On Jan 28, 2025 I awoke to an email stating that Nuna (the company that I worked for) was dropping their core business and that I was laid off. I was neither surprised nor upset. The severance package included 2 months paid cobra and a lump sum payment covering 2 months salary. I figured that I’d spend a few days relaxing, and then catch up…
Many people, churches, and religions take a negative stance on transgenderism. This post is not going to argue why I think that they are wrong, but rather, I want to point out that the LDS/Mormon stance is uniquely inconsistent with their other teachings (in ways that probably don’t apply to most other religions). Many religions teach that there is a difference between a soul and…
My nephew is applying to a design school at Western Washington State University and decided that he needed a new wood working project to round out his portfolio. I have a very modest wood working shop in my garage, so he came over looking for some ideas and he decided that he wanted to turn a wooden bowl with a resin lip. Of course, I…
Every few weeks, I see a question posted by Christians on Quora questioning if atheists have morals. For example: “If there is no God, no hell and no heaven, then why have we developed a conscience? Why don’t atheists commit crimes and what stops them?” “This may sound naive, but what keeps an atheist from committing adultery and doing other things that a Christian wouldn’t…
I was invited to speak on Jan 23, 2025 at a community event in Shoreline, WA on the topic of homelessness, with the goal of raising support for Camp United We Stand (a county sanctioned homeless camp for which my wife and I volunteer). The event was attended by various church leaders and by the mayor of Shoreline, WA. I gave the first speech of…
Complexity 1: We generally do not receive claims in a timely manner If we always received the claim data during the same month in which the visit occurred, things would be much simpler, but we receive the claim data only after it has been paid and that can take several months. Medicaid pays 99% of their claims within 90 days, whereas commercial payers generally average…
While this description seems complicated, it is greatly simplified (and excludes all discussion on episodes of care for simplicity, which is like a program on tip of other programs). Terminology Member The person covered by the insurance (i.e. the patient) Partner The insurance company. Provider The entity that contracts with the value based program. In some programs, this may be a doctor’s office, while in…
Payment in the US Healthcare has traditionally been a fee for service model. If I go to the doctor, the doctor receives a certain amount of money. The more that I go to the doctor and the more procedures are done to me,, the more money the doctor receives. If I’m healthy and never go to the doctor, the doctor makes no money. This model…
At the time that I joined Nuna, their core business was focused on supporting value based healthcare. My job at Nuna was tightly intertwined with the business logic needed to support value based healthcare. Rather than forcing you to understand all of this logic, I will put the details in links that you can read if you want to understand the space and the unique…
My experience joining Nuna was so bizarre and unexpected that I figured that it warranted its own chapter. In October 2021, I decided to leave Niantic after a phone call with Piaw. Piaw then sent two emails introducing me to the engineering manager at Nuna and to a recruiter at Aurora. Nuna’s response was instantaneous – I was on a call with them later that…
