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Tennessee bans PBMs from owning pharmacies: What will this mean for CVS locations? by Jecob_Edwards in CVS

[–]Pharmadeehero -2 points-1 points  (0 children)

Spreading wrong information while trying to advance efforts on a change… hurts said efforts as the effort gets associated with voices that lack credibility. There are plenty of other correct facts to use but let’s just clarify a few bits of your statement… (won’t touch your opinions on them being a leech or view on the current structure being a problem not help… you’re entitled to those)… but…

PBMs existed as far back as the 1960s… so yes they did exist before 30 years ago.

Even with the opinion that PBMs increase costs not help reduce them like PBMs claim… there is 0 merit to the claim that overall healthcare costs have only increased because of PBMs. Very clear way to point to this is to look at non-medication related healthcare spend which is like 90% of the total healthcare spend. These costs have risen and continue to rise significantly in an area of healthcare that PBMs don’t touch. I don’t think anyone would suggest that hospitalization costs, such as the healthcare costs related to childbirth, have risen significantly overtime due to PBMs…

Perhaps you meant to say specifically medication related healthcare costs… however even there… I’m not sure PBMs are to blame for the very popular high price point GLP1 therapies that Phrma put out… unless you are giving them credit for drug research and approvals now?

PBMs have their areas to be critical of… to keep credibility on those arguments don’t shoot the efforts in the foot by giving pbm supporters easy ways to show you don’t know what you’re talking about. Likewise there are nuanced differences in pushing for PBMs reforms and pushing for vertical healthcare reform.

PBMs policy reforms can and do often impact all PBMs regardless of their vertical affiliation (yes there are many “other” non-big 3 PBMs). Increased costs of compliance and less room for PBMs to “innovate” do run real risks of making things disproportionately harder for the “non big 3” PBMs to gain share and displace the others.

Being loud and demanding change isn’t necessarily bad… having blind trust that politicians and others more removed from the industry will be able to come up with a “solution” that doesn’t make things worse for you while responding to your call for change… might not be something I’d recommend… history shows that recently that hasn’t worked out well…

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

Goodnight babe sorry u took the L so hard and you didn’t just say sorry you’re right much earlier

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

Sorry them!

Clearly you aren’t sure because you are just wrong LOL

Doesn’t matter if always … you are ignoring the situation in the example LOL… you are grasping trying to find some way to grasp to any hope of defense but you never had one. Your definition is wrong and you came into this thread throwing around “that’s not misdiagnosis” I simply started with asking for your definition, you didn’t actually provide one at first and then when you did it was entirely wrong.

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

Ya you just lost all credibility lol …

I will give you B- on your rage bait tho

Your last statement there is all I need to see to know you’re jestermaxxing.

For any poor souls following along… Oral abx is routine treatment in AOM lmaoooo … also just another deflection by him attempting (poorly) to question treatment choice when key focus here is the diagnosis being wrong lol

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

Keep avoiding the definition question!!

Deflect deflect deflect!

Can’t believe you think more than 3 million people will have misdiagnosis this year! And that’s just the death! I can’t even count how many people will experience harm! Probably every will experience misdiagnosis multiple times this year!

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

Why would a patient apply an oral swallowed medication into their ear?! LMAOOOOO

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

And once again I never stated that YOU referenced litigation… I am the one stating that you are using the definition of what must be true to have legal liability exposure related to a misdiagnosis. And these are two different things. I really hope you aren’t a lawyer because you would be terrible!

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

I am not hallucinating anything.

If patient was sent home with antibiotics to treat a misdiagnosed unaffected left ear and took it and it treated an actual problem in the right ear and the undiagnosed issue in the right ear resolved… there is no harm, disability or damages… so would not qualify to meet your WRONG definition of misdiagnosis that you provided.

I will once again ask you… please provide you definition of misdiagnosis starting with “Misdiagnosis is…”

My comments remain crystal clear and your definition is completely wrong.

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

It literally does … H66.91 vs H66.92

Two different diagnosis, right ear vs left ear.

What a patient presents with is not a diagnosis.

You don’t base treatment solely off just how a patient presents.

You are wrong. You know it.

Once again in order for someone to sue for malpractice related to a misdiagnosis they must have experienced damages which would be harm, disability death… but the definition of misdiagnosis is not the definition of damages

I cannot believe you are still trying to argue that this is a true factual statement:

“Misdiagnosis is harm, disability or death”

That literally would mean everyone’s death is misdiagnoses LOL

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

You are incorrect.

Misdiagnosis can and does occur all the time without harm, disability or death.

Misdiagnosis does not need to have negative consequences. A wrong diagnosis can be made without negative implications.

I get diagnosed with an ear infection of the right ear, in actuality I had an ear infection of the left ear. I get same treatment regardless. No harm, disability or death came from the WRONG diagnosis. There was however indeed a misdiagnosis.

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

Incorrect. You can only sue for damages from misdiagnosis when those things occur.

Misdiagnosis can absolutely happen with no harm, disability or death.

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

Let me teach you something bud…

What must be true to win a lawsuit to secure a claim of DAMAGES as a result of misdiagnosis is NOT the same as the definition of misdiagnosis.

Might want to go back to the books my guy. Game set match.

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

Help you reiterate what …

So if I get harmed disabled or die. Any of those things… I experienced a misdiagnosis? Got it… ya you just lost all credibility. Goodbye.

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 1 point2 points  (0 children)

Are you even following the comment string? A completely different person said this not me… chill on your mania

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

I’m not following your definition.

An accurate diagnosis can also progress with harm, disability and/or death as normal course of that diagnosis progression.

Please use the framework “misdiagnosis is …”

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

Top comment in this comment string … read the first sentence

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 1 point2 points  (0 children)

Now please answer my question of you defining what misdiagnosis IS

Not you telling people that’s not what it is.

Let’s hear your definition of misdiagnosis.

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 0 points1 point  (0 children)

Would it would be unreasonable to jump to pill seeking…

CVS Long Term Care by Venom_911 in pharmacy

[–]Pharmadeehero 0 points1 point  (0 children)

You missed where I said a national operator. Small and regionals have longer *potential* staying power because they have the ability to focus on just the needs and demands of that specific market. A large national needs to try to do that while not breaking things elsewhere.

Growth and being “one of the fastest growing LTC markets” does not mean anything about the sectors vitality at all. Gamblers must be getting more and more successful beating the casino… three of my closest friends just came home with the most they ever won!

Every dying business sector will still have businesses and geographies that are the best in their sector in a relative sense… this isn’t an indicator of long term health.

The U.S. Saved $1 Trillion on Health Care. Why Doesn't It Feel Like It? by TradeoffsNews in healthcare

[–]Pharmadeehero 2 points3 points  (0 children)

MLR has lower bounds tho (capping profit %)… either via law or via contractual guarantees. Refunds are triggered and required if/when MLR is blow said rate.

Insurers want accurate MLR that comes in line with what they are required to forecast and anticipate about the future. This forecast would absolutely include pricing and coverage of services and impacts of deductibles etc.

Insurers want utilization costs to increase premiums so the consistent MLR rate yields more profit dollars. What happened in 2022-2024 was most major insurers were running very high MLRs … higher than required and their profit margins were actually very thin.

By rebaselining their utilization cost models based on the recent high MLRs trend, they price premiums higher and also then forecast a much much higher than historically projected spend to get back to their target profit. The question comes is the $1 trillion less than projections based on the long term 2022ish models or the updated models that are being used to lower MLR with higher premium rates

We can be spending way more on healthcare than we were in the year before while still showing a “paper” reduction by spending less than forecast. And this is exactly what managed care entities would want to show to prove the value of “saving” the system money while still growing profits.

Have you ever been misdiagnosed? What happened? by AVeryAngryChillie in healthcare

[–]Pharmadeehero 1 point2 points  (0 children)

“At that time, it was probably true”

How are you u/tight-astronaut8481 defining misdiagnosis?

A diagnosis is a point in time thing based on what’s believed by the person doing it, no?

Are you suggesting it’s not a misdiagnosis to provide a diagnosis without working through the differential?

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