Tuesday, March 21, 2017

Broken world: applying for a minimum wage job via a corporate HR web site

My #1 son is a special needs adult. He’s excited to start at $10/hour job running food around a sports stadium. It’s work he can do — he’s got a great sense of direction and he is reasonably fit.

The job engagement process is run by an archaic corporate web site that looks like it was built for IE 3. The site claims to support Safari but warns against Chrome. It is not useable on a smartphone.

The HR process requires managing user credentials, navigating a complex 1990s style user interface, and working around errors made by the HR staff — who probably also struggle with the software. He would not have the proverbial snowball’s chance without my ability to assume his digital identity.

Sure, #1 is below the 5th percentile on standard cognition tests — but this would have been a challenge to the 15th percentile back in the 90s. In the modern era, where most non-college young people are primarily familiar with smartphones, this is a challenge to the 30th percentile.

Which means the people might want to do this job are being shut out by the HR software created to support the job. Which probably has something to do with this.

The world is broken.


Saturday, March 18, 2017

All our family healthcare visits are now billed as CPT E&M Code "Level Four"

Very few people will understand what that subject line means.

The short version is that the way we account for physician services was born broken in 1994 and it is now in a state of advanced collapse.

It can’t go on and it can’t stop.

Don Berwick, the best CMS administrator we’ve ever had (forced out by GOP) said this five years ago:

.. Dr. Donald Berwick, the immediate past administrator of the Centers for Medicare and Medicaid Services (CMS), which administers the Medicare program, said a small portion of the billing increase is likely caused by outright fraud, but in the majority of cases hospitals are legally boosting profits by targeting the vulnerabilities of Medicare’s payment system. “They are learning how to play the game,” Berwick said about the hospitals....

... Berwick, the former CMS head, said patients haven’t changed. What’s changed is the aggressiveness of how hospitals bill. “They are smart,” Berwick said. “If you create a payment system in which there is a premium for increasing the number of things you do or the recording of what you do, well, that’s what you’ll get.”...

See also