Cerner Speech | Administrative costs called exorbitant: health ...

Neal's quote regarding "...eliminating insurance companies..." parallels the fact that Cerner has created its own TPA, Third Party Administrator to handle its' Associates (employees') health care claims eliminating its' relationship with all of the previous TPAs (Lumenos, etc.) it has done business with in the past. As Cerner is self insured and has created their own TPA, their power to investigate their Associates Medical Records has zero limits. A Cerner Associate, Dr. Andrew Svetly was appointed Medical Director of this Cerner created TPA, The HealtheExchange. The email of The HealtheExchange lives on and operates on Cerner's own servers with Cerner Associates email. The address to HealtheExchange is actually a Cerner address. When you phone Cerner to speak to the Healthe Exchange personnel, they transfer you immediately. Could they do this if the TPA was TRULY a separate organization on a separate phone system? In creating their own TPA and having Cerner associates review precertification needs, monitor and handle claims, review medical records, Associates are not happy with this violation of privacy. Imagine knowing the Medical Director of The Healthe Exchange has reviewed your medical records, turned you down for medically necessary surgery, then having to work with this Dr.(whose position is also as an Executive Physician for Cerner) on a project at a client site setting up their system. You are supposed to convince your hospital client that Cerner truly does encourage favorable health and improved health outcomes, yet you know Cerner's Associates are complaining about Cerner's lack of coverages. Is this right? Cerner associates claims have had to be refiled with Cerner's created TPA similar to a regular insurance company begging to get reimbursement. Associates have complained about their coverage, which is actually a lack of coverage of standard health care benefits which other organizations offer and pay for promptly. Associates who have chosen the most expensive, highest level of Cerner coverage possible have complained about the lack of standard coverage benefits.

I'm shocked an organization which publishes to their clients that they too are a healthcare organization, has created their own TPA, making it easy for them to review their Associates Medical records. This information could easily be used against an employee in numerous ways, such as regarding raises and promotions. Julie Wilson's quote in the KC Star article also could cause one to wonder if Cerner really is interested in the health care of its own Associates or solely focused on their own pocketbook although someone may be harmed. The fact that Associates are complaining about Cerner's coverage, or lack of health coverage, makes one wonder if this organization is truly interested in saving lives and improving health outcomes as their marketing material states they are.

Cerner's health plan shows its true vision for healthcare: shift as many costs as possible to the employee, and weed out employees with high healthcare costs. This strategy increases Cerner's profitability and allows it to be a healthcare leader (using the term loosely).
Healthe uses a third tier provider network that leaves many major metropolitan areas uncovered, although Cerner's covered employees are nationwide. Worse, the plan includes no provision for out-of-area coverage. For instance, if an employee falls seriously ill while working at a Cerner client site in Big Town, USA and the plan has no in-network providers (including hospitals) nearby, the employee is stuck with the large provider bill for any charges over Healthe's usual and customary amount. This tab will typically be 60-75% of the provider's claim. It doesn't even matter to Healthe if there are no in-network providers in the employee's city of residence.
Alarmingly, Cerner is also marketing Healthe to its clients. This may be a blessing in disguise, as client employee backlash could increase anti-Cerner sentiment and cause it to lose EMR clients. But back to Cerner's concern for the health and welfare of its own employees. If the health plan doesn't cause sick employees to quit, they can look forward to automatic termination if they are disabled for 6 months. This situation could occur, for example, if a pregnant woman is on bed restriction. Cerner cares all right--about lining its own pockets.