birthing people in the US do.  The midwifery model made sense for me and my family, and my two home births are the very proudest days of my life. 

San Francisco Business Times Future of Health Care

Last week, we attended the San Francisco Business Times’ annual Future of Health Care breakfast. The theme this year was innovators and disruptors.

In the $3 trillion healthcare industry, trying to disrupt or even make a dent in the current ways. However, there are significant changes in the healthcare industry that necessitate innovation. These trends include the movement away from medical care happening primarily on site to being in the home or via telehealth. There is an increasing rate of chronic illness, and we need to be assessing ways to treat chronic illness before it leads to emergent situations. Healthcare users need to feel that healthcare is not a burden to their lives, as it is so often seen. We all dread waiting in doctor’s offices, only to be seen way after our appointment time and for only a brief amount of time. Another point that was made, was that in the migration toward value based care, the measure of value is not usually the patient’s measure of value.

However, despite the need for healthcare innovation, there are many barriers to implementing new ways of doing things. Usually, healthcare organizations are large, slow-moving organizations. It takes a long time for these organizations to make innovation decisions, let alone implement the decisions. Healthcare organizations, at the frustration of the disruptors, don’t move fast enough. It is entirely possible that by the time a healthcare organization implements an “innovative” system, it is time for another round of innovation.

This event is one that we look forward to every year because of the interesting discussion regarding the healthcare system as a whole.

julia 110

Our Fifth Annual Benchmark Report: Coming Soon

It’s an exciting time at MD Ranger headquarters in Burlingame, California. Over the past four months, we have collected thousands of contracts from our 200+ subscribers across the US. In preparation for publishing our annual benchmark report (coming soon!), we’ve been auditing our data and working around the clock to ensure our data is reported accurately.

One of the reasons why we’ve been able to produce high quality data year after year is our rigorous data auditing process. We like to be transparent, so I wanted to take the opportunity to tell you how we whip our data into shape.

First, we review all data that comes in from subscribers as soon as it comes.  This allows us to look at the hospitals’ contracts holistically, and in relation to all other contracts at the hospital. This makes it easy to catch if there’s a strange number of contracts (say, three medical directors of radiation oncology on one campus), or if there’s a strange per diem (say, $5,000 for family practice coverage that probably is $500 instead). We run updates on our database internally, to check and see if our data is changing (and if so, by how much).

As we get closer to production time, we start auditing our data by service.  What this means is that we take an entire service, say general surgery call coverage, and we look at each contract within the service for errors. We pay special attention to outliers (especially high or low contracts), as well as statistics that have changed from last year’s published data.  As our database grows larger and more diverse, the more stable it becomes.

Questions about our auditing process?  Shoot me a note at This email address is being protected from spambots. You need JavaScript enabled to view it.


The Future of Health Care Leadership Summit

MD Ranger attended “The Future of Health Care Leadership Summit” in San Francisco this morning. This annual event is produced by the San Francisco Business Times, and is always a big hit among the business and health care community in the Bay Area.

Today’s panelists were:

Mark Laret, CEO, UCSF Medical Center
Paul Markovich, CEO, Blue Shield of California
Dr. Tom Lee, CEO, One Medical Group
David Joyner, COO, Hill Physicians Medical Group
Wade Overgaard, Senior Vice President, Health Plan Operations, California, Kaiser Permanente

The discussion revolved around topics of health care affordability and sustainability, and how technology could help us achieve both. Because the implementation of the Affordable Care Act is in such early stages, it is still difficult to predict effects of this major transformation.  Interestingly, no provider was comfortable reporting seeing an influx of patients with expanded coverage, nor did they comment on any changes to payer mixes or any other effects of the exchanges. They were still in “wait and see” mode.

The specific types of technologies mentioned to decrease the costs of healthcare have to do directly with the consumer. Telemedicine was heralded as important contributor to lowering healthcare costs and accessibility challenges. Handheld mobile devices could be the key to further innovation for consumer education, marketing, and and even treatment.  Why hasn’t healthcare already embraced these technologies that have been critical for innovation in other industries?  According to panelists, reimbursement must keep up with the changing pace of technology and health care. The argument was that provider will adopt a technology if there isn’t a way to get paid for it.

The panelists imagined seeing both cost savings and patient satisfaction increase when care is coordinated across the continuum, with an emphasis on customizing the message. While the panelists urged communicating to consumers in a personalized fashion, no solutions discussed on how exactly to do this.


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