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190-827 - Administering IBM Workplace Services Express 2.5 - Dump Information

Vendor : Lotus
Exam Code : 190-827
Exam Name : Administering IBM Workplace Services Express 2.5
Questions and Answers : 90 Q & A
Updated On : April 19, 2019
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190-827 Questions and Answers

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190-827 Administering IBM Workplace Services Express 2.5

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190-827 exam Dumps Source : Administering IBM Workplace Services Express 2.5

Test Code : 190-827
Test Name : Administering IBM Workplace Services Express 2.5
Vendor Name : Lotus
Q&A : 90 Real Questions

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Lotus Administering IBM Workplace Services

AOL, IBM work on company IM integration | killexams.com Real Questions and Pass4sure dumps

clients of IBM Corp.’s Lotus Sametime utility can be able to greater with ease communicate with the 195 million registered users of the united states online Inc.’s instant Messenger (aim) below a new deal forged by both corporations.

beneath the agreement, because of be announced Monday, the groups will verify the skill for Sametime customers to speak with users of the intention enterprise Gateway the use of one reveal identify, one password and a consolidated contact record, the organizations said.

“this is a trial about pooling communities of users together,” spoke of Bruce Stewart, senior vice-president of Strategic enterprise options at Dulles, Va.-primarily based AOL.

The purpose commercial enterprise Gateway, launched last November, manages company IM use in the back of company firewalls, and serves as a proxy between business clients and the outside purpose network. The enterprise additionally offers a set of company IM features, together with a non-public area carrier, listing authentication, and IM administration, logging and monitoring capabilities.

The pilot checks are centered at integrating the intention Gateway and company IM services with Lotus Sametime’s immediate messaging and net conferencing software.

aim elements are already built-in into the Sametime messaging client beneath a outdated settlement, but users should log into goal the use of a distinct password, and the contact lists for both techniques are kept separate.

the brand new tests are aimed toward presenting a more seamless messaging journey by including again-conclusion integration, the companies said.

If a success, 8 million Sametime shoppers would at last be capable of control aim utilization on their systems and IT managers can be in a position to log and display screen immediate messages between the AOL and Sametime systems.

Stewart did not give a timeline of when he believes that the integration could be a hit, announcing best that the checks would take “months.”

“We’re hopeful. We just need to be sure it all works,” he mentioned.

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IBM Buffs workplace and WebSphere Portal | killexams.com Real Questions and Pass4sure dumps


IBM Buffs office and WebSphere Portal
  • with the aid of Stuart J. Johnston
  • November eleven, 2004
  • IBM this week announced new and up to date items in its place of work household of collaboration items, together with 19 role-based built-in functions for medium and small company purchasers. The company additionally observed it's going to deliver ad hoc internet conferencing as a provider for purchasers beginning in December.

    The solutions deliver customizable business capabilities for specific industries or categories of enterprise initiatives and operations – all built the use of IBM office products and selected third-celebration purposes.

    although possibly a cliché via now, IBM officers also persisted to emphasize the differences between a “network-delivered” collaboration atmosphere and one based mostly primarily on personal computer systems – chiefly Microsoft’s view. “[With Workplace Solutions] you shouldn't have to have Microsoft office,” says Larry Bowden, vice president, of IBM office utility options.

    IBM designed the options by studying the job roles required for performing common units of projects or operations within a group of vertical markets. on the equal time, it considered a way to implement horizontal business roles inside usual companies’ IT environments, together with procurement, finance and administration, customer carrier, and human supplies. the new place of work options deliver integrated software sets that meet at that nexus; as an example, programs to deliver branch banking or retail save administration capabilities.

    “They’ve taken classes out of IBM’s capabilities community and . . . they've designed these packages to make these people with the important thing business roles extra useful,” says Robert Mahowald, research supervisor at IDC. That should, the reasoning goes, make those organizations that undertake those options more a hit.

    since the options and IBM office items assist business necessities, together with Java and XML, other products will also be integrated with different systems as smartly. IBM workplace comprises Lotus workplace, WebSphere Portal, Lotus Notes and Domino, and WebSphere Everyplace, based on the enterprise’s net site.

    “Our focus is on organizational productivity,” says Bowden, adding, “Having a aggressive facet is not pretty much as good as having a sustainable aggressive edge.”

    definitely, imposing entire built-in methods in line with the features that a enterprise must perform as smartly as the roles of the individuals who function the indispensable projects, and featuring that to shoppers in an answer package it really is the subsequent best thing – or so IBM officials hope – to a turnkey answer, gives that sustainable facet, company executives put up.

    The options don’t do every thing. Implementation details continue to be however IBM’s intent is to take part of the pain out of the procedure for small and medium-sized organizations that don’t have a division dedicated to presenting IT. “Why don’t we get you 70 % of how?” asks Bowden rhetorically.

    in a single of IBM’s demonstration eventualities, a financial institution department teller receives a large investigate and wishes to reap the approval of a client provider grownup, and additionally should clear the deposit for regulatory compliance and auditing. The branch banking answer provides job roles for 3 distinct employee project units to meet the required enterprise capabilities. indeed, the brand new workplace options encompass more than 30 job features or worker roles, enterprise spokespeople pointed out.

    among the many areas where IBM is offering new workplace solutions are: retail, electronics, manufacturing, finance, telecommunications, executive, existence sciences, healthcare and car groups. moreover, the company has up to date its department Banking answer as well as its company Controls and Reporting solution (now at version 2.5).

    fundamentally, youngsters, IBM is taking a a little bit different tack on coopetition. To organizations like Oracle, SAP and PeopleSoft, “They’re saying, ‘we’re going to provide the plumbing for you,’” says IDC’s Mahowald, leaving a part of the pie for different gamers.

    IBM will additionally start offering on demand net conferencing next month, officers noted. “when you've got a browser and a mobilephone, that you could installation a web convention,” Bowden says. “in its place of purchasing the software from us, that you may simply purchase the provider.” This comes as an instantaneous try to take business faraway from Microsoft’s live meeting, says Mahowald.

    additionally, IBM also introduced a brand new product within the workplace family. IBM workplace services categorical v2.0 is a fresh product designed for small and mid-sized agencies and departments in enormous businesses. It contains group collaboration, doc management, net forms, assignment lists, and portal functions as well person customization aspects. IBM office services express also integrates with the user's latest applications and statistics, in addition to email, calendar and tackle book, and provides a number of collaboration tools including integrated speedy messaging. it will ship in December, officers stated.

    at last, IBM debuted the newest free up of WebSphere Portal – edition 5.1 – which provides virtual portals, business procedure workflow facets, and improved content administration capabilities. version 5.1 could be available with the aid of the conclusion of November.

    The company will announce pricing for all of the products and services when the products can be found, enterprise officers observed.

    in regards to the writer

    Stuart J. Johnston has lined expertise, primarily Microsoft, due to the fact February 1988 for InfoWorld, Computerworld, suggestions Week, and notebook World, as well as for business Developer, XML & internet services, and .net magazines.

    Blockchain Goes To Work At Walmart, IBM, Amazon, JPMorgan, Cargill and 45 other companies | killexams.com Real Questions and Pass4sure dumps


    n the Jersey facet of the Hudson River simply across from big apple’s financial District, there's a pitcher-and-steel office tower designed in a severe international vogue aesthetic. “DTCC” is emblazoned across the properly, but few outside of Wall road recognise that during this building, occupied by means of the Depository have faith & Clearing Corp., are information for most of the realm’s securities, representing some $48 trillion in property—from shares and bonds to mutual cash and derivatives. within the Nineteen Seventies, Wall road created a DTCC predecessor to replace a gadget that had been powered by means of young men working across the cavernous alleys of lower long island supplying inventory certificates from brokerage residence to brokerage residence.

    DTCC nevertheless has paper certificates in its vaults, but records ­related to the ninety million daily transactions it handles are stored electronically on its servers and backed up in a number of areas. heaps of economic associations and exchanges in a hundred thirty countries rely on DTCC for custody, clearing, settlement and other clerical ­features. 

    In a couple of months DTCC will start the biggest live implementation of blockchain, the allotted database expertise made established with the aid of the bitcoin cryptocurrency. facts for about 50,000 accounts in DTCC’s trade guidance Warehouse, where advice on $10 trillion price of credit score derivatives is saved, will flow to a personalized digital ledger referred to as AxCore. 

    according to Rob Palatnick, DTCC’s chief technology architect, the warehouse already maintains an electronic “golden listing” of routine akin to maturity dates, price calculations and different activities needed to clear and settle these securities each day. but each participant in a sophisticated credit derivatives transaction additionally keeps its own information, which have to in turn be reconciled assorted instances earlier than the investment matures. by means of relocating these data to the blockchain, visible to all individuals in true time, most of these redundancies received’t be critical.

    “We’re not speakme about removing humans and companies,” Pa­l­atnick says. “We’re speaking about removing layers of databases and translations between those databases.”

    On the other aspect of the area, in Taipei, Taiwan, Foxconn, the electronics huge highest quality known as a company of iPhones, launched a Shanghai startup referred to as Chained Finance with a chinese language peer-to-peer lender. Chained will soon connect Foxconn and its many small suppliers (and their suppliers’ suppliers) on an Ethereum-primarily based blockchain so as to use its personal token and sensible contracts (examine: immediately performed) to make payments and provide financing in close actual time, putting off a daisy chain of paperwork. 

    “We view blockchain as the skeleton of our work,” says Jack Lee, the founder of Foxconn’s venture capital arm, which has invested $forty million in six blockchain startups. “smart contracts that automatically execute transactions are the muscle tissue, and tokens are the blood.”

    Welcome to the brave new world of business blockchain, the place enterprises are embracing the know-how underlying cryptocurrencies like bitcoin and the use of it to speed up company methods, enhance transparency and doubtlessly retailer billions of bucks. At its core, blockchain is conveniently a dispensed database, with the same copy stored on many computers. That allows transactions (financial or in any other case) between people (or agencies) that don’t be aware of or believe each and every different. It’s virtually unattainable to cheat, considering each transaction is recorded in lots of ­areas and the particulars of those transactions are visible to all and sundry. organizations are already the usage of blockchain to track fresh-caught tuna from fishing hooks in the South Pacific to grocery cabinets, to velocity up coverage claims and to control scientific data. total company and government spending on blockchain may still hit $2.9 billion in 2019, an increase of 89% over the previous 12 months, and attain $12.four billion by using 2022, in response to the overseas facts Corp. When PwC surveyed 600 “blockchain-savvy” pros ultimate 12 months, 84% referred to their companies are involved with blockchain.

    To chronicle the upward thrust of so known as “business” blockchain,  Forbes has created its first annual Blockchain 50 listing of massive organizations that are placing the expertise to work in ­meaningful methods. whereas blockchain’s first application, cryptocurrency, is struggling to achieve mainstream adoption, these organizations are committing manpower and capital to build the long run on precise of shared databases.

    The edition of a blockchain future these agencies are constructing is, for essentially the most part, a long way distinctive from what the founders and early adopters of blockchain had envisioned. whereas many crypto­foreign money idealists fantasize about a world, public community of individuals related without delay and democratically, with out middle­guys, these businesses—lots of which are middlemen themselves like DTCC—are building deepest networks they'll use to profit from centralized management. 

    no longer notably, economic enterprises—from Allianz to Visa and JPMorgan Chase—dominate the list. however Blockchain 50 businesses run the gamut of industries, including energy company BP, retailer Walmart and media enterprise Comcast. 

    because of the lingering dangerous style left with the aid of bitcoin drug bazaars like Silk road and the 2017 digital forex bubble, most organizations emphasize the big difference between crypto and blockchain, shunning the previous and embracing the latter. In many ways the participants of the Blockchain 50 represent a bridge between the old and new worlds. just as inner computing device networks had been adopted by way of businesses lengthy before the cyber web took off, these firms are beginning by using adopting dispensed ledger expertise at a small scale.

    “The period of blockchain tourism has ended,” says Bridget van Kralingen, Senior vice president for systems & Blockchain. “We’ve basically seen blockchain move from being overshadowed by means of cryptocurrency to focus on true company problems and sophisticated strategies.”

    In 2009, when Satoshi Nakamoto, bitcoin’s pseudonymous creator, activated his community, its blockchain was the underlying accounting equipment that let any one with bitcoin switch cash devoid of the need of a intermediary. Transactions are processed in blocks—just a fancy word for a hunk of records—about every ten minutes, every containing a compressed edition of the previous block, linking them together into a series. instead of counting on a bank or an additional intermediary to retain tune of when a bitcoin leaves one area and arrives at yet another, the hundreds of computer systems on the bitcoin community do the work and in trade for his or her efforts are paid in bitcoin. 

    for many businesses this introduced a potential difficulty. while identities aren’t required to use the bitcoin blockchain, the transactions themselves are tied to addresses which are publicly available, that means that with a little of labor many of these addresses may also be tied to exact individuals or agencies. consequently companies like Coca-Cola and JPMorgan Chase, familiar with maintaining aggressive advantages in keeping with proprietary tactics and manage, were at the beginning skeptical of cryptocurrency.

    agencies additionally need some control over their statistics. “The whole company world has been customary around who has responsibility over a particular a part of the company stream,” says David deal with, the global head of Accenture’s fiscal functions Blockchain follow. “There will also be no gaps, as a result of it is unacceptable for a multibillion-dollar enterprise. You can't have a spot, otherwise you are discipline to big protection breaches and social contract breaches.”

    possibly no enterprise has had a superior impact on the starting to be corporate use of blockchain know-how than Digital Asset Holdings, a new York-based startup that hired the previous JPMorgan Chase banker Blythe Masters as its CEO in early 2015. below Masters, Digital Asset began making acquisitions and almost immediately bought a small company that was in the method of constructing an “invitation handiest,” or permissioned, blockchain. Then in late 2015 Digital Asset donated the code for its “open ledger” challenge to the Linux groundwork, which helps business open-source utility tasks, including the Linux operating device.

    The mission became referred to as Hyperledger, and thanks partially to ­Masters’ connections, its backers examine like a who’s who of finance and technology. Thirty businesses are listed as founders, together with ABN AMRO, Accenture, Cisco, CME community, IBM, Intel, JPMor­gan Chase, NEC, State road, VMware and Wells Fargo. Hyper­ledger immediately dependent itself as the gold typical for company blockchain tasks.

    What took place subsequent could be considered the massive Bang second of business blockchain. In early 2016, IBM donated forty four,000 traces of code to the task, which fashioned the core of a brand new blockchain with sooner speeds and expanded privateness. No fewer than half of the contributors of the Forbes Blockchain 50 are actually the use of that blockchain, called Hyperledger textile.

    “We’ve been very focused on making sure that now not only is the blockchain technology standard but that the files and information are average,” says Marie Wieck, IBM Blockchain’s general supervisor. “This standardization permits [the companies] to now not spend their time comparing adjustments and validity in the documents.”

    shortly after the launch of Hyperledger, which is a nonprofit project, a new York fintech known as R3 raised $107 million from the likes of ING, Barclays and united statesto create a for-profit enterprise blockchain platform known as Corda commercial enterprise.

    because the commercial abilities of co-opting blockchain know-how grew to become greater obvious, many cryptocurrency startups all started to rethink their models.

    as an instance, San Francisco’s Ripple, originally known as OpenCoin and conceived of as yet a different choice financial system, extended its focus in late 2015 from the cryptocurrency (called ripple and trading as XRP) to building utility for enormous banks. A bitcoin startup called Counterparty spawned another enterprise, Symbiont, in March 2015, which coded a proprietary blockchain that’s now getting used via forefront for sharing inventory index data. In February 2017, ConsenSys, a Brooklyn-based mostly collection of crypto businesses managed with the aid of one in all Ethereum’s founders, helped launch the commercial enterprise Ethereum Alliance. 

    simply as company the united states co-opted counterculture vibes for its advertising and promoting (“believe diverse,” “Don’t Be Evil”), its most forward-pondering corporations are quick incorporating a technology that become designed in significant half to dispose of them.

    In coverage, for instance, MetLife’s cell app Vitana bundles insurance with a test for gestational diabetes that uses a blockchain to record facts and verify and pay claims. In contemporary checking out in Singapore, the place one in five expectant mothers develops gestational diabetes, a practitioner readily enters a good check result right into a affected person’s digital medical list and in a remember of seconds MetLife’s wise contract deposits an assurance fee into that affected person’s bank account to cover the medical charges associated with the situation. No paperwork or claim filing indispensable.

    in a similar fashion, Germany’s Allianz, working with EY, established relocating certain captive coverage claims techniques—often involving many emails, attachments and contact calls throughout varied times zones—to a private blockchain. The time required to process a claim fell from weeks to hours.

    The French financial institution BNP Paribas, which has lent cash to commodities merchants considering the nineteenth century, is because the use of a ledger platform known as Voltron to procedure letters of credit score for traders. Northern trust has begun administering inner most fairness dollars the use of Hyperledger textile. Broadridge financial has been working pilots trying out assorted distributed ledgers for its dominant proxy vote casting and shareholder communications business.

    “In precise time, you know who owns the stock, who’s entitled to vote and how it’s tied to the universally-agreed-upon shareholder assembly agenda,” says Michael Tae, Broadridge’s head of method.

    in the ceaselessly fraught food company, which constantly endures disasters starting from E. coli outbreaks to a worker being cooked alive, agencies like Nestlé and Bumble Bee foods are turning to blockchain to comfortable their give chains and cut back bureaucracy.

    Golden State meals, a huge McDonald’s service provider that makes greater than 400,000 hamburgers per hour, tracks the place and temperature of its patties with instruments like radio-frequency identity tags and Hyperledger cloth. The equipment can automatically alert GSF to conditions that may cause spoilage. at the same time, it could actually optimize inventory levels by means of monitoring how a whole lot meat is in a truck or in a restaurant’s freezer, in precise time. 

    At this 12 months’s SXSW convention in Austin, Texas, Bumble Bee unveiled an SAP-built give-chain blockchain providing comprehensive transparency to its valued clientele. quickly you will not need to take Bumble Bee’s note for it when its assures you that the 12-ounce kit of yellowfin tuna you simply purchased became caught by individual fishermen within the South Pacific and never by means of a factory ship. The fishing crews, tuna processors and packers are now entering their own facts in real time on Bumble Bee’s disbursed ledger. by using summer season, Bumble Bee will be sharing that counsel with sellers and purchasers who make the effort to assess. 

    From a public relations standpoint by myself, Bumble Bee’s SAP blockchain is likely to endure dividends. In 2017 Greenpeace ranked Bumble Bee 17th out of 20 tuna manufacturers for its sustainability practices, accusing it of “greenwashing” a number of unhealthy behaviors with environmentally pleasant advertising.

    “food safety and sustainably sourced product has turn into an overwhelmingly crucial subject in our trade,” says Tony Costa, the CIO at Bumble Bee. “Leveraging the latest expertise makes it possible for us to open it up to extra of a public viewpoint, if you will. So we get out of the business of managing data. We’re relying on a relationship.”

    in the healthcare business, an estimated 20 cents of each ­dollar—some $700 billion a year—is wasted because of inefficiencies. Ciox, a little-prevalent enterprise based mostly in Alpharetta, ­Georgia, that manages clinical-information exchanges for 60% of the ­hospitals within the U.S., is considering that constructing a non-public blockchain that healthcare suppliers may use—for a charge paid to Ciox—to alternate statistics. Blockchain 50 businesses like Ciox and the media tremendous Comcast, which is toying with the usage of blockchain to micro-target television advertisements, plan to use the privateness elements of blockchain to take advantage of their valued clientele’ facts while maintaining their identities. 

    despite the surge in firms working on blockchain projects, the know-how remains new, and comparatively few have generated tremendous revenues or savings. 

    The one neighborhood that's getting rich from the existing business blockchain gold rush: consultants. Deloitte, PwC, KPMG, EY and Tata Consultancy capabilities are deploying small armies to preach the virtues of blockchain to the C-suite and charging large costs to support corporations enforce the expertise. (We excluded consultants from the Blockchain 50 as a result of they performed a key role in helping us ­create the checklist.) Deloitte, as an example, has 1,four hundred full-time blockchain employees. India’s Tata has 1,000 staffers, 600 of them full-time, in its blockchain unit. Tech organizations, including Oracle, SAP and Amazon, are also staking out their turf.

    part expertise firm, half consultant, IBM may be the largest and most a hit business blockchain company of all. anyway assisting create Hyperledger textile, the company has 1,500 staffers—by and large engineers—devoted to the brand new technology and studies that its IBM Blockchain powers 500 client tasks.

    IBM food have faith, for instance, counts Walmart, Kroger, Nestlé and ­Carrefour, the French grocer, among its 50-plus participants. IBM is also at the back of TrustChain, a consortium of corporations in the give chain for diamonds and ­rings, together with Rio Tinto Diamonds, Asahi Refining and Helz­berg Diamonds. health Utility network, a further massive Blue neighborhood, counts three of the 5 biggest U.S. fitness insurers—Aetna, Cigna and Anthem—as contributors.

     “The power of any blockchain network is in its contributors and its participants,” says IBM’s Wieck. It concerns little ­whether those participants are crypto-idealists or international companies.

    cowl picture with the aid of Viktor Koen for Forbes. Illustrations via Tony Healy for Forbes.

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    New 'transparent' setup for Medicaid drug purchase will be secret to public | killexams.com real questions and Pass4sure dumps

    Medicaid managed-care provider CareSource last week announced that it had inked a new contract with pharmacy-benefit giant Express Scripts that CareSource said would bring groundbreaking transparency to Ohio's billion-dollar Medicaid drug marketplace.

    But the contract itself is secret.

    That has some experts questioning whether there still will be room for the kinds of non-transparent behavior blamed for costing taxpayers billions nationwide.

    The price of prescription drugs is the fastest-growing part of the health-care sector, and critics have blamed pharmacy middlemen such as Express Scripts, CVS Caremark and OptumRx for part of that rapid rise. The critics say the pharmacy benefit managers used secrecy to raise prices and boost profits while the PBMs say they're saving consumers money.

    Last year, after a data analysis by The Dispatch, the department of Medicaid released its own that showed the PBMs working for managed-care organizations such as CareSource billed the plans — and ultimately taxpayers — $224 million more for drugs than they paid pharmacists. That total reflects three to six times the going rate, the Medicaid department's consultant found.

    Issues surrounding PBMs have spread far beyond Ohio, with the U.S. Senate holding hearings into their practices this month and several states taking steps to investigate — and possibly eliminate managed care from their Medicaid pharmacy operations altogether. Some Ohio lawmakers want to return to a fee-for-service, a setup replaced by managed care under the administration of Gov. John Kasich.

    Against that backdrop, Dayton-based CareSource announced last week that CVS Caremark would no longer be its PBM to the 1.2 million Medicaid patients it serves in Ohio. The company also announced that it was dropping CVS and tapping Express Scripts be its PBM to another 600,000 clients in Kentucky, Indiana, Georgia and West Virginia, a move that will cost CVS billions of dollars.

    The Ohio Department of Medicaid already has implemented a new pass-through pricing model that it hopes will add transparency to the way the state buys $2.5 billion worth of drugs annually. But the department did not answer directly this week when asked whether it reviews its managed-care organizations' contracts with the PBMs that spend that money.

    CareSource is touting its new contract with Express Scripts as transparent because Ohio Medicaid officials will be able to see it and because CareSource will work with the department to hire an independent third party to review its performance.

    "(T)here’s nothing hiding, nothing leaking, it’s all there,” CareSource President & CEO Erhardt Preitauer told The Dispatch when the new contract was announced.

    The Medicaid department said its lawyers are reviewing the CareSource-Express Scripts contract.

    But there's still the fact that CareSource is calling "transparent" a contract that the public can't see, and the only parties that will be able to view it are those on whose watch nearly a quarter-billion dollars worth of spread pricing took place in 2017.

    In an interview Monday, CareSource Senior Vice President Clayton Edwards said that if CareSource made public its contract with Express Scripts, its competitors would have an advantage by copying its new transparency model and other innovations.

    "We believe that we're creating a new and novel solution for the people of Ohio, and if we disclose that to the general public, then all of our competitors would understand that as well and potentially replicate it," he said.

    Edwards emphasized that those responsible for Ohio Medicaid will be privy to the terms of the contract.

    "It is very transparent, but to the state," he said. "They're the stewards of the taxpayers' dollars and they're the ones who really represent the people that we serve and the general public. When the announcement was made about our model, it was well received across the state. We really see (the Medicaid department) as the representative of the people we serve and the public in general."

    But Linda Cahn, who writes and scrutinizes PBM contracts for a living, said state officials need to be double- and triple-checked.

    "Given that Ohio has already wasted hundreds of millions of dollars from inflated prescription drug costs, Ohio state should insist on full disclosure of all contract terms — to the Medicaid office, to the state legislature and to the public, especially since taxpayers are footing the bill for terrible PBM contracts," she said.

    "After all, the PBM contract is the single document that controls how much the state will pay, how much in profit spreads the PBMs will make, whether the PBM can collude with manufacturers against the state’s and Medicaid beneficiaries’ interests, what services the PBM will provide, and every other aspect of Ohio’s Medicaid prescription coverage program."



    As Indian companies grow in the U.S., outsourcing comes home | killexams.com real questions and Pass4sure dumps

    New York — Ray Capuana paces the rows of cubicles in a haggard high-rise a stone’s throw from Wall Street as his people hustle the phones and hope for a bonus check.

    His employees are not bond traders, though. They are call center workers. Many are African Americans without college degrees. Some lack high school diplomas. They work for a Mumbai-based company called Aegis Communications.

    India’s outsourcing giants — faced with rising wages at home — have looked for growth opportunities in the United States. But with Washington crimping visas for visiting Indian workers, some companies such as Aegis are slowly hiring workers in North America, where their largest corporate customers are based. In this evolution, outsourcing has come home.

    Capuana, a manager for Aegis in New York, motivates this U.S. office with dress-down days and the prospect that workers could, one day, earn a stint training call center workers in Goa, India. One of his tasks is to staff 176 cubicles, where workers make or take calls for customers of prescription drug plans or Medicare contracts and enter and verify information. The pay runs $12 to $14 an hour, with bonus checks of up to $730 a month.

    “Our recruitment model is simple,” says Capuana, who played Division III college football, wears rosary beads on his wrist and has a picture of Jesus above his desk. “I don’t care if you come from Park Avenue or the park bench. If you can do the job, we want you.”

    Aegis, a subsidiary of India’s Essar Group, an energy, telecom and metals conglomerate, says it’s pioneering the next generation of outsourcing: putting the work close to its global customers. Its executives call the practice “near-sourcing,” “diverse shoring” and, sometimes, “cross-shoring.”

    Madhu Vuppuluri, chief executive and dealmaker for the Americas division of Essar Group, remembers watching outsourcing grow in India in the late 1990s and early 2000s and thinking that the decline of U.S. call centers was overdone. He persuaded the billionaire Ruia brothers, Essar’s Indian owners, to let him make a counterintuitive bet: In 2000, he bid on the bankrupt assets of Telequestion, a 500-person call center in Arlington, Tex., for $2.5 million.

    That led to other acquisitions in the United States and abroad. Today, Aegis employs 50,000 of Essar’s 70,000 employees on several continents. About 5,000 people work at nine U.S. call centers. Aegis, which is on the hunt for more acquisitions, has said it aims to triple its U.S. head count, to more than 15,000.

    The strategy is based on the old-fashioned idea of being close to your customers. It’s one embraced by companies such as credit card giant American Express, insurer Humana and government agencies, which sometimes prefer on-shore call centers to handle customer service for sensitive life insurance, financial or health-care products.

    “The customer is the king,” Vuppuluri said. “Wherever the customer wants the services to be, we can provide.”

    Visitors on visas

    At its U.S. sites, Aegis says, 90 percent or more of its workers are American. In that way, Aegis is an exception to the rule. Until now, India-based outsourcing companies have largely brought Indian workers into the United States using H-1B visas and L-1 visas and have been the heaviest users of those programs.

    In India’s $60 billion software-exporting industry (which employs roughly 4 million people worldwide), Aegis is competing with companies such as Wipro, Tata Consultancy Services, Genpact, WNS and Infosys. Most are expanding their outsourcing work — from call centers to high-tech consulting and financial services — to the United States. In many cases, it’s a key part of the companies’ growth strategy. But political and economic forces in this country and India complicate things.

    Some say the visa practice has hurt U.S. jobs and wages. These new visa categories were created by the Immigration Act of 1990, allowing foreigners to work in the country for up to six years. The aim was to lure high-tech talent. Tech America, an industry trade group, says that the visas are crucial to American innovation, future competitiveness and job creation.

    But they have been abused, too. In a study released in 2008, the government found fraud and technical violations on 20.7 percent of H-1B applications. Violations ranged “from document fraud to deliberate misstatements regarding job locations, wages paid and duties performed,” said Donald Neufeld, of the Department of Homeland Security, at a March hearing.

    Immigration officials and the State Department have worked to crack down on the fraud.

    “There will be, in any situation, an effort to go around the law,” said David T. Donahue, deputy assistant Secretary of State for Visa Services. “Our job is to catch the companies doing that.”

    Some lawmakers are looking to curb the practice and to encourage the India-based outsourcing firms to follow Aegis’s model of hiring Americans at U.S. sites. Issuance of regular H-1B visas — 10,200 so far this year — is down 43 percent percent from 2010, according to federal data. Last year, the Obama administration added a roughly $2,000 fee per H-1B visa for large companies, which could be curbing applications.

    In the past, if, say, BNY Mellon inked an IT contract with Infosys, Infosys would handle 70 percent of the work in India and send 30 percent of its project staff to the United States on temporary work visas. These Indian workers often live in ethnic enclaves on the outskirts of a city, work long hours and earn less than an American would for the same work.

    Companies such as Tata Consultancy Services, Genpact and Infosys are the largest users of the H-1B visa program and have collectively brought as many as 30,000 workers into the country in a year on H-1B or other visas.

    Critics of the visa programs, such as Ronil Hira, a public policy professor at the Rochester Institute of Technology, say the work arrangements can amount to indentured servitude. The workers are often paid “home-country wages” in America. “That’s as low as $8,000 a year” with housing allowances, he says. The employers own the visas — so the workers can’t bargain for wages, and if they lose their job they have to leave the country.

    Hira said Indian workers still make up more than 90 percent of most outsourcing companies’ U.S. head counts. He and other critics argue that many of these workers are not more highly skilled than their American counterparts but are simply willing to work for less. “It’s harming American workers,” he said. “It’s taking away their job opportunities, bringing down their wages and harming their working conditions.”

    The companies that use the visa programs have faced opposition from U.S. labor unions as well as age-discrimination lawsuits from American tech workers alleging that they were passed over by the hiring practices.

    At the same time, as high unemployment lingers and the economic recovery lags, India-based companies have seized on an opportunity to improve their image and expand their U.S. businesses by taking over companies and hiring more U.S. talent.

    Rivals for IBM, Accenture

    Infosys and others find themselves in a quandary. U.S.-based rivals such as Cognizant, Accenture and IBM are ramping up hiring and offshoring in India, pushing up wages. So Infosys, Tata Consultancy Services and Genpact have had to move into the culturally uncomfortable area of managing Americans.

    “What you have going on in India are salary hikes,” said Joseph Vafi, an analyst at Jefferies & Co. in San Francisco. “As these companies get larger and larger, it just makes sense for them to do some hiring in the States.”

    Tata Consultancy Services, for example, is ramping up its North American presence in major deals with Citibank, Dow Chemical and Hilton Worldwide. It plans to hire more than 1,000 Americans in 2011 and to base 10,000 of its 185,000 global employees in the country.

    “The focus is on building stronger relations with our customers in North America, by far our largest market,” said spokesman Mike McCabe, who added that more than half of the company’s revenue comes from North America. “It’s kind of a natural effort to invest more here.”

    Robert Webb, chief information officer at Hilton Worldwide, said Tata Consultancy Services and Infosys increasingly rival the established consulting companies, such as IBM, Accenture and Bain Consulting, in areas such as integrating massive computer systems, developing applications for companies and even strategy consulting. He predicts that the India-based companies “will evolve to be more like one of the traditional consulting firms in the U.S.” by taking on higher-end capabilities such as business planning, industry knowledge and change management. Already, they are “starting to encroach on IBM’s territory, where data centers can be run from other parts of the world.”

    He said IBM and Accenture are rapidly hiring talent in India and other emerging markets as a counterstrategy. “They’re all keeping their eyes on wage inflation in low-cost countries” like India, where wages are increasing 10 percent a year.

    Hilton hired Tata Consultancy Services in 2009 to take over some back-office operations, such as human resources, financial systems and its intranet portal for the company’s 10 brands and 3,700 hotels. Hilton used to handle this work in-house or with hundreds of small consultants.

    Tata Consultancy Services is doing most of the work in Memphis and McClean, where Hilton has offices. Hilton is sharing these best practices with its parent company, private-equity firm Blackstone Group. Using companies with talent around the globe allows Hilton to continue working on projects around the clock and to innovate more quickly.

    “While some people are sleeping in the U.S.,” Webb said, “people can be coding in India and vice versa.”

    Rebadging U.S. workers

    Genpact, the outsourcing company created and spun off by General Electric, doubled its U.S. employment last year, to 2,000 of its 40,000 global employees. Most of that expansion came with Genpact’s contract with drugstore giant Walgreens to take over its accounting services. It bought Walgreens’ accounting center in Danville, Ill., promising to hire there.

    Taking over existing employees of another company is called “re-badging.” Indian firms have been uncomfortable managing U.S. workers in the past, Hira said, particularly when Indian workers are working alongside Americans who are paid more. But companies increasingly see rebadging as a necessary way to expand.

    Genpact is also hiring at centers in California and Pennsylvania as it aims to expand in the mortgage and regulatory compliance industries and in consumer product, hospital and health-care companies.

    “The U.S. became the fastest-growing location for us,” last year, said chief executive V.N. “Tiger” Tyagarajan. “We expect that to continue on this year.”

    Bob Kane, treasurer of New York-based textilemaker Westpoint Home, which makes Ralph Lauren linens, uses Genpact for general accounting in India and accounts payable in Mexico. He’s used Genpact’s Pennsylvania office for its accounts receivables work since 2007.

    The Pennsylvania office “is the most competent and is the most business-savvy,” he said, noting that it does the work 40 percent more efficiently for less money and with fewer people than his company could do in-house.

    “They understand it is important to get the job done and stay the extra hour,” he said. “They get it. They get what we need. We don’t always get the same feeling from” outsourcing contracts abroad.

    He pays slightly higher wage rates — $15 an hour — to keep the receivables work in the United States. He said he’s heard from executives at other companies that the quality of work in India is slipping as turnover increases and Indian companies invest less in training, especially if a client isn’t willing to pay higher wages over time. Some U.S. companies don’t want sensitive customer data transmitted abroad. Others are tired of poor service, accents and crackling phone lines.

    Managing across cultures

    The lower Manhattan branch of Aegis, on Broad Street, is one of the company’s top performers. And Capuana, 41, is hiring. The 11th-floor lobby is crowded with applicants looking for training and jobs, some of them unemployed and on public assistance.

    At $12 to $14 an hour with possible monthly bonuses, workers can make four times what call center workers in India do. But Essar executives say it’s worth paying more in wages to leverage a large U.S. presence to gain contracts with banks, health-care companies and governments that require the work to be done here.

    Some workers at the call center, such as Mary Auguste-George, eventually move up the ranks. Originally from St. Lucia, she started as a phone rep, moved to supervisor, then trainer and and is now payroll manager of the lower Manhattan division. Capuana calls her “a diamond in the rough who just hits the ground running.”

    Capuana, a stocky man who prefers jeans and wears his hair long, uses a motivational-speaker’s approach to get workers to show up on time and do their best. “You really need to leave everything you have on that phone call,” he says, walking amid the 3-foot-by-4-foot cubicles with signs that read “Perfect Service” and “One Member at a Time.”

    He pins pictures of the top 12 performers on a “Circle of Leaders” bulletin board each quarter. They receive free movie tickets, have greater dress-down privileges and eat free lunch. The practice has been adopted by Aegis on a corporate-wide level, he says.

    Many Aegis employees at the site are not very aware that they work for an Indian company. The Dallas headquarters, though, celebrates India’s independence on Aug. 15. And the call center workers have made music videos for each other: The Indian office performed a Bollywood song, and workers at the U.S. office danced to the Black Eyed Peas.

    But with all its globalism, Aegis also has its culture clashes. Some managers from India have a hard time understanding what motivates U.S. workers and why they are less-educated than their Indian peers. One Indian-born manager said he thinks that the U.S. standard of living has spoiled Americans and that they take less pride in their work. In other words, he says, they are lazy.

    The India executives are also puzzled by the appeal of dress-down practices. “We don’t do that” in India, says Ramya Devi Ramachandran, 27, a former administrative assistant at the lower Manhattan office who worked for Aegis in India before moving to New York.

    Essar and Aegis, however, want to step up the cross-sharing this year, shuffling dozens of U.S. Aegis employees to Goa and Bangalore in India to help handle large U.S. government contracts. Aegis executives say the cross-continent exchange will help India’s call centers keep up during peak Medicare enrollment season and aid the company’s cross-cultural efforts.

    A few employees from the lower Manhattan call center are applying for the temporary transfer. “I’ve never been to India,” said Keith Swindell, 39, a trainer. “I’d enjoy traveling and getting international experience.”

    Glader is a journalist based in New York.

    Pharmacy-Benefit Managers Under Pressure | killexams.com real questions and Pass4sure dumps

    High-priced drugs have everyone ticked off this year. And for good reason. While health-care spending in the U.S. is growing faster than the economy, pharmaceutical costs are growing faster still. New treatments for arthritis and cancer certainly merit a premium, but pharmacy bills can’t grow unchecked.

    A whole industry exists to keep drug bills in check, of course, namely pharmacy-benefit managers, or PBMs. Leaders like Express Scripts Holding and the pharmacy-benefit units of CVS Health and UnitedHealth Group have rung up big profits in recent years while promising to slow the upward trend in drug prices. But the relentless rise raises questions about their effectiveness.

    There are other reasons for investors to wonder about the prospects for PBMs. After rising four times more than the market in the past decade, shares of Express Scripts (ticker: ESRX) got knocked for a loop early this year when the company’s largest commercial client, health-insurer Anthem (ANTM), claimed in a lawsuit that Express Scripts was overcharging it by $3 billion a year. Express Scripts disputes the claims, and the stock has begun to recover. But analysts fear that the PBM will lose Anthem’s business and, with it, as much as 20% of its earnings.

    A broader challenge was the recent launch of the Health Transformation Alliance, a coalition of 30 of the country’s biggest employers who want to get more for their health-care dollars. Their roster includes American Express, Caterpillar, Coca-Cola, IBM, Shell Oil, and Verizon Communications (a list of the first 20 to join appears below). As a group, they spend over $20 billion a year on health benefits.

    Unhappy with the health-care status quo, the companies set an early goal of making prescriptions more affordable for their six million employees. They’d do this by rewriting their pharmacy-benefit contracts to eliminate the undisclosed drug-price markups that supply much of the PBM industry’s profits. Instead, the PBMs would mainly receive administrative fees, which would be significantly lower.

    “That’s clearly not the business model that the big PBMs have today,” notes David Dross, who heads the prescription consulting practice at Marsh & McLennan’s Mercer unit. “It would be asking them to step away from the way that they do business.”

    It could take several years to see whether the alliance members can carve the fat from their PBM contracts. Many of these big companies are probably customers of either Express Scripts or CVS (CVS), which dominate this portion of the marketplace. Their margins would be severely affected. Although it would be hurt by any pricing downtrend, UnitedHealth Group (UNH) has less immediate risk in the alliance’s actions.

    At 79 bucks, Express Scripts shares reflect the Anthem worries. They trade at just 12½ times this year’s expected earnings. Should big customers rebel, however, this pure-play PBM could see its earnings and stock price come down substantially. CVS gets about 39% of its operating income from benefit management and a specialty pharmacy, so it, too, could face a big hit, particularly since it trades at a respectable 17-times multiple. UnitedHealth generates just 16% of its operating earnings from its PBM unit, and, therefore, its 18-times multiple would be vulnerable, but less so than the others. Industry leader Express Scripts has grown tenfold since Barron’s extolled its prospects years ago (“Rx for Prosperity,” Jan. 20, 2003). Those heady days are over.

    THE MAJORITY OF AMERICANS, about 170 million, get their health benefits from their employers. Maintaining those benefits hasn’t been cheap. As we show in the nearby chart, the annual cost of employer-sponsored health care for an American family of four rose 84%, to almost $25,000, over the decade ended in 2015, according to the insurance consultants at Milliman. Drug costs are 16% of the total, a smaller piece than either hospitals or doctors. But the cost of drugs has risen faster than any other health-care expense. It’s up 102% over the same decade. Last year alone, it spiked 14%.

    Big-ticket specialty drugs drove much of last year’s burst. The heaviest burdens aren’t the obscure, outrageously priced pills that earned notoriety for Turing Pharmaceuticals, under Martin Shkreli, and Valeant Pharmaceuticals International (VRX), but rather the medications from mainstream drug companies for prevalent diseases like cancer and hepatitis C, which can easily cost $50,000 for a course of treatment. Many forecasters expect that specialty drugs will account for half of pharmacy bills by 2018.

    Human-resources chiefs like those involved with the Health Transformation Alliance worry that health-care inflation will force their companies to roll back benefits. Another concern is the so-called Cadillac tax contained in the Affordable Care Act, or Obamacare. Starting in a few years, it will hit employers with a 40% excise tax on any health plans that spend more than a certain dollar amount.

    To stem the rise of drug costs, PBMs typically offer a combination of remedies. With the aggregate volume of its health-plan clients, a PBM can negotiate discounts from drugmakers and drugstores. It steers plan members from brand drugs to generics, and from retail stores to mail order. As a result, the PBM guarantees that a health plan will get a fixed discount off drug manufacturers’ list prices. A common example would be 15% off brand prices and 80% off generics.

    Each of these tactics is also a source of profit for the PBM. A drugmaker will pay rebates to a PBM that shifts market share to the drugmaker’s brands by making rival brands more expensive to plan members, or by excluding rival brands altogether. PBMs get deep discounts on generics from manufacturers who want to supply their mail-order business, and from drugstores that want to become part of a preferred retail network. Yet a PBM doesn’t necessarily pass through all of these rebates and discounts to its health-plan clients. The PBM typically won’t tell its clients how much of the discounts the PBM is pocketing. This black-box aspect of the industry has long been a source of gripes.

    A decade ago, health plans started asking PBMs for more-transparent contracts. The PBMs responded by offering such contracts with a smaller savings guarantee, say, 22% off list price, compared with 25% off for a traditionally opaque contract. Come the 2008 recession, however, most plans were willing to revert to the black-box deal, recalls John J. Malley, the leader of pharmacy-benefit consulting at Aon Hewitt.

    These arrangements have served clients well, say PBMs. Express Scripts spokesman Brian Henry says that customers saw their drug spending increase by just 5.2% in 2015, compared with 13.1% in 2014. Health-plan customers that adopted more of his company’s solutions—such as restrictions on drug and pharmacy choices—held their spending increase to 3.3%. CVS, for its part, has said that it kept pharmacy spending growth to 5% last year, compared with 11.8% in 2014.

    CVS BECAME THE SECOND-LARGEST PLAYER in the PBM business when the drugstore chain acquired Caremark Rx in 2006 for $21 billion. The company has gone from strength to strength in recent years, growing revenues to $153 billion in 2015 and earning $5 billion, or $4.63 a share, while paying dividends totaling $1.40 per share. Retail stores accounted for $72 billion in revenues, and pharmacy-benefit services accounted for $100 billion ($19 billion in internal sales was eliminated in the company’s total). Caremark’s pharmacy for specialty drugs, like injectable treatments that need refrigeration, is the biggest in the business. One popular innovation from CVS enables its retail locations to dispense 90-day prescriptions to benefit-plan members, just like a mail-order service.

    Investors have rewarded CVS shares by boosting them by nearly three times the Standard & Poor’s 500 index’s return in the past five years, to a recent $97. Figuring the stock has had its run, Morgan Stanley analyst Ricky Goldwasser downgraded CVS to Equal Weight last month, with a 2016 forecast for earnings of $5.83 per share, and in 2017, $6.54 a share. Her target price is $104.

    One thing prompting her downgrade was the heightened industry competition evident in CVS’ loss of three big pharmacy-services customers to UnitedHealth’s OptumRx unit. The state retirement programs Calpers and Texas ERS, along with General Electric, were big wins for the giant health insurer’s PBM, which became a strong No. 3 in the industry last year with its $13 billion acquisition of Catamaran.

    The OptumRx segment of UnitedHealth had 2015 revenue of $48 billion, but OptumRx can aggressively compete on price with the backing of a parent whose total revenues were $157 billion, with earnings of $5.8 billion, or $6.01 a share. The stock has many fans, including Barclays analyst Joshua Raskin, who has an Overweight rating on the shares, in part due to the company’s multipronged approach to health care.

    EXPRESS SCRIPTS has remained a pure play on pharmacy-benefit management. It runs a big mail-order operation and has the second-largest specialty-drug pharmacy. Revenue growth flattened out in the past few years, with 2015 sales coming in at $102 billion. It earned $2.5 billion last year, or $3.56 a share. Morgan Stanley’s Goldwasser cut her rating to Underweight in June, after concluding that Express Scripts’ falling out with Anthem could cost the PBM as much as 25% of the $7.11 in earnings per share she’d otherwise anticipated for 2018. Her target for the stock, recently $79, is now $70.

    Like Priceline.com and eBay booking revenue for the stuff others sell on their sites, the PBMs claim the drug sales of retail pharmacies for which the PBMs set the drug’s price. Accounting regulators have let PBMs count drugstores’ sales on the PBM’s income statement, under the rationale that the PBM does more than just pass along the health plan’s payments. This accounting treatment also makes a PBM’s profit margins appear more modest. That comes in handy when PBMs encounter complaints that they are “over-earning” for their services.

    Express Scripts has been dogged by questions about whether it makes too much money at the expense of drugstores, drugmakers, and even its health-plan clients. On each of the 1.3 billion prescription claims it handled in 2015 (adjusting all scripts to 30-day equivalents), Express Scripts averaged earnings before interest, taxes, depreciation, and amortization of $5.43 apiece, compared with $3.98 at CVS. Critics argue that Express’ industry-leading profitability comes from overcharging clients like Anthem and selling services to drugmakers, which arguably conflicts with its cost-containment mission.

    The PBM says its work for the drugmakers ensures patients’ access and compliance.

    The Pharmaceutical Care Management Association, a trade group, argues that drug prices would have risen even higher without its interventions, and it published a study in February predicting that PBM customers would save $654 billion on drugs in the next decade.

    One prominent industry gadfly is Linda Cahn, who brought the first class-action suit against PBMs in 1997. The Morristown, N.J.–based lawyer now advises health-plan sponsors about the pitfalls in PBM contracts. In the hundreds she has reviewed, she says almost all let a PBM decide whether a drug is considered a generic or a brand—thereby changing a 78% discount to a 15% discount. Contracts allow PBMs to relabel rebates, so they needn’t be shared with health plans; one PBM had 35 different names for such payments. “Health plans don’t realize they are signing contracts that effectively say, ‘Charge me whatever you want,’ ” says Cahn. “They need to realize they’re getting scalped.”

    In the March lawsuit that Anthem filed in Manhattan’s federal district court, it alleges that Express Scripts is charging Anthem plan members $3 billion a year in excess of prevailing market prices for drugs under the 10-year contract they signed in 2009. Express Scripts’ response, filed in April, disputes that dollar amount while acknowledging that it’s charging Anthem above-market prices in a quid pro quo for the $4.7 billion it paid Anthem to take over the insurer’s struggling PBM unit. Anthem could have gotten a better deal for its members, says Express Scripts spokesman Henry, if it hadn’t wanted so much money up front. While the suit drags on, the PBM will continue to service Anthem members. Executives at both companies have told investors that they won’t back down.

    THE RISING COST OF PHARMACY BENEFITS, with their opaque pricing and hidden spreads, have compelled the companies in the Health Transformation Alliance to pool their resources and seek better deals. One of the HTA’s first projects, says Tevi Troy, its executive vice president for public policy, will be a data warehouse allowing members to compare health-care prices and outcomes. Another project would help health plans better control their drug benefits by separating the PBM services of claims administration, mail order, and specialty pharmacy.

    “All [the HTA] is recommending is stuff that is already in the marketplace,” says Mark Merritt, head of the pharmaceutical care trade group. “But if they can come up with new ways to save money, that’s great.”

    Similarly, CVS says the alliance and its objectives aren’t unique. Spokeswoman Christine Cramer says, “We continue to deliver innovative solutions that improve cost, quality, and access for our clients.” UnitedHealth declined to comment.

    Many previous efforts to tame health-care costs were failures, acknowledges Troy, who was a deputy secretary of Health and Human Services and senior White House aide for George W. Bush. The HTA thinks it can succeed now because data analytics are better and can study million of patients, because it will combine the market power of its big members, and because it doesn’t rely on any government action. “We’re not trying to lasso the moon,” he says. “But we hope to come up with something that works regardless of who wins the 2016 election.” 

    Additional reporting by Travis Arbon.

    E-mail: editors@barrons.com

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    Lotus 190-827 Exam (Administering IBM Workplace Services Express 2.5) Detailed Information


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