Health care costs and financial risk management

Once again MedAssets has claimed the KLAS #1 spot ( they acquired the company that held the spot.)

MedAssets likes to claim that they have "Cutting-Edge" solutions - by which they mean that you can use some of their modules in a web browser.

But what they cannot tell you is that any of the algorithms being used have a single patent or are the result of the work of a single PhD in Computer Science or related field.  Nor can they point to a single peer-reviewed publication of a scientific nature.

This lies at the core of the high cost of health care: the medical field is the most backward in computing, more backward than insurance companies or university administration or the global audit firms.

There is a parallel in the 2008 financial crisis: the utter inadequacy of the risk managment software for both auditors, insurers and bankers - and that is a story which is not going to be told.  Part of it can be investigated by looking at the lack of patents held by the the "leading" software vendor in that area, the lack of PhD's in their employ, and their practices of stifling competition through what I have termed "predatory partnerships".

Both fields have top software vendors acquired by large companies - but those "innovators" in software were accountants in both cases - and with an appalling lack of engineering staff.

Fundamentally, accountants do not understand computing as an applied science or as a branch of electrical engineering.  They just don't get it.  Important revolutions in computing were totally ignored by both niche leaders.  Software is sold by "financial" folk to other "financial" folk.

Just try to imagine that the airlines were operating using aircraft developed without regard for wind tunnel results, air foil science and without those "leading vendors" hiring PhD's.  Warfare prevented this: the early passenger aircraft are linked closely to air warfare and military engineering.  That is not the case with software for either healthcare or financials with almost the sole exception of derivatives. Just check the hiring - read the open position descriptions as they appear advertised on the web.

The lessons learned in software at NASA have not been passed on to either the audit firms, the banks, the insurance companies or the healthcare providers.

In what is perhaps the most egregious folly, both major hospital systems and major health insurers use the self-same software.  Oh - but it can now be used from a web browser, so it is "cutting edge".  It is the patient's wallet that is slit open by the "bleeding edge".

To get just one clue, look at the Minnesota fiasco.  Then look at the Leymann Brothers audit firm (could we let another global audit firm fail?)  Ask one question: were they using the same audit software vendor as the failed Enron auditor?  Ahem.

MN Google search:
http://www.google.com/search?q=%22HealthMatch%22+SSi+Albion+ACS+Minnesota