User talk:HIGPA

December 2010
Please do not add commentary or your own personal analysis to Wikipedia articles. Doing so violates Wikipedia's neutral point of view policy and breaches the formal tone expected in an encyclopedia. Thank you. The Blade of the Northern Lights ( 話して下さい ) 03:05, 15 December 2010 (UTC)

Welcome to Wikipedia. Because we have a policy against usernames that give the impression that the account represents a group, organization or website, your account has been blocked; you are welcome to create a new account with a username that represents only you. You should also read our conflict of interest guideline. If your username doesn't represent a group, organization or website, you may appeal this username block by adding the text below this notice. Thank you. Elen of the Roads (talk) 03:27, 15 December 2010 (UTC)


 * For what it's worth, if you want to post your proposed changes to this page, I'd be willing to go through them with you. I know enough about the healthcare industry in the US to understand what you're writing about, and I'd be more than happy to work with you.  However, you may need to change your username so that people don't believe you're editing on behalf of anyone&mdash; you should probably check with an admin on that one, though.  The Blade of the Northern Lights  ( 話して下さい ) 03:10, 16 December 2010 (UTC)
 * As it says in the block template, xe is actually able to create a new username if xe wants. Just post on here what it is, so the accounts get tied up.  Or xe can ask to change it and I'll unblock xe to make the change. Having someone work with xe on this will help too. Elen of the Roads (talk) 10:18, 16 December 2010 (UTC)
 * Thank you for your responses. I would be happy to go over what concerns I have, I can see why my paragraph additions can be seen as an issue. I havent changed my username because I was not sure if that would be considered evasion by Wikipedia administrators, and would now rather work directly with someone who knows how to better structure the language so articles retain their neutral tone. I will go ahead and change my usernmame is the next few days, but will post it on the talk page to notify who it is. Thanks again, and I will be in touch with what specifics concerns I have about the article soon.HIGPA (talk) 20:47, 17 December 2010 (UTC)

Proposed edits to the group purchasing organization article
 * Thank you again for your willingness to help and to consider possible edits to the article. Below are the specific line edits I am submitting for consideration, along with appropriate citations. I leave the actual language of the edits to your better judgment and would be happy to discuss any concerns or questions about my suggestions. I understand that all my suggestions may not be accepted or edited in the exact way I proposed – any explanation or suggestions you could provide as to why would be much appreciated, and would be helpful in improving future edit requests.


 * I hope this is not too long – I thought it may be easier to post all my concerns and requests in in one post for whomever may review and make any edits. I divided my edits into the sections where the specific paragraphs and sentences are located.


 * I do have one last question, should I also post my proposals to the GPO talk page as well (I would have to change my username to do so), or is posting them here sufficient?


 * Thanks again for your help.HIGPA (talk) 21:47, 22 December 2010 (UTC)

“History” Section
 * In the fifth paragraph of the “History” section, the sentence beginning “Despite these safeguards” is incorrect and should be removed. The 2002 GAO report listed was only a pilot study, which was later superseded by the 2003 GAO report, “Group Purchasing Organizations: Use of Contracting Processes and Strategies to Award Contracts for Medical-Surgical Products,” and which did not find that healthcare GPOs increased costs for hospitals. The report can be found here: http://www.gao.gov/new.items/d03998t.pdf


 * The second sentence in the same paragraph, beginning “Further examining the practices,” should be altered to clarify that the FTC’s finding did not apply to GPOs specifically, but to all sectors of the health care industry. The FTC report can be found here: http://www.ftc.gov/ogc/healthcarehearings/docs/030926bloch.pdf


 * The sixth paragraph in the “History” section – which begins “In 2002” – is inaccurate. The Senate Judiciary Subcommittee never required, mandate or imposed Codes of Conduct on healthcare GPOs. The Senate called for stricter standards for healthcare GPOs, and GPOs responded by voluntarily adopting Codes or revising existing industry Codes of Conduct. There was no legislative action that required such industry response. This information can be found in the Government Accountability Office’s 2010 Report: http://www.gao.gov/new.items/d10738.pdf


 * Another action that the GPO industry voluntarily undertook directly in response to these Congressional concerns was the creation of the Healthcare Group Purchasing Industry Initiative (HGPII). The Initiative, created in 2005, was designed to promote and monitor ethical business practices for healthcare GPOs. The goal was to “assure ongoing adherence to ethical conduct and business practices, and to hold the confidence of the public and the Government in the integrity of the industry.” Lastly, the member organization in the Initiative must pledge to participate in an ongoing dialogue with other GPOs and organizations, including the Department of Health and Human Services, regarding the most effective policies and procedures for implementing these Principles. Information concerning the Initiative, including the quotes, can be found at: http://www.healthcaregpoii.com/abouthgpii.html


 * The 7th and final paragraph of the “History” section of this article also contains an incorrect characterization. It is incorrect to say that GPOs are charged with “policing” vendors from which they receive fees. GPOs don’t police vendors in any way, and have never been charged with that function. A small change that would keep in the industry criticism but make it accurate might be to say “vendors with whom GPOs contract.”


 * If editors believe it is equitable, a response from the GPO Industry regarding the criticisms from GPO critics in this paragraph might be appropriate. The criticism is that the GPO practices described are anti-competitive – the following are independent, third-party analyses which found that the very GPO practices in question are not anti-competitive and that GPOs save hospitals money: Government Accountability Office’s 2010 Report (http://www.gao.gov/new.items/d10738.pdf) or the August 2010 8th Circuit Court of Appeals Case between Southeast Missouri Hospital and Bard Inc., US (http://caselaw.findlaw.com/us-8th-circuit/1535190.html).


 * The article currently cites outdated studies, including the2002 GAO report. If the editors find it appropriate, I think it is relevant to at least include that GAO also released a 2010 report on the GPO industry. The report was called “Group Purchasing Organizations: Services Provided to Customers and Initiatives Regarding Their Business Practices,” and can be found here: (http://www.gao.gov/new.items/d10738.pdf) The GAO found that about 98 percent of American hospitals voluntarily contract with GPOs, and that those hospitals use an average of 2-4 GPOs per facility (relevant to the discussion that appears below on sole-sourcing); that the average weighted contract administrative fee for GPOs ranged from 1.22 to 2.25 percent (relevant to discussion below that all GPO fees are 3%); that all GPOs interviewed by GAO offer a broad range of services to hospitals; that GPOs responded to the needs of hospitals and long-term care providers by adding a broad range of services to improve quality, safety and economy; and that all GPOs have in place programs to evaluate innovative technologies that could provide meaningful benefits to patients, and can take steps to rapidly introduce those technologies to the marketplace.  If editors believe that the GAO report is too positive on the GPO industry, please omit, but I wanted to make sure you were aware of report’s existence, as it is both more current that the 2002 report and directly disproves several of the un-cited claims included in the current article.HIGPA (talk) 21:47, 22 December 2010 (UTC)

“Healthcare” Section


 * In the 3rd paragraph under the Health GPO section, the first sentence (beginning “It is important to note…”) implies that Administrative fees are not negotiated and incorrectly states that the fees are always 3.0%. This is false. Fees actually begin at 0% and range on average from 1.22% to 2.25%, according to the Government Accountability Office. Fees are negotiated and are fluid. This fact can be found in the Government Accountability Office’s 2010 report here: http://www.gao.gov/new.items/d10738.pdf


 * The next two sentences, beginning with “While it behooves” and ending with “kickbacks for the GPO,” should be deleted. The claim that bonus payments from suppliers amount to kickbacks is inaccurate, without factual basis, and made only by medical device manufacturers. When Congress created the GPO Safe Harbor to the Medicare Anti-Kickback law in 1987, it expressly determined that GPO administrative fees were not kickbacks.


 * The third and final sentence in this paragraph, beginning “Additionally, health care industry,” claims that healthcare GPOs signing single source contracts results in members of GPOs overpaying for supplies and not being able to access superior products. This was found not to be the case by the Government Accountability Office’s 2010 Report: http://www.gao.gov/new.items/d10738.pdf


 * Thank you again for your help and willingness to consider these changes. If there are any concerns or questions regarding these proposed changes, or if further information is needed, I would be happy to discuss them at greater length.HIGPA (talk) 21:47, 22 December 2010 (UTC)
 * Sorry I haven't been by- real life has caught up with me- but I will definitely take the time to review this. I don't want you to think I've forgotten about you. The Blade of the Northern Lights  ( 話して下さい ) 20:21, 3 January 2011 (UTC)
 * No problem as it was the Holidays, I appreciate your help on this. Hope you had a good break.HIGPA (talk) 23:08, 3 January 2011 (UTC)
 * The Blade of the Northern Lights - Have you had a chance to look over any of my suggestions/recommendations? Thanks for your help.HIGPA (talk) 17:00, 9 February 2011 (UTC)
 * Let me first apologize for taking so long to respond; I've gotten enveloped in rather nasty on-wiki dispute that badly needed a neutral third party and has dragged on for far longer than I could have possible anticipated (about 2 months as of right now), and there's finally a few-day break. I won't get into details, but suffice to say it's incredibly draining and involved enormous walls of invective directed every which way.  As to this; I took a look earlier today, but I didn't have time to comment.  I'll need to take another look tomorrow, when I'm in a somewhat better frame of mind (real-life issues), but from my first look most, if not all of it seems all right.  I'll work it out, probably make a few tweaks here and there, and see what it looks like, and maybe get a third opinion on it.  I must say, though, I'm encouraged at seeing the above.  The Blade of the Northern Lights  ( 話して下さい ) 04:50, 8 March 2011 (UTC)
 * Have you had a chance to review the changes again? I know its been a while, but want to know if at least some of these changes can be made. Thanks for helping review and let me know if you have any questions regarding my suggestions. Thanks.HIGPA (talk) 20:32, 18 August 2011 (UTC)