Americans, Fanny Trollope observed in that acetic manner of hers, pursue the DOLLAR with such a unity of purpose, such a sympathy of feeling as found nowhere else, except, perhaps, in an ants’ nest. “The result” she added “ is exactly what might be anticipated. This sordid object, for ever before their eyes, must inevitably produce a sordid tone of mind, and, worse still, it produces a seared and blunted conscience on all questions of probity.” To which we on Blighty’s shores might happily reply “Amen to that”, were it not that American ants’ nests have lately appeared with pestilential frequency in NHS offices up and down the land.
Dr No refers, of course, to the invasion of the NHS by the American for-profits health insurance giant UnitedHealth. UH now has more feet under NHS desks than a hydra has heads. Only last month, UH beat off BUPA and Humana to win a DoH contact to ‘support’ PCTs and of course in due course GP commissioners on their ‘commissioning capabilities’. Amongst the UH goodies on offer, PCTs can choose from:
• Practice based commissioning data tools for budget setting and actuarial design of risk pools and incentive overlays and facilitating consortia development to gain maximum benefits
• Profiling primary care performance, Medicines management and Skill mix redesign at the primary/secondary care interface
• Strategies for changing clinical practice including clinical decision support methods including Turnaround help with rapid development of plans
• Change programmes underpinned by tools that integrate silos of data into patient-centric information tools
Fanny, of course, would have spotted the DOLLAR in all of this straight away. For Dr No, who does not speak American, it took a bit longer, and a bit more probing on UN’s UK website. Nonetheless, it is all there, all in plain and easy language, if one is prepared to dig that bit deeper. Dr No particularly recommends – for those who want to brown their trousers in double quick time – the following four pdfs: HealthNumerics- AIV; HealthNumerics- EBM; HealthNumerics- RISC and HealthNumerics- eSync.
HealthNumerics-RISC, for example, assures us that UH technology ‘loads data from multiple sources’, determines admission risk, and then ‘ranks every patient from highest to lowest risk’, so providing ‘predicted costs for the next 12 months at individual patient and population level’. A helpful graphic reveals that a Henry Fordham, an 82 year old white Irish male, tops today’s high risk pops.
Just too bad if you rate as high risk, and are predicted to cost too much: for you, your care is over…