Archive for December, 2009

A (Moderate) Toast to the New Year

Thursday, December 31st, 2009

We conclude this bi-polar year with a risk-related story that is both a phenomenal high and a pathetic low. In what appears to be a record-breaking performance – at least for South Dakota – police found Marguerite Engel passed out behind the wheel of a stolen delivery truck. The article does not specify the contents of the vehicle, but if Engel had her Christmas wish, it was full of alcoholic beverages. Her breathalizer test revealed a blood-alcohol level of an astounding .708. That’s some serious drinking: a level of .40 is fatal for about half the adult population.
You might think that Engel’s dubious achievement qualifies for the Guinness Book of World Records. Not even close. According to Wickipedia, the record belongs to an unnamed Pole: in March 2009, a 45-year-old man was admitted to the hospital in Skierniewice, Poland after being struck by a car. The blood test shows blood alcohol content at 1.23%. The man survived. He did not remember either the accident or people he drank with. With that much alcohol in his system, it’s a wonder that his brain can retain anything.
As we say farewell to the decade that gave us x-rays of shoes, Octomom and the I-Phone, we ring in the new year with a toast: “May the gifts of moderation be yours in abundance. Salud!”

Risk Management and the Vectors of Life

Tuesday, December 29th, 2009

Umar Farouk Abdulmutallab was depressed and lonely, so he decided to blow up an airplane. He boarded a Northwest flight from Amsterdam to Detroit on Christmas day with explosives strapped to his underwear. (The Freudians will have a field day with that one.) As the plane prepared for landing, Umar, in seat 19A, began to detonate his deadly concoction.
One row back and several seats over, Jasper Schuringa sat in seat 20J. As soon as flames and smoke began to rise in front of him, Jasper lunged across the row and seized Umar around the neck. He disarmed the would-be terrorist and prevented the ignition of the explosives. He suffered some burns, but none as severe as Umar’s.
We will probably never know the pathetic thought process that led the spoiled and privileged Umar to seek an end not only to his own life, but those of 280 innocent people. But we can certainly acknowledge the instinctual courage that motivated Schuringa. Like U.S. Airways pilot Chesley Sullenberger, Schuringa demonstrated grace under pressure. In the weeks ahead, most of the attention will be on the Umars of the world: how to find them, how to prevent them from carrying out their wretched pseudo-political vendettas against life itself. It would be reassuring to think that our risk management tools might help us identify these folks before they can act, but I doubt it. Umar has succeeded in adding underwear to the long list of items to be scrutinized before boarding a plane. What’s next: explosives hidden in dental crowns?
Seen from a perspective of time, our lives are vectors: as we move in the world, our paths intersect randomly with others. There are mostly gifts in these encounters – but there are also dangers. We all try to manage risk – personal and professional – but there are risks that fall well beyond our control. It takes a lot of luck just to survive. As we welcome the New Year, let’s take a moment to appreciate all the good fortune that brought us to this moment. And let’s give thanks to the latent heroes among us – the Schuringas and the Sullenbergers – who are ready in a flash to do what needs to be done.

The risks of being Santa

Wednesday, December 23rd, 2009

In one final post before we check out for the holidays, we’d like to offer an update on Santa. Our friends at the Renaissance Group have looked at the various types of insurance it takes to cover Santa’s operations in their post Protecting the big guy. We thought we’d expand on this theme by highlighting some of the risks that Santa has faced this year as noted in recent headlines:

  • Swine flu outbreak has Santa taking extra precautions. Here’s a tip for your investment portfolio: buy stock in companies that produce hand sanitizers.
  • Someone is impersonating Santa to rob banks. At least, we think that’s not the real Santa. Times are tough, but we don’t think Santa has had to resort to theft to finance his operations yet.
  • Santas debate whether it’s naughty for them to be obese: “This battle of the bulge has been raging quietly within the Santa community, which is made up of an estimated 4,000 professional Santas who congregate at annual conventions, chat year-round on Claus-centric online message boards, spend thousands on customized outfits and perform everywhere from shopping malls and military bases to homes and hospices. In some Santa circles — typically, the ones with the largest circumferences — the idea that Santa Claus should consider swapping sugar cookies for carrot sticks has been about as popular as vegan eggnog.”
  • Santa’s “naughty-nice” database may have been hacked. This could cause untold mayhem. Perhaps the hackers are the same folks that messed up Congressional databases allowing the naughty to get financial bailouts while the nice folk are left high and dry?
  • Claus in Crisis. If it’s not one thing, it’s another. There are rumors that some of his reindeer may be on steroids. Plus, Santa has OSHA examining him on one front and the anti-immigration people questioning the status of his workers on the other.

Bossman Santa
We know the job of being Santa is a tough one, but he still has obligations as an employer. We’ve been trying to keep an eye on Santa’s record as an employer over the years – we don’t want his workers to be forgotten up there in the North Pole. After all, they work long hours under arduous conditions. Via David Letterman, we’ve learned about the Top 10 Elf Complaints:
10. Bells on clothing target for jeers at truck stop
9. Need two pieces of I.D. to buy beer
8. Santa’s union-busting goons killed a guy last spring
7. Black elves control weight room
6. R&R weekends in Aleutians spoiled by trigger-happy shore patrol
5. Incredible markup at North Pole 7-Eleven
4. Workmen’s compensation doesn’t cover “Mistletoe lung”
3. The Colonel practically runs my life (Sorry, that’s an Elvis complaint)
2. Dead elves just tossed out on tundra
1. Santa only invites his favorites to join him in the Jacuzzi
In a recent interview, Santa dispels most of these charges. He says that he pays the elves a living wage and “We give full benefits, pension, 401(k), and free shoe lifts for life. Plus, the uniform is free.” He offers an alternate viewpoint – apparently the elves aren’t always fine, upstanding employees. After firing some leves for lying on their application, all hell broke loose. Santa says they “…Got drunk on eggnog and ginger ale and had chicken fights all over the workshop. Nothing worse than an angry, drunk elf.”

“No, Edith, There is No Sanity Clause”

Tuesday, December 22nd, 2009

You probably never heard of Gilby, North Dakota, population 226. Edith Johnson, 56, worked as a teller in the town’s bank, which, somewhat surprisingly, has been robbed three times. Edith was in the bank during two of the robberies. The last one was especially traumatic: she was handcuffed and placed face down on the floor with a sawed off shotgun pressed against her head. After this incident, she became too afraid to return to her job. Diagnosed with post-traumatic stress syndrome, she filed for workers comp. The claim was denied. North Dakota, like many other states, will pay a “mental” claim only if it is precipitated by a physical injury.
Edith has an attorney and is appealing the denial of her claim. Given the way the law is written, she is unlikely to prevail.
The irony, of course, is that with just a bit of coaching at the time of the incident, it would have been easy for Edith to collect comp. All she would have had to do is complain about a pain in her wrist and shoulder, caused by the handcuffs and the awkward position on the floor. Even without objective medical evidence, these physical complaints would have opened the door to her claim of post-traumatic stress.
Coming from a small town and working as a bank teller, Edith is undoubtedly the soul of rectitude. She is not about to tell a lie. Unfortunately, she is up against the letter of the law, which, in North Dakota, is very clear. Workers Safety and Insurance director Bryan Klipfel explains the denial: “A post-traumatic stress disorder that is directly related to a physical workplace injury may be compensable if it can be shown that it was primarily caused by the physical work injury, as opposed to all other contributing causes.”
Letter and Spirit
Edith’s dilemma reminds me of the scene in the immortal Marx Brothers movie, “A Night at the Opera.” Groucho (Otis. B. Driftwood) and Chico (Fiorello) are discussing the proposed language of a contract. Every time Chico objects, Groucho tears the page from the contract.
Fiorello: Hey, wait, wait. What does this say here, this thing here?
Driftwood: Oh, that? Oh, that’s the usual clause that’s in every contract. That just says, uh, it says, uh, if any of the parties participating in this contract are shown not to be in their right mind, the entire agreement is automatically nullified.
Fiorello: Well, I don’t know…
Driftwood: It’s all right. That’s, that’s in every contract. That’s, that’s what they call a sanity clause.
Fiorello: Ha-ha-ha-ha-ha! You can’t fool me. There ain’t no Sanity Clause!

With that impeccable logic, the Insider wishes the beleagured Edith and the citizens of Gilby all the best and we bid our readers a splendid holiday. Every week we try to invoke the “sanity clause” in risk management and workers comp. It’s not always easy. We sincerely hope that Santa – whether or not he exists – rewards you for all the good that you have done this year.

Bath Iron Works: “All I want for Christmas is a Fee Schedule”

Monday, December 21st, 2009

It’s hard to think of anyone bullying Bath Iron Works, the General Dynamics subsidiary that builds destroyers for the U.S. Navy. But they are being kicked around like the proverbial 90 pound weakling by the workers comp system in Maine. Two years ago we blogged the inability of Mainers to come up with a viable fee schedule for workers comp medical costs. The legislation authorizing the fee schedule became law in 1992. Now we approach 2010 – nearly 20 years! – and there’s still no fee schedule.
Workers comp insurers are free to negotiate rates for medical services. In effect, they develop their own de facto fee schedules. Bath Iron Works (BIW) is self-insured for comp. They do not have the leverage to negotiate fees. So when a local hospital sent a bill for $107,000 for treatment of two injured workers, BIW filed a lawsuit. They lost: they had to pay the hospital’s “usual and customary” fees – an ironic appelation if there ever was one. The only suckers stuck with paying the full boat (so to speak) are self-insureds and uninsureds.
So how is the fee schedule coming along? And why the inordinate delays?
The rule-making group charged with developing the fee schedule is trying to come up with something acceptable to the medical providers. That’s like asking an employee how much of a pay reduction they would like. How about nothing? In the current draft, total billings of $80 million would fall by about $1 million. In other words, a drop of less than 1 percent. That’s a fee schedule only a medical provider could love!
The Massachusetts Model
Maine officials are worried that low fees would drive doctors away. Paul Dionne, executive director of the Maine Workers’ Compensation Board, says he heard from a group of orthopedic doctors who said if the board made the new base fee too low, “they weren’t going to treat injured workers. They’re private, they can do that.”
That’s not what happens in Massachusetts, which has the lowest fee schedule in the nation. Everyone recognizes that the fee is too low. So insurance carriers and TPAs routinely negotiate a reasonable fee with doctors on an individual basis. For example, the scheduled fee for hand surgery is only $725. The “usual and customary” fee of a skilled surgeon might be $5,000. The insurer and doctor would settle somewhere in the middle, perhaps $3,000 for the service. It sounds frictional and inefficient and to some degree it is, but overall, medical costs remain unusually low in Massachusetts, doctors continue to provide services and injured employees are satisfied with the results. The system is working despite what appear to be severely deflated medical rates.
One unusual and perhaps unintended benefit of the low fee schedule is the leverage it provides against medical providers who refuse to treat with a return-to-work focus. If “Dr. Feelgood” insists on keeping a marginally injured employee out of work, the adjuster can dig in and offer to pay only the deflated fee schedule rates. That will get the doctor’s attention immediately.
Maine used to be part of Massachusetts. If they want to solve this particular problem, they might consider re-joining the Commonwealth, or at least copying Massachusett’s highly successful comp model. Step one involves some tough negotiations – with or without the doctors in the room. Thus far, by trying to please everyone, Maine is punishing some of their most valued employers. Nearly twenty years into a failed process, it’s time to face reality: a fee schedule is a cut in pay. If the doctors are happy, it’s not an effective fee schedule.
Meanwhile, it looks like a bleak Christmas for the mighty folks at Bath Iron Works. There are undoubtedly a lot of nice goodies under their tree, but a fee schedule is not among them.

(Cannon) Fodder for a Friday: The Fate of Foreign Interpreters in Iraq

Friday, December 18th, 2009

How would you like a job that pays $12,000 a year, where 1 percent of the workforce is killed annually and hundreds of others are seriously maimed? I didn’t think so. You would probably take a pass on working for Titan Corporation (now part of L-3) as an interpreter for the U.S. armed forces in Iraq. The L-3 website promises that “as a member of the L-3 Communications team, you will be exposed to the most exciting career adventures situated on the cutting edge of technology.” Alas, it’s not just the technology that is cutting edge. The roadside bombs cut pretty deeply, too.
We read in the Los Angeles Times about the sad fate of translators in Iraq. There are about 8,000 in all. Over the five year period from 2003 to 2008, 360 were killed. Those who were lucky enough to survive were often shipped to Jordan for treatment. The workers comp benefits fell under the Defense Base Act and were administered by AIG, among others. (See our previous blog here.) According to some of the wounded, they were offered a stark choice: accept a proposed settlement (which absolved the insurer of any future costs) or be shipped back to Iraq, where retaliation and death awaited former employees of the U.S.
The Times article describes the life of Malek Hadi, an Iraqi national who lost a leg and several fingers in a roadside bombing. He now struggles to survive in Arlington, Texas. At first, he was unable to collect any benefits:

Internal AIG documents indicate that a claims examiner withheld Hadi’s benefits in an effort to force him to accept the lump sum. Hadi was “clearly entitled” to benefits, a different AIG examiner wrote in a memo dated August 2008. The company had not paid because the previous examiner “was trying to get the claimant to decide whether to settle his claim,” the memo said.

Malik now receives the maximum monthly disability benefit – a whopping $612 per month. He has been diagnosed with post-traumatic stress syndrome, but AIG has refused to cover any treatments. Perhaps they are waiting for a second opinion from the company shrink? Meanwhile, Malik will just have to deal with it!
Former insiders at AIG describe how the game is played:

“If you’re missing one piece of documentation, you got denied,” said Colleen Driscoll, who oversaw the handling of interpreters’ insurance claims for L-3. “These guys get murdered coming and going to work, and AIG turns them down because they don’t have a letter from the insurgents.”

Driscoll, a former United Nations refugee official, left L-3 in 2007. She said the cause was a dispute with company executives over treatment of injured interpreters.

She and another former L-3 official, Jennifer Armstrong, said their experience suggested that 10% to 20% of the company’s Iraqi workers who should have received benefits were denied.

AIG stock is currently trading at the equivalent of about $1.40 a share. It would be nice to think that this was the market’s judgment on the way things are being handled in Iraq, but that, of course, has nothing to do with it. The market, not exactly known for its humanitarian concerns, is punishing AIG for financial – not ethical – sins. Indeed, the market might well approve of the way the injured, the maimed and the dead are being squeezed in this mockery of a benefits program. After all, indemnity and medical expenditures are being kept as low as possible and that can only help support AIG’s battered bottom line.

Cavalcade of Risk #94 and general workers comp news notes

Thursday, December 17th, 2009

Cavalcade of Risk #94 is posted at My Wealth Builder. Among the many good posts, our friend Hank Stern offers some good news for the holiday season.
Our fellow blogger Joe Paduda was recently speaking at the Casualty Actuarial Society’s annual meeting on the topic of health reform and its impact on workers comp, and his remarks were covered by Insurance Journal. Paduda noted that, whether or not it gets enacted, health care reform is already having a major impact on workers’ comp. On the same topic, Roberto Ceniceros has a post about how healthcare reform is stalling some return-to-work advancements.
Jon Gelman on Genetics and Workers’ Compensation Claims. Also see our past posts on the topic: Brave new World and Genetic Testing And Workers Comp
Risk & Insurance has posted some interesting case law: In Michigan, a worker establishes asthma as compensable disability and in Colorado, a claim for a bad faith denial of benefits is considered to be separate and distinct from the underlying workers’ compensation entitlement claim and therefore is not precluded. However, an insurer can preclude certain issues in a subsequent proceeding.
We recently touted Mark Wall’s WC forum on LinkedIn as an excellent resource – but one feature that we neglected to mention is an active job board, where members can post a job or find a job. That’s a natural use for LinkedIn, particularly in today’s tough times – register for the Forum.
Winter safety tips from BLR Daily Advisor: Cold Weather Hazards: Are Your Workers at Risk? and Brrr-ing Down the Risk of Cold-Related Injuries
Finally, this item made us wonder if the North Pole’s workers’ comp coverage includes stress?

MA Supremes: teacher chaperoning ski trip due workers comp

Tuesday, December 15th, 2009

In a recent decision that shouldn’t be too surprising to those who follow workers’ comp compensability issues, the Massachusetts Supreme Court recently upheld a decision by the Department of Industrial Accidents to grant workers compensation benefits to Karen Sikorksi, a Peabody teacher injured while chaperoning high school kids on a 2004 ski trip. The City of Peabody had contested the award on the basis that she was a volunteer engaged in a recreational activity.
We’ve seen many of these cases and the decision often hinges on the voluntary nature of the activity. In this case, the city of Peabody probably thought they were well within the law in denying benefits. According to Insurance Journal, the Massachusetts legislature added a little twist to the workers’ comp statue in 1985, when it excluded “… any injury resulting from an employee’s purely voluntary participation in any recreational activity, including but not limited to athletic events, parties, and picnics, even though the employer pays some or all of the cost thereof.”
Note the adjective “purely.”
When is a volunteer really not a volunteer? Usually, when an employer encourages the employees to participate in said activity. (Everybody who has ever been an employee is likely familiar with the concept of so-called voluntary recreational activities – non-participation can be a career-limiting option.) According to reports, the Peabody school administration has historically expected teachers to become involved with the school’s extracurricular activities and, in this particular case, the school principal and the ski club adviser solicited teachers to serve as chaperones. In Sikorski’s case, the Supreme Court justices unanimously found that she was “acting in the course of her employment” and not in a recreational activity as described in the law. The court found that her responsibilities as chaperone were “…essentially the same ones teachers must exercise while working in the school building during school hours.” Chaperones were expected to supervise students both in the lodge and on the slopes.
Another common criteria that courts use is in determining whether an activity is “voluntary” is how beneficial it is to the employer and whether it furthers the employer’s interests. In this case, the court found that it did: “…the ski club’s trips benefited the city by furthering the school’s educational mission.”
Of course, nothing is ever simple with workers’ comp – there are 50 different flavors, so every state law may have its own particular nooks and crannies related to these issues. Andrew G. Simpson has an excellent article on ‘Forced Fun’ and related workers’ compensation problems, in which he discusses variations in state laws.
Other posts related to the issue of “mandatory fun”:

Joint and Several Bust

Monday, December 14th, 2009

Back in June we blogged the failure of several self-insurance groups (SIGs) in New York, all run by Compensation Risk Managers (CRM). There was bad news all around: participants in CRM SIGs were suddenly without coverage; and participants in other (non-CRM) SIGs were hit with a huge surcharge to make up the deficits created by CRM’s deficient management. Now the proverbial “other shoe” (presumably a Gucci) has dropped, directly on the heads of CRM managers: the company has been indicted by Attorney General Andrew Cuomo for fraud and sued by the state comp board. CRM is having what appears to be a well deserved, terrible, horrible, no good, very bad week.
In their own defense, CRM asserts that problems are industry wide:

According to the WCB’s website, of the 65 self insurance workers compensation trusts authorized by the WCB and subject to its oversight and regulation, as of November 2009, 32 were either insolvent, being terminated or were underfunded, 13 had been voluntarily terminated and only 20 were operating with no fiscal issues and no regulatory restriction. Compensation Risk Managers managed 8 of these 65 trusts. The Company believes that an industry-wide problem exists and that the WCB has unfairly singled the Company out. The Company intends to defend the WCB litigation vigorously and prove that the WCB’s unsubstantiated allegations are utterly without merit.

In other words: don’t hold us accountable for something everyone is doing.
Well, maybe other SIGs are in bad shape, but CRM is under fire for operating the insurance equivalent of a Ponzi scheme: the indictment charges that they deliberately under-reserved claims, leading to under-stated losses. The resulting “healthy” loss ratios became the basis for under-pricing the rest of the market, which led to increased membership in their self-insurance groups. The new premiums helped CRM keep up with increasing payments. It all came crashing down when insufficient reserves ran out and payments exceeded available cash. Heck, the experts at Madoff Consulting guaranteed that it would work… right up until the moment it didn’t.
Joint and Several Liability
Most people buy insurance with stand-alone policies. Each company is the master of its own fate. If the company performs well, they benefit from lower premiums. If losses are high, the experience rating process leads to higher premiums. As long as the carrier remains solvent (not a given these days), there are no big problems.
Self-insurance groups are different. They involve a much higher level of trust (and risk): not only are you accountable for your own losses; you are on the hook for the losses of other group members. A SIG is only as strong as its weakest member. Indeed, SIG participants in New York discovered that they were on the hook for losses in other SIGs, through a painful surcharge imposed by the comp board.
This brings to mind the response of the immortal Groucho Marx to an invitation to join an exclusive club: “I don’t want to belong to any club that will accept me as a member.” That’s just the kind of thinking that might have helped the unfortunate companies who find themselves swinging in the wind at the end of CRM’s tattered rope.

Health Wonk Review: the sausage-making-is-a-messy-business pre-holiday edition

Thursday, December 10th, 2009

We’re honored to be hosting the holiday edition of Health Wonk Review. As we approach the holiday season waiting for a verdict on health care reform, we can take a lesson from Santa Claus, whose ordeal on this publicity shoot reminds us that good things don’t always come easily:

Our wonderful wonkers don’t let the holiday season slow them down. This edition offers a wide array of excellent posts on health care reform, health care quality, and health care 2.0 developments.
Sausage Making
Joe Paduda of Managed Care Matters kicks things off with a simple but powerful observation: If private health care insurance worked, we wouldn’t need reform.
Over at the Health Affairs Blog, Tim Jost, the Robert L. Willett Family Professorship of Law at the Washington and Lee University School of Law, composed a series of four detailed posts analyzing the Senate health reform bill. He avoids the politics, but examines all the bill’s nooks and crannies, including an overview of reforms and new programs, as well as issues ranging from mandates and constitutionality to abortion and Medicare.
Richard Elmore of HealthcareTechnologyNews summarizes a recent health care reform analysis by MIT Professor Jonathan Gruber which counters health insurance industry claims that premiums will increase and other fear, uncertainty & doubt (FUD) talking points put forth about health care reform.
Roy Poses of Health Care Renewal sees parallels between the current health care dysfunction and the global financial meltdown, but most of these parallels have gone unnoticed. Left unaddressed, he sees the potential for a burst bubble with lives and personal fortunes on the line. Don’t say you weren’t warned.
To put health care in some global perspective, here at Workers Comp Insider, Tom Lynch takes a world tour of the state of care in various countries in his post, the geography of health: US vs. them.
At Colorado Health Insurance Insider, Louise posts about the Chamber of Commerce’s campaign to discredit proposed health care reform, but in examining their arguments further, found the Chamber offered little in the way of positive ideas or creative solutions to lower costs and expand health coverage to all Americans.
At the Robert Wood Johnson Foundation’s Health Reform Galaxy Blog, Steven Findlay tells us why he thinks health reform would be a holiday gift for every consumer and Minna Jung looks at the messy doings in Congress now, reminding us that even though that first step is a doozy, it’s still only the first step.
At a new blog called Healthy Debate Georgia, which focuses on on health care reform at both the state and national level, Mike King explains why Georgia may just say no and Timothy Sweeney posts about why national Medicaid expansion may be a bargain for Georgia.
Over at InsureBlog, Hank Stern says that Joe W was right, noting that the latest version of Obama’s health care plan will include coverage for illegals after all and he discusses why this is important.
In another Joe-related post on the other side of the political aisle, Madeleine Kane has composed a No-Man Joe limerick at her Mad Kane’s blog.
Quality & Safety
Jaan Sidorov of Disease Management Care Blog detours from legislative sausage-making to summarizing an interesting Canadian study called “EFFECT,” which demonstrated that public reporting of hospitals’ quality metrics can save lives. In light of this, he wonders if Medicare’s much ballyhooed “Hospital Compare” web site is – in retrospect – evidence-based.
At New Health Dialogue, Tom Emswiler presents a case history of a group of Premier Hospitals that made significant progress in saving lives and saving money after participating in a year-long Quality, Efficiency, Safety, and Transparency (QUEST) initiative. He asks if seven percent can save lives and money, why can’t the other 93% follow suit?
To commemorate the 10-year anniversary of the Institute Of Medicine’s seminal report on patient safety, To Err Is Human, see Terri Schmitt’s post, Nurses: The Crucial Link for Patient Safety from the Interdisciplinary Nursing Quality Research Initiative (INQRI) Blog. See the entire series of posts on the To Err is Human anniversary
Technology & Innovation
At The Health Care Blog, Brian Klepper and David Kibbe team up to offer an excellent review of the surprises and changes in the Electronic Health Record technology market during 2009.
HIV testing at your next dental visit? David Williams features a podcast and transcript of an interview with Dr. Catrise Austin of VIP Smiles at Health Business Blog.
David Kibbe talks about the critical importance of establishing and adopting a a core set of relevant and portable personal health records at The Health Care Blog.
At EHR Bloggers, Glenn Laffel pens an open letter to David Blumenthal asking if he is going fast enough. He lauds the work of the National Coordinator for Health Information Technology, while gently chiding him that he needs to pick up the pace on EHR deployment to providers.
Peggy Salvatore of Healthcare Talent Transformation posts about another letter to Blumenthal, this one penned by Medical Group Management Association President William F. Jessee, urging Blumenthal to get real, real fast.
Meanwhile, at Health IT Buzz, David Blumenthal weighs in to offer a progress report on technology initiatives.