Sunday, August 31, 2014

An Innovative, Outside The Box Incentive Program From Industry Leader Walgreens

Deerfield, IL- Corporate executives at Walgreens, the nation's largest pharmacy chain, today announced a new employee bonus program that they promised would "shake up the retail industry, if not the entire business world" at a press conference at its Zug, Switzerland Illinois corporate headquarters.  "We're turning conventional thinking upside down" stated company CEO Greg Wasson. "How? Well hang on to your seats. By rewarding.....failure"

According to Wasson, effective immediately, all Walgreens employees will receive anywhere from 0.75 to 1.2 percent of any financial errors they are responsible for in direct payments from the company. "Now granted, to a cashier whose drawer is off by ten dollars at the end of a shift, a payment of an extra dime may not mean much, and let's face it, a store manager getting an extra ten dollars for a deposit off by $1000 certainly won't be a game changer. That's why I'm announcing the start of this program with two executives who we think will become emblematic of what we're trying to accomplish. Wade, Kermit, step on up here."  

Mr. Wasson was then joined at the podium by Company Chief Financial Officer Wade Miquelon and President of pharmacy, health, and wellness Kermit Crawford*

"Now, these two men were recently responsible for a billion dollar forecasting error when projecting our upcoming Medicare business" Mr. Wasson continued. "And there's no company where a billion dollars isn't a good sized chunk of change, so naturally, we have to let them go. But not before, and I want everyone to know this, we load them up with payments and compensation worth $8.5 million and $12 million, respectively."**

"That's right" Wasson said "Write that down for the whole world to see. Make a billion dollar fuckup at Walgreens and walk away rich!"

Asked how a plan that rewarded failure could possibly further the company's interests, Wasson replied "That's the genius of this whole thing. Like I said, this won't mean a whole lot to the vast majority of our employees. Right now that is. But what it does is let them know that if they work their way up to a position where they are responsible for a whole lot of dollars, well...then the world is their oyster. So what we're gonna have here is 250,000 employees striving every day to reach a position of greater responsibility so they too can have a $10 million screwup payday. And quite honestly, 250,000 store-level employees giving their best is worth far more than one fuckup at the top."

While executive-level business people were almost universally positive in their reaction to the new bonus program, others were more skeptical.

"I don't see how this changes current executive compensation practices at all" said Harvard business professor Camfield Rosenburg. "And to be effective, the expansion of fuckup bonuses to store level employees would have to be coupled with a policy where promotions to positions of great responsibility were based on positive performance. And I didn't see anything in today's announcement to indicate such a change has taken place."

After the press conference, Miquelon and Crawford issued a joint statement that read simply "Moneymoneymoneymoney Brrrraaaahhhhhaaaahhhaaahhhaaaaaaaa!!!!!"

*As much as I would like to say I made this up,  "Kermit Crawford" is the guy's real name. 

** I didn't make  this up either. In case you were too lazy to click on the link, these guys made a billion dollar screwup and were rewarded with millions of dollars in severance money. 

Friday, August 15, 2014

Why The Fucking Flexeril Isn't Covered Anymore.

More than a few of you have come across this situation by now I bet. In the midst of a chaotic, stressful workday you finally snag an easy one. Thirty flexeril. Yay. Two seconds and we'll have this one right out the.....

Then you see the insurance reject. Prior auth required. What. The. Fuck.

We've all come to expect this with the bullshit drugs of course. And the expensive meds  with cheap alternatives. I'm looking at you Lyrica. One of the missions of the insurance companies is to save money after all.

But Flexeril? Are you kidding me? The generic is cheap as dirt. So I repeat, what the fuck? "They must be doing this for no other reason than to get me to crack" you might be thinking. "They've decided they must make each and every prescription a herculean effort to get out the door. There is a war on my sanity. Because there can be no logical reason to slap a prior auth on a seven dollar med."

Oh but there is a reason my poor underinformed retail drone. Logical or not can be a matter for debate, but read on to find out  why that insurance company pain in your ass just got a little bigger.

I'm going to go out on a limb here and say that rejected Flexeril claim was for a Medicare Part D patient. I know this because while you, my poor pillcounter, are still stuck in that outdated world where insurance companies obsess about nothing but money 24/7, I have seen the future, that bright new paradigm where the health care powers that be now obsess about.......money. But in completely new and innovative ways. Where an obsession with the dollar can lead to scrutiny of the most absurdly inexpensive of insurance claims.

It works like this. Someone got the bright idea that Medicare should do more than just sit there and pay claims sent in by the health care professional types. That since he who pays the bills can make the rules, they should use their bill-paying influence to try and influence quality of care. It was decided that Medicare would start to rate its Part D plans like AAA rates roadside motels, with a one to five star system.

So far this sounds OK, right? After all, who could argue with an effort to improve medical outcomes?

Next step involves how to go about being able to show how a large, paper-pushing, figure obsessed bureaucracy is improving things for the oldsters. How do we do that? We can't really just go around saying, " 'Ol Doc Johnson over there at Blue Cross of Lower Damnation does a pretty good job, Five stars for them!!" now can we? We need things to measure, so as we can compare like to like. Outcomes this year versus outcomes last year, Blue Cross versus Humana. In short, we need a way to generate numbers we can use in place of that unreliable human subjectivity.

I'll stop here the throw in the olive in the martini. Those star ratings are worth big bucks to the insurance companies, as Medicare pays bonuses to the highest rated plans.  It's estimated that the difference between a 3 star and 5 star rating is worth about $200 million to the plan getting rated.

That's right, the principle of using metrics to judge performance that has been such an unqualified success in making chain drugstores efficient customer service utopias has now been expanded to the realm of clinical judgement. In this case, Flexeril, the muscle relaxant that been part of the standard treatment plan for all sorts of painful conditions for longer than I have been alive, has been classified by some bureaucrat as a "high risk" medication for the oldsters. And a plan that goes over a 3% threshold of "high risk" meds is ineligible for a 5-star rating, and all the megabucks that goes with it.

So yeah, good luck getting them to approve that claim.

Except chances are, if you have a brain in your head and no desire to torture yourself, you won't even try. You'll notice that even if you moved heaven and earth and got that claim approved, the five dollar copay that would result isn't all that much less than you would normally charge a person with no insurance at all. As a matter of fact,  you could just say hell with the insurance company, charge the person five bucks,  make just a little less on the prescription than you would have anyway, and save yourself a hell of a lot of hassle.

It's a win win. And if grandpa gets a case of brain fog after popping a pill or two and falls down the stairs, it still goes down as a win for the insurance, as they don't have a claim for the "high risk" med on file, and therefore won't get dinged.

Meet the new health care order my friends. Where everyone wins, except the drugstore who made a little less on a prescription than they normally would have. And Medicare, who just paid out a big bonus that had zero impact on quality of care. And grandpa, who just fell down a flight of stairs.

Which means no one really won except the insurance companies.

Which means the new health care order looks a lot like the old health care order.

But at least you know why that pain in your ass is a little bigger now.

You're welcome.

Monday, August 11, 2014

Into The Mailbag We Go.......

Got this one as a comment to this post about the fun times people have working for CVS. Thought it deserved to be out front on its own:

Being a regular pain medication customer of CVS, I find it hilarious that not one single pharmacist will take ownership for their own fuck-ups. After getting rear ended at a stand still by a car traveling 60+ mph last year I was left with 8 bulging discs and an immense amount of pain that I will have to endure the rest of my life. My insurance won't work with Walgreen's so I got stuck with having to deal with CVS. I have a prescription for Tramadol and I don't know how many times I was supposed to have a script ready only to be told by my pharmacist that it can't be filled! You want to talk about a living hell? Try going through a Tramadol withdrawal on top of serious back pain! I am going through it again as we speak. I went back to my prescribing doctor and even pleaded to be put on anything else and he told me that there was nothing else that would help. He adjusted my prescription to where the frequency was 1 to 2 tablets every 4 hours as needed on a 120 count bottle. I have had one refill and one renewal since the adjustment and just had the online app tell me that my script was ready for a refill. I only had a few pills left so this seemed right. I put in the order online and was told it would be ready at 11:00 am. I show up at 1 pm and get told that they can't fill my script because it is too soon! They try to tell me that it was supposed to be a one month supply and I look at the label on my bottle and see "1 dose every 4 hours as needed". I talked to my prescribing doctor and he verified that he did not change the script. So some fuck head pharmacist filled out the script wrong the last time I renewed and I'm left to suffer until I can get this mess sorted out. Having just started a new job, this is the worst time to be going through this and I hope there is a special place in hell for all the fuckers at CVS who have repeatedly fucked me over. I am lodging a formal complaint with the pharmacist board. I have had enough. Meanwhile you fucktards whine about corporate pressure and how horrible it is. Then fucking quit! I can't quit my pain! Stop bitching and take ownership of your actions. Jesus Christ what a bunch of whiny fucking babies you all are . . .

Actually it was the answer I wanted to make sure everyone saw. Here goes:

Dear Whiny Douchebag:

Imagine you just got a letter from your insurance company about your tramadol coverage, and in it it said for you to get any more refills, you had to suck my dick. I bet you'd be all like "No way!! You guys can go to hell!" Right? Or at least something similar.

At least I hope so, 'cause I'm not getting any kind of hot chick vibe from your writing style.

Now, let's say I came to you and said for $15 a month, I'll tap you with a magic wand that will make sure your pain is under control and you will never have to go through tramadol withdrawal ever again. Assuming you're not a liar, (Many, many people with these type of stories are.) I bet you'd say something like "Wow! tramadol withdrawal sucks so bad, and I have this new job now with some dough coming in, and I work better when I'm not in pain, That's a bargain!! Sign me up!"

Well guess what Mr. Whineyfuck, this is your lucky day. because I am about to give you a clue as to how you should have been able to solve your problems all along.

I brought up my first point to show you that there is no law that says you have to do what your insurance company says. You wouldn't (I hope) suck my dick to get your tramadol, and you don't have to go to a pharmacy run by incompetent clowns. I'm not about to defend CVS here. The obsession with short staffing that permeates the chain drug world ensures that many people go through your type of experience.

Notice I said chain drug world, which means I wouldn't count on your Walgreen's being any better.

So what's a hurtin' tramdol dependent dude supposed to do? That's my second point. If you came into my place, I'd have you fixed up in about 5 minutes. Ten tops. And I'd charge you around $15 dollars a month without your insurance. If I happened to be in your fucky company's network, it'd be even less.

I'd also tell you the maximum dose of tramadol is 8 tablets a day, so your doctor kinda fucked you if he really did make out a prescription for 1 to 2 tablets every 4 hours. Do the math.

Which brings us to our conclusion. I'm not sure why I have to tell you this, but you don't have to be your insurance company's little bitch boy. Take some ownership of your own life, get your head out of your ass, and find yourself a real pharmacy. It'll cost you less than a Jackson. And if avoiding a life of pain and withdrawal isn't worth that much to you, then you'll get no sympathy from me.

You're welcome asswipe.