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Sam Chanen

Mitchell MCN Earns URAC Re-Accreditation as an Independent Review Organization

Mitchell MCN is proud to announce that it has earned URAC re-accreditation as an Independent Review Organization. URAC is the independent leader in promoting healthcare quality through leadership, accreditation, measurement and innovation.

By achieving this status, Mitchell MCN has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

ABOUT URAC
Founded in 1990, URAC is the independent leader in promoting healthcare quality through leadership, accreditation, measurement and innovation. URAC is a nonprofit organization using evidence-based measures and developing standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

The URAC accreditation process demonstrates a commitment to quality services and serves as a framework to improve business processes through benchmarking organizations against nationally recognized standards.

URAC accreditation requires applicants to submit policies, procedures, and other organizational information that is followed by a review. Once an application is received by URAC, a primary reviewer is assigned and coordinates all aspects of the review until a decision on accreditation has been determined. URAC’s accreditation process enables learning and compliance with nationally recognized healthcare standards and supports improvements and innovation in healthcare management and delivery. URAC also offers educational content, including workshops, webinars, articles, issue briefs, videos, and white papers.

Starting with standards development, representatives from URAC’s volunteer committee convene to establish and revise benchmarks. These volunteers represent the interests of a wide variety of stakeholders that include consumers, purchasers, regulators, providers, and healthcare organizations. Once drafted, URAC standards are circulated for public comment and beta-tested before an accreditation product is launched or updated. This broad, inclusive process assures that URAC’s standards address a diverse set of needs.

Client Portal Enhancements Coming Soon

Mitchell MCN is pleased to announcement that within the coming weeks we will be launching a series of Client Portal enhancements. We’re in the final phase of beta testing now and look forward to soon introducing some new and many enhanced features. We’ve carefully designed and programmed the portal after listening to your feedback and working with multiple staff in different roles to understand the user experience in all areas, keeping the portal user-friendly while adding in details to streamline processes. Rest assured that you will experience:

  • Same easy access — web address/website links
  • Same customer-friendly philosophy
  • Using the portal to order services, check status, upload records, and download reports
  • An updated training guide available next week

Some areas we have focused on are our Cover Letter Creator, with more client-specific questions for each insurance line and specific product; the ability to customize the main information form per client, based on insurance type, jurisdiction, and product combination; and a new service wizard. The main dashboard is being modified to include additional tabs for easier viewing of the status of each case from order to invoice payment.

You are invited to reach out to your Mitchell MCN Account Representative to schedule a demonstration and learn more. An updated training guide will be available upon launch of the new features in the coming days.

MCN Has Been Acquired by Mitchell International

by Brian L. Grant MD, Founder and Medical Director

I am delighted to announce MCN’s acquisition by Mitchell International (www.mitchell.com), a leading provider of expert workflow and adjusting solutions, including cost containment solutions to the Property & Casualty industry. Follow this link to read the press release.

Our organization began in Seattle in 1985. Over the past 33 years, we have evolved both internally, in the development of our professional staff, and externally, in the success of our clients and growing customer base. We have decided to partner with Mitchell because we believe that a larger organization we will allow us to take our performance to the next level in providing a deeper and wider array of services. Our combined teams of talented individuals will work together to create greater value for our customers. As you many of you already know, Mitchell shares many of the same goals as MCN, including our commitment to providing an exceptional customer experience. The culture is very similar between the two organizations as we focus together on finding the best solutions and delivering superior results.

I strongly believe that through this partnership with Mitchell, we will further accelerate our expanding position in the independent medical exam and physician peer review market. It is our vision that by combining MCN’s leading medical review solutions with Mitchell’s data and analytics capabilities, customers will experience an improved user experience and a simplified IME and peer review process.

MCN will become part of Mitchell’s Casualty Solutions Group division. Together with the entire Mitchell team, we will continue to deliver the same great service that our customers have come to expect over the years.

I share this news with you on our blog for general public interest while we also reach out individually to our clients nationwide.

I am confident Mitchell will be an excellent partner for our customers. The MCN staff are enthused  about the opportunities that this partnership presents to our clients, consultants, and to themselves as they join the Mitchell team

If you have any questions, please feel free to contact me or your regular MCN representative.  The press release is below for your reference:

 

MITCHELL INTERNATIONAL ACQUIRES MEDICAL CONSULTANTS NETWORK
Acquisition Expands Medical Management Offerings to Include a Full Range of Independent Medical Exams and Peer Review Services

SAN DIEGO, CA (June 6, 2018) – Mitchell International, a leading provider of technology, connectivity and information solutions to the Property & Casualty (P&C) insurance and Collision Repair industries, announced today that it has acquired Medical Consultants Network (MCN) – one of the nation’s largest providers of independent medical exam services in the United States.

With the close of the transaction, Mitchell will now have the opportunity to integrate its industry leading bill review systems with a leading national independent medical exam (IME) provider, to improve the end-user experience and simplify the IME and peer review process for claims professionals. The combined Mitchell and MCN solutions will leverage extensive claims datasets and analytics to develop innovative decision support and risk scores to aid in the identification of claims in which an IME or peer review may be appropriate.

This strategic acquisition will give Mitchell and its customers access to an extensive national panel and network of providers – nearly 13,000 physicians with over 17,800 provider specialty-jurisdiction combinations to perform IMEs and additional review services for the auto and workers’ compensation industries, adding expertise to support Mitchell’s customer base of employers, insurance companies, state funds, third party administrators and managed care organizations.

“Through this acquisition we will further accelerate and expand upon MCN’s leadership position in the IME and physician peer review markets,” said Nina Smith, Executive Vice President and General Manager for Mitchell Casualty Solutions Group. “Our combined solutions will enable us to help more clients receive better outcomes – featuring high quality medical review solutions and deep insights into clinical issues. We are excited to create compelling technology, medical management, and workflow solutions, becoming the provider of choice to our customers.”

The combined solutions are designed to reduce the claims professional’s administrative burden in transmitting IME and physician peer review referrals, as well as incorporate claim decisions into the bill adjudication process for improved compliance and enforcement. Additionally, Mitchell plans to leverage its clinical expertise to help claims professionals identify what important medical review issues to address in the examination and review process.

With more than 30 years of clinical and independent review experience, MCN helps payors achieve significant and measurable clinical outcomes through its high quality services. With its longstanding history of providing expert review services to a broad range of customers in the workers’ compensation, auto, liability and disability and group health industries, Mitchell is excited to continue MCN’s level of service and provide expanded capabilities to customers.

“This transaction brings a tremendous wealth of expertise to Mitchell, and further strengthens our medical management and clinical expert bench,” continued Smith. “We are always looking for ways to deliver more value to our customers using an end-to-end, integrated suite of casualty solutions.”

“Both Mitchell and MCN are committed to providing our customers with exceptional solutions,” said Brian L. Grant, Medical Director and President of MCN. “Together, we are poised to provide even deeper, and robust capabilities and expertise to maximize outcomes for our clients. I truly believe that Mitchell will further MCN’s goals to offer best-in-class solutions to the market. More importantly, Mitchell, like us, is about people – from their employees to the customers they serve. Mitchell is committed to investing in its employees and we share many of the same values. We are proud to see our staff join Mitchell and continue to grow in an innovative, dynamic culture doing meaningful work.”

The acquisition of MCN is Mitchell’s latest strategic investment in its commitment to creating better outcomes for customers, while building upon its existing industry-leading casualty claims expertise.

Bailey Southwell & Co. served as the exclusive strategic and financial advisor to MCN on the transaction.

For further property casualty and collision repair updates and perspectives, follow Mitchell on Twitter @MitchellClaims and @MitchellRepair.

About Mitchell International
Headquartered in San Diego, California, Mitchell International, Inc. delivers smart technology solutions that simplify and accelerate claims handling, repair processes, and pharmacy transactions, driving more accurate, consistent and cost-effective resolutions. Mitchell integrates deep industry expertise into its workflow solutions, providing unparalleled access to data, advanced analytics, and decision support tools. Mitchell’s comprehensive solution portfolio and robust SaaS infrastructure connect its customers in ways that enable tens of millions of electronic transactions to be processed each month for more than 300 insurance providers, over 65,000 pharmacies and 30,000 collision repair facilities, as well as countless other Property & Casualty industry supply partners across the Americas and Europe. For more information, please visit www.mitchell.com.

About Medical Consultants Network
Medical Consultants Network (“MCN”) was founded in 1985 in Seattle, Washington, and provides medical review services including Independent Medical Examinations and Physician Peer Reviews. MCN created the first national network of independent medical providers and today serves workers’ compensation, disability, auto and group health clients in all fifty states and Canada. MCN is deeply committed to understanding our clients and their needs to provide the highest level of personal service possible so that each of the reports we deliver is fair, accurate and timely. Our clients know that we view each case and the people impacted by that case with the respect and dignity they deserve.

 

Mental Health as it Contributes to Homelessness: One Person’s Story

Homelessness plagues many cities throughout the nation and it’s all too common to see signs stating “anything helps.” Americans wrestle with how they can help the homeless, and often ask the question: Who were you and where were you before you were homeless?

The New York Times tried to answer these questions through one example. In this story they narrate the life of Nakesha Williams, an African American woman who pre-homelessness was known as “a bright light” of potential, personality, creativity, and intelligence, but somewhere along the way mental health disorders took hold and altered her course.

Nakesha’s reputation of being a “bright light” started in high school as she served as class president and a member of the National Honor Society. She had many friends and excelled academically. Nakesha attended Williams College where she studied dance, specifically emphasizing African origins. She was awarded a prize for the “best scholarly work submitted by a Williams undergraduate in the field of African studies.” With so much potential, success, and strong relationships, Nakesha seemed destined for a stable and happy future, but over the decade after college she spiraled downward as her mental disorders piqued and her future changed course.

Over the next few years Nakesha bounced between jobs and living with different friends all ending abruptly and without any explanation. Eventually, Nakesha became homeless. She still kept in touch with many college friends through emails and would express how she didn’t have any food, hadn’t showered in days/weeks, and was sleeping on benches, buses, and parks. Countless friends extended temporary offers of help (clothing, food, and gift cards), which she readily accepted, but when she was asked if she needed counselling, medication or help getting into a shelter or housing, she would deny that she was homeless and say she didn’t need any help. Slowly, she lost contact with her friends, and continued to believe she did not need assistance and was not “homeless.”

This article is an example of mental health being a leading cause of homelessness, and how it can severely alter a person’s ability to live a functional life if not remedied through appropriate care.

Good News for Soda Lovers

Per this article in The Washington Post, a new tax on soda in Great Britain seems to have had quite an impact in the mere two weeks since its introduction.

Soda taxes aren’t a new idea, and at MCNTalk we’ve been writing about them for a few years now (see “Big Soda, Big Problems” and “Americans are Starting to Drink Less Soda,” both from 2015). So what’s new about the British tax and why does it seem to be working? Because it’s not discouraging people from drinking sodas, but rather it’s encouraging soda makers to reduce the sugar content. To accomplish that, the tax rate is based upon the actual sugar content of the soda and so varies from brand to brand.

The tax is already being touted by people such as George Osborne, the former UK Finance Minister, as a model for this type of tax in other countries. However, another explanation for this most recent move by soda companies to reduce the amount of sugar in their drinks is simply to be more popular with customers and remain competitive with the whole range of sparkling water beverages.

Check out the article in The Post to see just how much the sugar levels — and therefore total number of calories and carbohydrates — in a variety of sodas including Coca Cola and San Pellegrino’s popular Limonata have recently been reduced.

Resisting the Industrialization of Medicine

Being a patient reminded one world-renowned physician, Dr. Bernard Lown, of the importance of a book he’d published twenty years earlier, The Lost Art of Healing. In this interesting opinion piece in The New York Times, Dr. Rich Joseph writes of what he learned from treating Dr. Lown — and their later conversations.  Whether we are providing direct medical treatment or non-treating, independent second opinions on the patients we serve, the ideas are important to consider. As Dr. Joseph notes:

This (approach to medicine) begins with our own training. Certainly doctors must understand disease, but medical education is overly skewed toward the biomedical sciences and minutiae about esoteric and rare disease processes. Doctors also need time to engage with the humanities, because they are the gateway to the human experience.

Read more…

Want to Lose Weight? Focus on Quality

healthy eating

For those among us whose New Year’s resolutions include losing weight or maintaining a healthy lifestyle, here’s an article of interest: a recent New York Times piece discusses some findings from a new study detailed in JAMA (the Journal of the American Medical Association).  The study — and the article — suggest a focus on a healthy diet rather than on counting portion size or calories. Specifically, focusing on reducing either fat or carbohydrate intake was shown to be successful. Study participants who ate less sugar, refined grains and highly processed foods while concentrating on eating vegetables and other non-processed foods — without worrying about counting calories or limiting portion sizes — lost significant amounts of weight over the course of a year.

“This is the road map to reducing the obesity epidemic in the United States,” said Dr. Mozaffarian, who was not involved in the new study. “It’s time for U.S. and other national policies to stop focusing on calories and calorie counting.”

MCNTalk has frequently focused on food consumption and health, whether in discussing rising global rates of obesity, rewarding food stamp beneficiaries for selecting fresh produce over processed foods, or the serious adverse impact of sugar on human health. A common theme in these stories, as highlighted by this new JAMA study, is the reduction/elimination of processed foods rather than a focus on calorie consumption to maintain health.

 

Searchable Data on Opioid Prescriptions

MCNTalk and most other news and information sources have discussed the opioid crisis frequently and at great length in recent years. One useful development: a relatively small software company, Appriss Inc., has designed software with the goal of reducing the number of prescriptions written. The software tracks relevant data in state prescription-drug-monitoring programs.

There’s a huge, on-going demand to see this kind of data:  in 2016 alone there were 130 million opioid-related queries to monitoring programs, many made by emergency room physicians assessing patients with pain issues.  A search of the data can let them know whether their patient has had any — possibly multiple — previous opioid prescriptions filled and therefore is at risk for addiction. Given the scope of the crisis – in 2016 there were 20,000 fatal overdoses from opioids nationwide – reducing access and identifying individuals at risk could save lives. For further details on the software and the crisis, including a discussion of concerns over data sharing and potential leaks, read more here. 

Fake News in Medical Journals

“Fake News” is a real topic these days, but should those reading medical journals be concerned with it? Bloomberg has published an interesting, in-depth case study  involving Srinubabu Gedela, Ph.D., whose quest to stock his home town’s library with more research journals for his diabetes studies has grown into an “internet publishing powerhouse” claiming 1,000 open-access journal titles posting 50,000 articles annually.

Per a 2016 lawsuit, the Federal Trade Commission terms his companies a “predatory publisher duping professionals.” The medical journal industry is not a small one: a 2015 study in the journal BMC Medicine estimated revenue generated at $10.5 billion annually for traditional journals from global subscriptions.

Jeffrey Beall, librarian from the University of Colorado, Denver, has ended up at the center of the controversy, having been tracking publishers for the past few years who seem to publish articles with little to no peer review, the traditional cornerstone of the industry. Beall estimates that as many as 25% of the publishers of “scientific” journals could fall into the “predatory” category.  Check out this article in Bloomberg for more details.

 

Investing in America’s Neediest Kids

“The road to college attainment, higher wages and social mobility in the United States starts at birth,” quotes a recent New York Times article titled “Too Small to Fail.” The quote is attributed to James Heckman, a Nobel-winning economist at the University of Chicago, who goes on to say, “The greatest barrier to college education is not high tuitions or the risk of student debt; it’s in the skills children have when they first enter kindergarten.” Renowned for his work on econometrics, Mr. Heckman is now focusing his work on early education for disadvantaged children. By his calculations, he believes that early-education programs for needy kids pay for themselves several times over and could perhaps be the highest-return public investment in the world today. However, this issue does not lie only in education. Help is also needed for families beginning in pregnancy to reduce the risk of children being born with addictions and to improve the potential for more meaningful engagement and conversation in the time after birth and before enrollment in school.

The best metric of child poverty may have to do not with income but with how often a child is spoken and read to.

Investments made in early childhood have a large impact. Recent research in neuroscience shows that early childhood is when the brain is developing most quickly, which is why it is such a critical time. According to the author of this New York Times article, which you can read here, the current presidential campaign would be an ideal time to transcend the debates centered on free tuition and to instead focus on early-childhood programs for needy kids.