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Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
@mass_marion
May 31, 2021 • 10 tweets • 6 min read • Read on X
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1. Here is something to know about physicians, Mr O'Neill:
Despite your maligning our millennia old profession,
you could show up in the ER with an appy, MVA, or your sick child and we would treat you + loved ones.
No questions asked.
We would keep your information private.
2. I have questions, @dp_oneill
Hope you don't mind being transparent, because your extensive work in the healthcare IT field is affecting billions of Americans. dponeill.com
3. Question 1: Is there a standing seat/s on the @SenateHELP committee for a RWJF? Does it depend on what party is in charge of the senate? @SenSchumer @LeaderMcConnell
The company you, Mr ONeill were SVP of : Change Healthcare: almost $100 million in Equity.
Do you have any stock options?
And did you have the Senate Help Job before or after your tenure at this company?
Change healthcare gobbled up by @fortune500ceo distributor, @McKesson
Why are there so few distributors. All in Fortune 500 top 15. How did they get so big?
@FTC can you shine 🌞?
Next questions: You were VP of @PracticeFusion
Worth $1.5 BILLION
So how did @allscripps get to buy it for $100million?
I'm no businesswoman, but seems like loads-o-loot missing.
Is it magic?
Do you have stock options, @dp_oneill ?
Inquiring minds want to know more about @ElsevierConnect Clinical Solutions, too.
You were their director. I cannot find a list of board members. elsevier.com/about
Laudable goals, but it seems to so many of us that big co like this have 'friends' who fill their positions
Same questions about Boston Consulting.
When time permits, I am eager to read your presentation at the National Academy of Medicine. Truly.
You have a broad swath of experience.
I swore an oath to keep my patients info private.
The oath is millennia old.
We DO need to rethink this!
nam.edu/wp-content/upl…
USA🇺🇸 has tens of thousands of excellent physicians.
We trained and want to care for our patients.
Keep them well,
keep their info private.
We took an oath.
World of business needs to let us do our job, not throw shade on us. @PPA_USA @Free2CareHC
practicingphysician.org/champions-of-e…

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More from @mass_marion

Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
Dec 16
There is nothing free-market about the BIG #PBM
-They are consolidated both horizontally and vertically with the big insurers like United/Aetna/Cigna, and with big box pharmacies.
-Because they collect #kickbacks (legally per our government) they create monopolies or near monopolies of many medications, including insulin, and they make more 💰 when they choose a more expensive med for the formulary. ⬆️cost for 🇺🇸
-Because PBM control $$ flow to pharmacies, they have been shortchanging mom and pop pharmacies, while functionally helping themselves to $ from Medicaid, and putting Indie pharmacies outta business, in a practice called 'the spread'
NOT passing PBM reform is a windfall for BIG insurance, BIG PBM and harm for patients that I and every other physician pharmacist and nurse faces.
@nataliegwinters I ask you to read this thread and learn what I have learned over 8 years in advocating for PBM reform 1/5 🧵Image
2/5🧵From a 2021 piece in #BucksCounty @CourierTimes
I grew up here in bucks and served for 7 years on the editorial board of this paper.
I learned a LOT about the media while writing and on the board , that I'd love to tell you, @nataliegwinters ! Would make a super podcast about modern journalism.
phillyburbs.com/story/opinion/…Image
3/5🧵Here is a pictorial demonstrating that #PBM are responsible for 80% of the increased cost of insulin. The bottom line is the net price, what pharma is making from insulin, the top line, the list price is what pharma makes, PLUS what PBM get in kickbacks and other 'price concessions'.
This happens for MANY drugs. Ask rheumatologists, pulmonologists and others
The root of the problem is kickbacks which should be repealed. Why would we allow any company the right to collect kickbacks?
But it is how we are getting monopolies of medications, why 3 big pharma companies made most of the insulin instead of having competition.
Let the PBM unchecked and they will keep minting 💰 at the expense of Americans. Pic is from this presentation I did for LA health commission In 2022 .
I came in from a shift, pulled a jacket over my scrubs at 11 pm and had at it. hat fun! youtube.com/watch?v=WfVV1p…Image
Read 4 tweets
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
Dec 15
Pull up a seat for another multipart thread, this one is regarding #PBM pharma middlemen
as Congress is poised for PBM reform...

But, PCMA, the PBM lobby group is teaming up with the Competitive Enterprise Instutite and former Senator Toomey to tell us that PBM are 'market based".....in fact....

1/5🧵

We are all busy shopping and visiting and cooking up fab (hopefully healthy) meals, so I will make this shorter than last week's @voxdotcom threadImage
It's tough for me to see PCMA, CEI and Sen Toomey calling PBM 'market based', when they help themselves to medicaid money, through something called the 'spread', collect kickbacks (also non transparent) which creates a monospony ... a series of monopoies among pharmaceutical products, and cause the shutdown of independent pharmacies.
Last time I checked in the Bible of free market capitalism, monopolies, kickbacks and anticompetitive behavior were not Included 2/5 🧵
Here is article in #BucksCounty Courier Times where pic is from phillyburbs.com/story/opinion/…Image
I know about PCMA, the lobby group for PBM, but I did not know about The Competitive Enterprise Institute (CEI), who are also defending PBM as 'free market' so I did some looking. They are a non profit who has lobbied with $2million over the last several years and collects $10 million in revenue each year, from what I could find 100% is from contributors.
Who contributes? 3/5🧵.....
cei.org/wp-content/upl…Image
Read 5 tweets
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
Dec 7
Pull up for a long thread about this @voxdotcom article with the subtitle "What the fight between @AnthemBCBS and anesthesiologists was really about." 1/12 🧵 @anesthesianews vox.com/policy/390031/…
I'm a pediatrician. For 15 years I did hospitalist work. That meant I went to difficult deliveries where mom and baby were sick, I saw sick patients in the ER that needed to be intubated, some had critical airways or hard to get IVs.
In these and many more cases, the patient NEEDED the anesthesiologists... the physicians that slept in the hospital to make sure the patient had an airway or IV access. They are the docs that the surgeons rely on to keep their patients alive while they cut into bodies to save lives. 2/12 🧵
Here is a slide from the study that the vox article referenced that indicates what anesthesiologists find hard about their job.
Besides the long hours and endless glut of regulations, it is 💯 true that despite a fair surprise medical billing law, anesthesiologists and other docs have to fight tooth and nail to get paid for work done because @HHSGov favored the insurers in the implementation of the law . They are fighting the 3rd party payers who were ALREADY paid by the patients.
It's not the docs who are abrogating their duty to patients, it's the 3rd party payers who are, including our government . 3/12🧵Image
Read 12 tweets
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
Nov 8
Years ago, I went to a meeting in Philadelphia. The after lunch lecture was all about quality measures. They were all the CMS people up on stage yapping about what the quality measures were doing. I honestly don’t even know what they were saying. When they were done, they asked for questions.…1/3
@EdGainesIII …. So, CMS experts, I get it, you want to make sure you’re getting value from physicians so you have this MIPS. How much did it cost to plan launch and implement MIPS, and is there any data that it’s saving America 🇺🇸 money 💰?
The CMS experts all looked at each other… 2/4 🧵
And one of the CMS experts said “ma’am, I don’t know how much we spent. It might be on our website and we’re hoping we’ll have some data in a couple of years that shows we’re making savings.”

( incidentally if you meet me in person, please everyone call me ‘Miss’ so I can feel a little bit younger. Haha 3/4 🧵
Read 4 tweets
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
May 28
.@ChrisMurphyCT, we can't help Denise ( and many other patients) with unaffordable meds without #PBM reform. PBM are at the center of drug finances...Pic from Millman
a 🧵 milliman.com/en/insight/pri…

Image
Some of those 'rebates' in the pic above are really kickbacks that were legalized by our government. First for middlemen #GPO ( GPO in first pic on this thread) and then later for PBM
Great read here in @econliberties
Pic shows short letter to @WSJ 2 🧵economicliberties.us/press-release/…Image
There is almost no transparency on where the #PBM kickbacks that they call 'rebates' are going. @CVSHealth revealed at @SenateHELP hearing last year that the kickbacks are going to a GPO that PBM created. One of these GPO is in Switzerland. 🧵 3
Pic from this @realclearpolicy article realclearhealth.com/articles/2023/…Image
Read 6 tweets
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
May 10, 2023
a 🧵 In prep 4 today's 1pm @SenateHELP hearing on making #insulin affordable.
On graph: list price is roughly = net price (what pharma collects) + "rebates"/fees collected by Pharmacy Benefit Managers (#PBM) .

According 2 a 2021 @SenFinance "rebates" alone accounted for… twitter.com/i/web/status/1… Image
@SenateHELP @SenFinance @BernieSanders @SenBillCassidy @BoesingLoretta @NSmithholt12 @Free2CareHC @MsPattiPatti @nickjonas @tomhanks @VWOfficial @alldiabetesnews 2. With #PBM making most of the $ In the Insulin market (and for other meds) it's wild that there is little #transparency for PBM.
All of the red ovals show places where we cant see the $
Pic from our @Free2CareHC report: free2care.org/files/report.p… Image
3. If @SenateDems and @SenateGOP and @USCongress and @POTUS want to remedy the cost of Insulin and other drugs, hopefully they won't make the same mistake they did with the Inflation reduction act, "USA will NEVER solve the drug pricing problem without PBM reform – and instead… twitter.com/i/web/status/1…
Read 5 tweets

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