September 22, 2015
By Steven Wishnia
MedReview CEO Joseph B. Stamm was one of 16 people in the field of health care, hospitals, and pharmaceuticals who received Corporate Social Responsibility awards from City & State Reports on Sept. 17. Stamm, who has headed MedReview, the for-profit offshoot of the New York County Health Services Review Organization, since 1985, was honored for Excellence in Providing Transparency and Open Data for New York's Health Care Marketplace in a ceremony at Hunter College.
The 15 other honorees included health-care industry executives, medical-education administrators, New York State Nurses Association executive director Jill Furillo, and Ann Goldman of the United Federation of Teachers, vice president for members who work outside the New York City school system.
MedReview evaluates the cost and quality of health services paid for by its clients, who include labor unions—Local 1199SEIU, a client for more than 20 years, is the “flagship”— government agencies, and managed-care companies. It now operates in 15 states and, together with NYCHSRO, has saved clients more than $1 billion “post-review” since 1974. It checks whether services were actually rendered, were ordered by the physician, didn’t duplicate each other, and weren’t erroneously billed, and reviews the level and quality of care. It also investigates the quality of and conditions in adult-care facilities, nursing homes, and home health-care services.
“It is our job to make certain that the services rendered are medically necessary,” Stamm told LaborPress in 2014.
He told City & State that he is in no way “anti-provider,” saying that providers deserve to get paid for the work they do as quickly as possible. “But if there is something that is inappropriate,” he added, “we will identify it, and we will challenge it.”
If providers game the system, “it’s not just the government being impacted, but individuals, private citizens,” Stamm explained. People with copays, who are paying for medical care out of their own pockets, need to feel secure that they are not being cheated, so “there has to be a watchdog, an eye that is looking to make sure everything is being done appropriately.”
“The unshakable fact is that providers act more diligently when they are being monitored,” City & State wrote.
The health-care awards are part of a series of seven City & State inaugurated this year, beginning with real estate, construction, and housing in March, and concluding with sports, entertainment, and television in November.