#Auto Lifts Installation MA
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nicholdautofab · 1 year ago
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Nichols Auto Fab: Your Premier Off-Road Shop in Prescott, AZ
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Prescott, Arizona, is a paradise for off-road enthusiasts, with its stunning landscapes and rugged terrains waiting to be conquered. Whether you're a seasoned off-roader or a beginner looking to get started, Nichols Auto Fab is your go-to destination for all your off-road needs in Prescott, AZ.
Unleash Your Off-Road Adventure Nichols Auto Fab has been a staple in the off-road community for years, known for its dedication to providing high-quality products, exceptional service, and unmatched expertise. As the leading off-road shop in Prescott, AZ, Nichols Auto Fab offers a wide range of products and services to help you unleash your off-road adventure to the fullest.
A One-Stop Off-Road Shop When it comes to off-roading, having the right equipment and accessories can make all the difference. Nichols Auto Fab offers a vast selection of off-road products, including:
Suspension Systems: Elevate your off-road experience with premium suspension systems that can handle the harshest terrains, ensuring a smoother ride and improved performance. Tires and Wheels: Choose from a wide variety of off-road tires and wheels designed for enhanced traction and durability so you can conquer any terrain with confidence. Bumpers and Armor: Protect your vehicle and enhance its look with rugged bumpers and armor that can withstand impacts and keep you safe on the trail. Winches and Recovery Gear: Be prepared for any situation with high-quality winches and recovery gear to help you avoid sticky situations while exploring the backcountry. Lighting: Illuminate your path with state-of-the-art off-road lighting solutions for nighttime adventures and enhancing your vehicle's appearance.
Performance Upgrades: Whether you're looking to boost your vehicle's power or enhance its overall performance, Nichols Auto Fab offers various performance upgrades tailored to your needs.
Expertise You Can Trust At Nichols Auto Fab, their team of experienced off-road enthusiasts is always ready to provide expert advice and guidance. They understand that the right products are only as good as the knowledge behind them. With their extensive experience, they can help you select the right equipment for your specific needs, ensuring you make the most of your off-road adventures.
Professional Installation and Customization Nichols Auto Fab not only provides top-notch off-road products but also offers professional installation and customization services. Their skilled technicians can ensure that your chosen components are expertly installed, guaranteeing safety and performance. Whether you're looking to lift your vehicle, install new bumpers, or upgrade your suspension, their team has you covered.
Exceptional Customer Service Customer satisfaction is a top priority at Nichols Auto Fab. They are committed to exceptional customer service, and their friendly staff is always ready to assist you. They take the time to understand your unique off-road needs and help you find the right solutions. Nichols Auto Fab believes that happy customers are the key to their success, and they go the extra mile to ensure you are satisfied with your off-road experience.
Community Involvement Nichols Auto Fab is not just a business; it's a part of the off-road community in Prescott, AZ. They actively participate in local off-road events, support community initiatives, and contribute to the growth of the off-roading culture in the area. When you choose Nichols Auto Fab as your off-road shop, you are supporting a business that gives back to the community it serves.
Visit Nichols Auto Fab Today If you're in Prescott, AZ, ready to take your off-road adventures to the next level, look no further than Nichols Auto Fab. As the premier off-road shop in the area, they offer everything you need to enhance your off-road experience, from top-notch products to expert guidance and installation services. Visit Nichols Auto Fab today, and let them help you make the most of your off-road journeys. Unleash your off-road adventure with Nichols Auto Fab, your trusted off-road partner in Prescott, AZ.
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griceshopequipment-blog · 7 years ago
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driscollroman3-blog · 6 years ago
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Participate in! 0.30 For Android.
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The video game is actually an excellent option for smaller sized kids that might yearn for some monitor opportunity however typically aren't ready for a more intricate adventure. In the stepping in years, Illiger has actually remained to update the game and also keep, and it's stays a precious favourite for its own attractive environment and efficient gameplay - a very early example from ways to create a mobile phone video game ideal. Retina-searing fine art design aside, the video game believes that a slam-dunk for any type of follower from timeless platformers. One of our favored components of PlayStation Virtual Reality is actually merely how many other categories of games this has. Arranging birthday party notification is effortless: select the 'Write Information' tab and also you will be rerouted to a page where you may write your birthday celebration notifications. This's clear you'll never find Nintendo activities on iOS, yet PicoPicoGames is actually the second best point: a collection of tiny, addicting NES-like minigames. All your interactions with this game are actually with clicking and also dragging, so this works merely great on a Chromebook. Fantastic Britain get in a staff for the video games which is made up from sportsmens from England, Scotland, Wales and Northern Ireland but throughout guide it is mentioning the England volleyball crew as well as other such rubbish. Directing cabling in the real world provides madness, and so this might not be actually the most intelligent operation making in to an activity played on an unit with a glass display. This's certainly not just what I expected from an author that formulated the rather one-of-a-kind suggestion of the NPCs in computer game being actually active as well as real individuals embeded storage tanks from goo. There were actually absolutely no happy individuals within this publication apart from one, as well as they placed him in a psychological establishment. The small grab is actually a hexagon sits at the top, and also the 2nd this comes under deep space, your game mores than. By comparison, in a problem game time works like an egg cooking timer: fracture a degree just before your patience ends and the timer is flipped; your store of persistence is renewed. Enjoying popular music demands that individuals open up the media gamer or Groove Music application and also pop this sideways from their monitor along with their game. The Hunger Games is high quality YA, smartly created, and also despite its own imperfections this's worthy of effectiveness. This brings in the listing due to the fact that is one of the best addicting and also straightforward games you'll obtain your practical. I kept viewing The Despising Activity on my Twitter, Instagram, and also Goodreads timetable as well as because that is actually been actually collecting higher scores, certainly my inquisitiveness was piqued. Does Not Commute is actually a clever activity that incorporates driving and challenge aspects to offer you along with a suspenseful as well as unique experience. I specifically suched as the opening stock, which provided a concrete capability test surrounding activities like deciding on a word that ought to be actually gotten rid of off a paragraph or testing your callback after reviewing an extract. Quite potentially the most effective LEGO video game to date, LEGO Superstar Wars: The Pressure Awakens is a certain breath of clean Hoth air for the stagnating flick franchise-turned-LEGO game formula.
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Loading Dock Equipment, Commercial Door Products, and Installation Services
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Overhead Door Company of Charlotte, a division of DuraServ, provides Charlotte, Concord, Davidson, Fort Mill, Gastonia, Huntersville, Lake Wylie, Monroe, Mooresville, Rock Hill, and Weddington, NC with loading dock equipment, commercial door products, and installation services. We are a distributor and installer of McGuire loading dock, and Overhead Doors, LiftMaster, and TKO Dock Doors commercial doors.
Call Overhead Door Company of Charlotte today at 704-594-5094 or connect with us online to find out how we can help you.
Commercial Products
Dock Levelers & Lifts
McGuire loading dock levelers include industry-leading features which increase productivity and improve safety to the loading dock.
Mechanical Dock Levelers
McGuire mechanical dock levelers set the industry standard for durability, dependability, and safe operation. Mechanical dock levelers have a single-point adjustment extension spring counterbalance, unlimited float hold-down, an integral maintenance strut, and lip support latch features.
MP Mechanical Leveler
 Hydraulic Dock Levelers
Hydraulic dock levelers provide the highest capacity rating and are designed for busy loading docks. McGuire hydraulic dock levelers are high-performance, low-maintenance, fast, safe, and have an easy push-button operation.
Autodok® H Series Hydraulic Leveler
HP Hydraulic Leveler
 Air Powered Dock Levelers
McGuire Air Powered dock levelers are safe, easy to operate, and with advanced technology used in heavy-lifting industries. It offers a low-maintenance solution and operational efficiency. A simple push-button activation rises the deck effortlessly.
CentraAir® Air Powered Leveler
MA Air Powered Leveler
 Specialty Dock Levelers
McGuire specialty dock levelers deliver reliable powered up and powered down performance.
VSH Vertical Storing Leveler
Portable Steel Yard Ramp
RRH Hydraulic Rail Ramp
 Edge of Dock Levelers
Edge of dock levelers provide accessibility to docks and permit the safe and efficient transfer of products.
 HED Hydraulic EOD Leveler
MEDLF Mechanical EOD Leveler
 Dock Seals & Shelter
Dock seals or shelters cover the gap between a dock and a trailer by creating an extension of a facility that seals the top, sides, and back of a trailer.
Dock Seals
McGuire dock seals create an airtight seal between a dock system and trailer.
TS101 Fixed Head
TS103 Curtain Head
TS500 CWT Adjustable Head
 Dock Shelters
McGuire dock shelters enclose trailer tops and sides for ultimate sealing efficiency. Dock shelters offer reliable performance and protection from compression and reversing trailers.
TC300 Flexible Steel Frame
TC400 Rigid Wood Frame
TC900 Soft Sided
TC1000 Weather Sentry™
 Safety Equipment & Truck Restraints
Loading dock safety equipment prevents dock accidents during loading and unloading.
 Vehicle Restraints
Vehicle restraints keep a truck or trailer stationed at the dock.
Hold-Tite® Push Button Vehicle Restraint
Stop-Tite® Manually Operated Vehicle Restraint
Stop-Tite® Push Button Vehicle Restraint
TPR® Automatic Vehicle Restraint
TPR UniLock® Automatic Vehicle Restraint
 Light Communication System
Light communication systems improve security and productivity at the loading dock.
Edge Lights
Light Communication System (LCS)
 Safety Barriers
Safety barriers protect personnel, goods, and equipment from accidentally rolling off the dock.
Bar Lift Barrier
Barrier Lip Leveler
 Commercial Door Products
Rolling Steel Doors
Overhead Door carries a full line of rolling steel doors including coil-away rolling steel service doors, rolling fire counter doors, rolling steel fire doors, insulated rolling steel fire doors, rolling steel service doors, and rolling sheet doors. Rolling steel doors provide long-lasting performance and are reliable solutions for self-storage facilities, warehouses, pharmacies, hospitals, offices, schools, and retail businesses. 
Overhead Door – Fireking 630 Series – Insulated Rolling Steel Fire Rated Service Door
Overhead Door – Fireking 630 Series – Rolling Steel Fire Rated Service Door
Overhead Door – Fireking 631 Series – Rolling Steel Fire Rated Service Door
Overhead Door – Fireking 634 Series – Rolling Steel Fire Rated Service Door
Overhead Door – Model 600 Coil–Away Rolling Steel Service Door
Overhead Door – Model 610 Rolling Steel Service Door
Overhead Door – Model 620 Stormtite Rolling Steel Service Door
Overhead Door – Model 625 Stormtite Insulated Rolling Steel Service Door
Overhead Door – Model 640 Rolling Fire Counter Door
Overhead Door – Model 641 Stainless Steel Rolling Fire Counter Door
Overhead Door – Model 660 Integral Frame Rolling Fire Counter Door
 Sectional Doors
Overhead Door Company of Charlotte carries Overhead Door commercial sectional doors include aluminum full view sectional doors, insulated sectional doors, steel sectional doors, screen doors.
 Overhead Sectional Doors
Overhead Door™ sectional steel and insulated steel doors are economical, durable, and reliable. An assortment of door panel profiles, track and hardware, and specialized options allows the further customization of doors to your specific project requirements.
Overhead Door – Model 416 Steel Sectional Door
Overhead Door – Model 430 Steel Sectional Door
Overhead Door – Model 418 Insulated Steel Sectional Door
Overhead Door – Model 420 Steel Sectional Door
Overhead Door – Model 422 Insulated Steel Sectional Door
Overhead Door – Model 424 Steel Sectional Door
Overhead Door – Model 426 Insulated Steel Sectional Door
Overhead Door – Model 432 Insulated Steel Sectional Door
Overhead Door – Model 511 Aluminum Sectional Door
Overhead Door – Thermacore 591 Insulated Sectional Door
Overhead Door – Thermacore 592 Insulated Sectional Door
Overhead Door – Thermacore 593 Insulated Sectional Door
Overhead Door – Thermacore 594 Insulated Sectional Door
Overhead Door – Thermacore 595 Insulated Sectional Door
Overhead Door – Thermacore 598 Insulated Sectional Door
Overhead Door – Thermacore 599 Insulated Sectional Door
 Screen Doors
Screen doors are an economical solution for screening bugs, birds, and other unwanted pests from your industrial facility.
Bug Blocker Sectional Screen Door
Screen Pro Roll-Up Bug Door
 Knock Out Doors
Knock out doors, the most rugged option, are designed to prevent damage to door panels and tracks when impacted. Knock out doors are the best solution for damaged dock doors in busy loading docks.
Pflow Model M Vertical Lift System
TKO Cruiserweight Knock-Out Door
TKO Thermalweight Knock-Out Door
TKO Welterweight Knock-Out Door 
 High-Performance Doors
Overhead Door high-performance doors optimize efficiency, improve production flow, operate quickly, raise the number of opening and closing cycles, and require less maintenance and repair cost.
 High Speed Exterior Rubber Door – 990  
High Speed Exterior Rubber Door – 991
High Speed Exterior Rubber Door – 992
High Speed Exterior Rubber Door – 993
High Speed Exterior Rubber Door – 994
High Speed Exterior Rubber Door – 995
 Door Operators
Commercial door operators provide security and reliability for business facilities. Overhead Door and LiftMaster door operators have a compact design, an emergency chain hoist with an electric interlock, and with adjustable friction clutch.
Liftmaster 115v Hoist Logic Operator
Overhead Door RHX™ Heavy Duty Commercial Operators
Overhead Door RMX™ Medium-Duty Commercial Operator
Overhead Door RSX™ Standard Duty Commercial Operator
 Aftermarket Products
Aftermarket products prevent energy loss and ensure dock personnel and equipment are protected from accidents.
 Energy Saving Products
APS LED Guide Lights
APS E-Saver LED Bulb
APS Turbo-ES™ Fan
ENERGY GUARD® Retrofit Kit
G-Flex LED Dock Light™
High Impact LED™ Dock Light
Rytec Turbo Seal INSULATED Door
Serco Energy Guard™
Serco S1000 Ultra Seal w/ fixed head pad
 Equipment Upgrades
APS Air Bag Conversion Kit
APS Flexback Panel
APS Hydraulic Conversion Kit
Industrial Fans
Industrial fans are High-Volume, Low-Speed Fans that efficiently move air through an industrial space. HVLS fans are ideal in climate-controlled and non-conditioned areas.
Aeratron
AirVolution
AirVolution-D 370
AirVolution-D 550
AirVolution-D 780
 Loading Dock Equipment and Commercial Doors Uses
 Auto Dealers
Cold Storage
Distribution Centers
Energy Efficient Facilities
Food & Beverage Plants
High Security Areas
 Industrial Operations
Manufacturing Facilities
Parking Garages
Pharmaceutical Facilities
Retail Businesses
Service Centers
Transportation & Transit
Warehousing Facilities
 North Carolina’s Most Trusted Loading Dock and Commercial Door Distributor and Installer
Overhead Door Company of Charlotte, a division of DuraServ, supplies loading dock equipment and commercial doors products to Charlotte, Concord, Davidson, Fort Mill, Gastonia, Huntersville, Lake Wylie, Monroe, Mooresville, Rock Hill, and Weddington, NC. With skilled technicians, fully equipped service trucks, and an expansive loading dock equipment and door parts inventory, Overhead Door Company of Charlotte is a company you can depend on.
Whether you need a simple part or searching for efficiency and safety improvements to a current loading dock design, turn to Overhead Door Company of Charlotte!
Call Overhead Door Company of Charlotte today at 704-594-5094 or connect with us online to discover safe, smooth, and cost-effective loading dock equipment, commercial door products, and installation services.
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mechanicswichita · 4 years ago
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Best Clutch Replacement Service and Cost in Wichita KS |A1 Mobile Mechanics Of Wichita
More information is at: http://mobilemechanicwichitakansas.org/clutch-replacement-service-near-me/
Clutch Replacement Service near Wichita KS: Are you looking for the Best Clutch Replacement Service near Wichita KS ? A1 Mobile Mechanics Of Wichita, our Transmission Initial Vehicle Check may find your problem is with your clutch and cannot be corrected by external adjustments, repair or replacement of a clutch-related component. Cost? Free estimates! Send us a message or call us today. Best Clutch Replacement Service around Wichita KS. We serve Wichita KS and other areas. Get a Free Quote Now!
BEST CLUTCH SERVICE IN WICHITA KS
WICHITA CLUTCH REPLACEMENT
Clutch Replacement Service Clutch Replacement Service near Wichita KS: At A1 Mobile Mechanics Of Wichita, our Transmission Initial Vehicle Check may find your problem is with your clutch and cannot be corrected by external adjustments, repair or replacement of a clutch-related component.
Our certified, expert technicians will then: ● Remove your vehicle's transmission. ● Inspect the clutch disc, pressure plate, flywheel and related components. ● Replace any required components to meet A1 Mobile Mechanics Of Wichita exacting standards. ● Reinstall of the transmission. ● Refill with fresh, clean fluid. ● Perform a lift check to ensure proper clutch installation and adjustment. At A1 Mobile Mechanics Of Wichita, your vehicle is then road tested to ensure proper clutch operation and your car, truck or SUV is ready to go for miles and miles to come.
The Basics Behind Clutch Replacement Services at A1 Mobile Mechanics Of Wichita
Clutch Replacement Service near Wichita KS: When a vehicle is running, the engine is always turning. The transmission connects to the engine and supplies power to the wheels, but this linkage cannot be constant, since a vehicle is not always moving. In a manual transmission, the clutch is used to engage and disengage the transmission and the engine. The clutch operates two shafts: one shaft connects to the transmission and the other connects to the engine. Clutches use friction to keep the transmission connected to the engine. When the clutch is disengaged, the pressure plate pulls away from the flywheel and separates the transmission from the engine. When the clutch is engaged, a pressure plate pushes against a flywheel and joins the transmission to the engine. In a manual transmission, a clutch allows your engine to continue spinning even when the vehicle is stopped. Switching between gears in a vehicle with a manual transmission is made possible by operating the clutch.
Why Should You Have Clutch Replacement Services Performed at A1 Mobile Mechanics Of Wichita?
Clutch Replacement Service near Wichita KS: Each time you press down on the clutch, the pressure plate pushes against a flywheel, joins the transmission to the engine, and enables gears to be changed. Over time, the friction accompanying this repetitive action will wear down the clutch, pressure plate, flywheel, and accompanying gears and bearings. Owners of vehicles with manual transmissions should always use their clutch with care and keep up with clutch maintenance. A clutch check can help extend the life of your clutch. If your vehicle’s clutch ever fails, the transmission will not be able to transfer power from the engine to the wheels. If you still experience grinding and rumbling noises after components have been replaced and a clutch adjustment has been made, a clutch replacement will be required to restore full operation to your transmission and your vehicle.
Why Choose Road Ready?
● 24 month/24,000 mile warranty ● Interest-free financing ● Offer zero interest for 6 months, subject to credit approval ● Shuttle pick-up and drop-off ● Digital inspections and texting ● Fleet services ● Aftermarket warranties available
Reliable Clutch Repairs For Nassau County Drivers
You’re in touch with your vehicle, which is why you drive a manual transmission car or truck. You coax your vehicle into the right gear, adjusting for speed and power. And when you’re feeling a little spirited, you might shift more aggressively. However, when the engine revs high but your acceleration doesn’t match, your clutch could be worn out. Road Ready in North Bellmore will take care of it.
Clutch repairs often involve removing the manual transmission from the car. Therefore, a clutch repair isn’t a job for the backyard mechanic; leave it to the Exceptional experts at Road Ready. Our ASE-Certified technicians perform clutch repairs on just about any make, from a Dodge Dart or Ford Mustang, to a BMW 3 Series or Mazda3.
The Proper Diagnosis For Lasting Clutch Repairs
Clutch Replacement Service near Wichita KS: Any number of issues can occur. The pilot bearing may be seized, the clutch material could be worn out, or there might be broken springs on the clutch plate. You may hear abnormal noises, or your shifts could be sloppy. Whatever the symptom, address the problem immediately with Quality clutch repairs. You’ll receive the highest level of clutch repair service from the professionals at Road Ready.
Operating since 2001, we understand the need for reliable work, especially on a matter as important as clutch repair. Road Ready utilizes OEM and high-quality aftermarket parts in all our clutch repair jobs, combined with our 2-year/24,000-mile warranty for your peace of mind.
Don't Ignore The Problem
Is your clutch slipping? Are you finding it difficult to shift gears? If so, your car or truck may be long overdue for a clutch adjustment or repair. At A1 Mobile Mechanics Of Wichita, we offer comprehensive clutch repair services for both domestic and foreign cars and trucks.
Serving Your Needs
Clutch Replacement Service near Wichita KS: At A1 Mobile Mechanics Of Wichita, we believe that our customers deserve outstanding service and fast, efficient repairs. We'll do everything possible to keep your car or truck running smoothly and reliably for years to come. So don’t trust your car or truck to just anybody. Call the auto repair specialists you can count on to handle each job with skill and integrity. Contact us today for an estimate or to schedule your clutch repair service.
Tips to Remember
● Most newer vehicles are fitted with a dual-mass flywheel, which is designed to absorb vibration from the clutch, and provide smoother vehicle operation. The downside is that they can be expensive when it comes time for replacement - the workshop will carry out an inspection of the flywheel and provide a quote for replacement, if required ● If you are towing larger loads such as caravans or large trailers, it may be worthwhile to upgrade to a heavy-duty style clutch that will be able to handle the extra load without failing prematurely, as factory clutches are not designed for extended towing use. The downside to installing a heavy-duty clutch is increased pedal pressure required to operate the clutch.
COST
Clutch Replacement Cost   How Much Does a Clutch Replacement Cost?
Clutch Replacement Service near Wichita KS: If you are dealing with problems with your auto’s clutch, you will be in for expensive repairs. The average clutch replacement cost is around $1,200 to $1,400, which includes both parts and labor. While that figure alone is not as high as some other repairs, it is still enough to make you think twice. Additionally, it is common for your clutch repair to be just one of several repairs your mechanic completes at once, adding to the out-of-pocket expense.
What Is the Clutch and Why Does It Matter?
The clutch is easily among the most important components of your auto, and if you do not have a functional clutch, you will find your auto impossible to drive. The clutch is responsible for connecting the transmission and the engine of your auto. The clutch must separate as well as connect since the engine runs at times that the wheels do not turn. Both manual and automatic transmissions have the same parts in their clutch, although automatics do have more clutches.
What Parts of the Clutch Factor Into the Cost of Clutch Replacement?
Clutch Replacement Service near Wichita KS: There are three major internal components of the clutch. These are the throw-out bearing, the pressure plate, and the clutch disc. All three are necessary for the clutch to function properly, and most clutch replacements will involve replacing all three of the components. In most cases, the clutch replacement will involve replacing the clutch disc, releasing the pilot bearing, and replacing or resurfacing the flywheel. It can also include replacing the clutch pressure plate and clutch bushing.
How Long Does a Clutch Usually Last?
Clutch Replacement Service near Wichita KS: If your car is getting older, then you need to know when to start looking at the replacement clutch cost. The clutch is designed to last for a long time, and it should last at least 50,000 miles, assuming you drive in normal conditions. In the case of newer autos, you may have a clutch that can last 80,000 miles or even 100,000 miles. On the other end of the spectrum, vehicles that deal with heavy strains, such as trucks that regularly haul loads, will need their clutch replaced sooner. In this case, you may need a replacement in just 35,000 miles. Since every car is slightly different, you should check your owner’s manual to see your recommended replacement interval.
Breaking Down How Much Clutch Replacement Costs
Clutch Replacement Service near Wichita KS: As mentioned, the average clutch replacement cost will be $1,200 to $1,400. Of this figure, the parts usually cost $700 to $750, with labor accounting for $500 to $650.
Depending on where you live, however, the average clutch replacement cost may drop to closer to $800. In some autos, you may only have to pay $400 or so for the materials. The cost will go down if only some components of the clutch require replacement instead of all of them. Most of the time, your mechanic will need to replace your throw-out bearing, clutch disc, and pressure plate. There will also be the need to replace two more cylinders for hydraulically operated clutches. The clutch slave cylinder replacement cost and the clutch master cylinder replacement cost can be as low as $20 to $50 each, but just for parts. You also need to factor in labor.
What Affects How Much Clutch Replacement Costs?
Clutch Replacement Service near Wichita KS: With such a wide range of potential prices for your clutch replacement cost, there are obviously multiple factors that affect what you will have to pay. The most important ones are:
● The make and model ● Automatic versus manual transmission clutch replacement cost ● Whether slave and master cylinders need to be replaced ● Whether it is a hydraulic clutch ● Whether you have a hybrid, which requires removing the trunk access panel ● If you opt for used or new parts ● Your location ● The mechanic you go to ● The warranty that the clutch replacement comes with ● Whether transmission service is also included ● Other services included, such as working on the torque converter clutch.
FREQUENTLY ASKED QUESTIONS
What is a Clutch? A clutch is a disc made up of a round metal plate with friction material riveted or bonded onto each side.
Is a clutch just one component?
A clutch is actually composed of at least 3 standard components with the variance of a fourth component: 1. Pressure plate; 2. Clutch disc; 3. Release bearing; 4. Pilot bearing (most vehicles).
How long should my clutch last from brand new?
In most cases the life of a clutch should see approx. 100,000 km all the way up to 160,000 km, depending on what model car and of course, how hard the vehicle is driven.
How long should I expect to be without my vehicle if the clutch fails?
When you have an appointment booked through A1 Mobile Mechanics Of Wichita we try our best to offer same day turnaround service, assuming no more than normal damage has been done to the components. If your vehicle’s clutch fails suddenly and you show up without an appointment booking, we offer a rush service designed to complete service on your vehicle within 48 hours, up to 4 days maximum.
If my car’s clutch is slipping, how long can I continue to use it before the vehicle won't drive anymore?
It is not a good idea for any clutch repair shop to predict how much longer a clutch should last if it already shows signs of slipping. It is likely that if the slipping just became noticeable that there will be some grace period before the vehicle is no longer operable. That being said, A1 Mobile Mechanics Of Wichita does not advise a vehicle owner to attempt to stretch the life of an already slipping clutch. If you can afford to replace the clutch, it should be done as soon as possible.
How much does it normally cost to have my clutch replaced through A1 Mobile Mechanics Of Wichita?
In most 2-wheel drive (rear wheel drive) vehicles we see an average cost of $850 for parts and labor. If the vehicle is a sports car or performance vehicle the costs can increase by another $50- $200. If the vehicle is a standard front wheel drive car, A1 Mobile Mechanics Of Wichita offers parts and labor starting at $799. Some newer or all-wheel-drive clutch jobs average out to be approximately $850 - $1050 after parts and labour. Certain exceptions will apply; please contact us for an accurate quote.
Do I still need a complete clutch replacement if my clutch pedal feels like it has little or no resistance or if it is stuck on the floor?
In most cases the answer is NO. Most clutches are operated by hydraulics so if one of the hydraulic cylinders or hoses has gone bad, A1 Mobile Mechanics Of Wichita can repair this problem too. The good news is the cost of a cylinder or hose is roughly 20% of the cost of a replacement clutch. This job takes far less time and can easily be performed the same day.
What are the Symptoms of Failing Clutch Components
● Hard to select gears ● Engine RPM increasing with no increase in vehicle speed ● Burning smell from vehicle ● Clutch pedal not returning ● Unable to depress clutch pedal ● Shudder when changing gears ● Clutch Disc
How is a Clutch Replacement carried out?
Our mechanics will remove the transmission of the vehicle, and replace the clutch and pressure plate, and the flywheel and slave cylinder (If required, at additional cost) The clutch fluid will be changed, a bedding in procedure will be carried out, and a test drive completed, to ensure correct operation of the system.
Depending on the style of your vehicle, the labour time may vary as many 4WD and SUV models have complicated drive-train and transmission setups that are very labour intensive to remove and refit.
Why It’s Important to Have Your Clutch Inspected or Replaced?
Having your clutch system inspected and repaired is vitally important for the safety of you, your family and other motorists around you.
If you continue to operate your vehicle with a failing clutch, it may leave you stranded on the side of the road with no drive, or leave you unable to accelerate properly, making you a danger to other motorists.
Ignoring the warning signs can also lead to expensive repair bills, as further damage may be caused by continuing to operate your vehicle with an issue.
If you've read this far, you obviously care about your car. A lot. So next time you need a service, repair or inspection, visit A1 Mobile Mechanics Of Wichita. We let you search and book from over 1,600 qualified mechanics, who eat car troubles for breakfast.
Why do cars need a clutch?
Imagine if the engine were to be always connected to the transmission via a set of gears. What would have happened when you started the engine? Since ‘spinning’ the engine would mean turning the wheels as well, because they are always connected, the starter motor would have had to lug the car forward each time you started the engine! That would certainly have damaged the starter after a few such starts.
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BEST CLUTCH REPLACEMENT SERVICE IN WICHITA KS A1 MOBILE MECHANICS OF WICHITA REQUEST MORE INFORMATION. CONTACT US NOW!
Contact us: A1 Mobile Mechanics of Wichita 24-hour mobile mechanic roadside assistance services in Wichita, KS! CALL: (316) 201-9247 MOBILE MECHANIC WEBSITE: www.mobilemechanicwichitakansas.org Service Area: 55 Cities within 30 miles of Wichita, KS: Andale, KS | Andover, KS | Argonia, KS | Augusta, KS | Belle Plaine, KS | Bentley, KS | Benton, KS | Buhler, KS | Burns, KS | Burrton, KS | Cheney, KS | Clearwater, KS |Colwich, KS | Conway Springs, KS | Danville, KS | Derby, KS | Douglass, KS | Elbing, KS | Garden Plain, KS | Goddard, KS | Greenwich, KS | Halstead, KS | Harper, KS | Haven, KS | Haysville, KS | Hesston, KS | Hutchinson, KS | Kechi, KS | Maize, KS | Mayfield, KS | Mcconnell AFB, KS | Milan, KS | Milton, KS | Mount Hope, KS | Mulvane, KS | Murdock, KS | Newton, KS | North Newton, KS | Norwich, KS | Peck, KS | Potwin, KS | Pretty Prairie, KS | Rock, KS | Rose Hill, KS | Sedgwick, KS | South Hutchinson, KS | Towanda, KS | Udall, KS | Valley Center, KS | Viola, KS | Walton, KS | Wellington, KS | Whitewater, KS | Winfield, KS | Yoder, KS ZIP CODES: 67001 – Andale | 67016 – Bentley | 67017 – Benton | 67020 – Burrton | 67025 – Cheney | 67026 – Clearwater | 67030 – Colwich | 67031 – Conway Springs | 67037 – Derby | 67039 – Douglass | 67050 – Garden Plain | 67052 – Goddard | 67055 – Greenwich | 67060 – Haysville | 67067 – Kechi | 67101 – Maize | 67106 – Milton | 67108 – Mt Hope | 67110 – Mulvane | 67118 – Norwich | 67120 – Peck | 67133 – Rose Hill | 67135 – Sedgwick | 67147 – Valley Center | 67149 – Viola | 672xx – Wichita | 67204 – Park City or Wichita | 67219 – Park City or Wichita | 67220 – Bel Aire or Wichita | 67221 – McConnell AFB | 67226 – Bel Aire or Wichita | 67543 – Haven
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localocksmithnearme · 4 years ago
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Lincoln Ignition Repair & Key Replacement Boston MA
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Lincoln Ignition Repair & Key Replacement Boston MA - CALL (857)930-4612
http://www.bostonkeyreplacement.com/lincoln.html
Boston Key Replacement extends a mobile Lincoln locksmith service in Boston MA and next door area applicable 24hrs. Well-informed in Lincoln replacement keys and lockouts, our workforce can repair, replace and program Lincoln lock or ignition difficulties besides key creation for immobilised and older Lincoln. Whether you want to open your motor vehicle door, would like to replace a lost transponder key, want to duplicate a switch blade key or need a proximity key programmed, our  car locksmiths masters are on a line of duty anytime you need able to arrive to your place of choice promptly with a work van decked with advanced key programmers, lock-picking tools and diagnostic equipment besides blank fobic keys, smart keys and transponder keys for any Lincoln year and model.
Lincoln replacement keys in Boston MA
One of the major element of any Lincoln is it's keys and locks system, which will need to be re keyed if lost or deteriorated. When this kind of a issue arises we, at Boston Key Replacement, in Boston MA, are absolutely skilled to monitor all patterns of lock, key or ignition difficulties on-site.
Lincoln transponder key is specially compiled to ignite an explicit car and our highly skilled team members can originate Lincoln VATS, Tibbe, smartkey or passive anti theft keys, as well as repair, replace or install any type of locks, ignition and keys onsite 24 hour 7 day a week 365 days a year.
About Lincoln keylock technology
Lincoln vehicle brand was constructed by the American manufacturer of cars Ford Motor Company in Dearborn, Michigan. The brand was 1st sold in the United States of America in 1918 as luxury vehicles. Since 1997  Lincoln vehicles combine.accommodate P.A.T.S keys that can be cloned in a comfortable and economical process, yet recent vehicles adopt coded transponders that must be programmed to the car employing a unique diagnostic hardware and if all keys are misplaced, the car's computer must be bootstrap.
Latest vehicles starting from year 2007 consistently decked with the contemporary stylish Intelligent Access System smartkey with features such as keyless entry, blind spot data and push-button start platforms.
Ignition switch repair
When drivers locking and unlocking the ignition cylinder countless of times, it is certainly natural to endure some sort of ignition trouble and the symptom might be key turn freely in the ignition, dash board lights blinking, ignition key is stiffly turning and key is stuck in the ignition switch and you cant fire up your car.  
The reason for those burdens could be a dilapidated key or an ignition switch issue and for one and the other scenarios, ignition replacement or repair is a task for a virtuoso technician, so we urge not to try to fix the ignition switch by incompetent person since it may going to cause a larger hardship.
</p> <h5>Decaying Lincoln ignition key</h5> <p> Bumping into issue is due to a battered key, simply cloning the key going to likely transfer the malfunction to the new duplicated key. In lieu of copying the bad key data, a trained car key-smith has to employ dedicated Lincoln programmers, cutters and diagnostic tools to generate a brand new key utilizing the vehicle identification number.
</p> <h5>Broken Lincoln ignition switch</h5> <p> Bumping into issue is due to the ignition switch, it might be due to dust or obstacle captured in the ignition key-tunnel or may be a detach or broken pin or spring inside the ignition switch restricting the ignition from turning. Using dedicated ignition diagnostic, repairing and troubleshooting appliances a key-smith will need to extract any dust or obstacle from the inside of the key-tunnel rekey or strengthen ignition switch or maybe even replace the ignition overall.
Transponder chipped key make
20 years ago and maybe even earlier, almost all automakers has began outfitting mandatory digitized immobilised vehicle ECM and chipped keys key and lock in their vehicles as an additional measure to eliminate car larceny.
The key contain a chip, programmed with an exclusive inscribed identification number and the ECM programmed with the same identification number. Once the key is slides inside the ignition key crack, the key send a radio frequency encoded signal to the car computer module. If the encrypted signal does not identified, the car computer module demilitarize the fuel injection and the vehicle wouldn't run.
The drawback of utilizing  digitized chipped keys and immobilised engine control unit keys and locks is that in nearly all circumstances to restore a stolen or lost key, the immobilizer need to be re-coded by appropriate programmer which implies that you will must hire a vehicle lockman or tow your vehicle to the dealership.
Lincoln keyless entry
Proximity key remotes, also known as (RKE or RKS) anable owners to lock and unlock their car or truck clicking the remote and moreover other components like releasing the trunk or kindling the front-facing fog lights to boost visibility at night or in cold weather. Likewise, a lot of the present-day keys include remote starting feature which is appear to be standard on contemporary cars.
Exceedingly all smart-keys include a proximity-radar platform that is activated when the keyless device located within a set range of the vehicle. This Keyless entry are hands-free meaning that the car can be locked and unlocked or deactivate and run the car without owners input.
Copy vs lost car keys
Present-day Lincoln key lock structure contains transponder key and car immobiliser and although transponder keys come in a variety of key-fob, switch blade key, smartkey and laser cut keys, the primary idea behind this structure is that the chip send a signal to the receiver in the car. If the receiver does not detect a suitable signal, the fuel injection will demilitarize and the vehicle wouldn't burst.
A few earliest cars keys could be comfortably copied utilizing dash-board process, although generally to duplicate a surplus key, the chip in the key has to be decoded by a suitable programming machine carried by the dealer-ship or a locksmith.
If the key is stolen or lost, the ECU has to be re programmed to accept the new key and reject the old one. This process dispenses a safety factor insuring the disabling of the stolen or misplaced key. This key recovery, instrumentation available only to the Lincoln dealership or a licensed locksmith, which means that you’ll must hire a car key smith or tow your vehicle to the dealership.
Twenty four hour car lock-out
When you locked your keys in the car, the first thing to understand that with newer vehicle electric locks and airbag wires it can be remarkably risky attempting to slim-jim car door by a non professional hands.
Our agents can cautiously handle majority of kind of car lock-outs employing particular lock pick tools to conform any motor vehicle lock-out problem you are going through in no time.
Car locks updating
Boston Key Replacement is illustrious to impart all type of Lincoln re key services at your location to shift a broken, lost or pinched keys. Nearly every contemporary vehicle are provided with electric locks and key system and the process vital to get your lock adapted ought to contain the good programmer for the precise vehicle. Instead of dragging your car to the dealer, just elevate the phone and call our central office in Boston MA and one of our car adapting employees will be with you as fast as possible with a unstationary service truck consisting modern programmers, key cutters, ignition parts and blank keys ready to work out any kind of emergency occasions.
Lastly
We are working 24 hours a day 7 days a week with the agilest nimblest response time in town. If you locked out of your car, can't find the keys to your vehicle or need to program a new remote and wish eliminate the towing truck to the dealer-ship, lift your cellphone and call us at (857)930-4612, share data abount your model, year, auto manufacturer and your address. Our thoroughly equipped local staff members will respond expeditiously replace your ignition, open your locked car or recover your lost key on site and let you back inside your car in a flash with cost effective rates. . If you’re searching for Car key replacement service in Boston Massachusetts call (857)930-4612 for a reliable local automotive locksmith, who duplicate and replace trunk, door and ignition keys and remote fob made on the spot.
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voituresetmotos · 5 years ago
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Après un million de kilomètres, cette Nissan Frontier 2007 ressemble toujours à une toute nouvelle
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Bradley Brownell Hier 19h00 • p Nissan Frontier 46.7K 145 2 Photo: Nissan Pendant le Salon de l'auto de Chicago, qui devrait s'ouvrir dans deux jours, Nissan aura cette délicieuse Frontière marron sur son stand. Il sera assis juste à côté des nouvelles frontières qui ressembleront plus ou moins à cela, car la série D40 a fait ses débuts en 2004 et les soldats aujourd'hui avec un peu plus qu'un petit lifting. La différence entre une toute nouvelle Frontier et ce joyau appartenant au chauffeur-livreur Brian Murphy? Murphy’s a accumulé plus de 76 000 milles par an! Selon le propriétaire, il était assis derrière le volant de cette transmission manuelle à 4 cylindres à 2 roues motrices Red Brawn King Cab, qu'il a achetée neuve en 2007 pendant environ 50 000 heures. Si vous faites le calcul à ce sujet, c'est une moyenne de 20 miles par heure, y compris les arrêts de livraison. L'homme est un démon de la vitesse! Et une putain de légende pour démarrer. Un million de kilomètres, et c'est un bâton! «Je ne doutais pas que ce camion atteindrait un million de kilomètres. Il est difficile et permet une excellente économie de carburant, exactement ce dont j'ai besoin pour faire le travail », a déclaré Murphy. «Je change ma propre huile tous les 10 000 milles et je conduis prudemment. Rien de majeur n'a été remplacé sur ce camion, c'est vraiment quelque chose. » Cet entretien a été essentiel pour que le camion fasse ce type de kilométrage. Murphy dit que le camion a toujours son moteur et sa transmission d'origine. Il a réussi à faire en sorte que l'embrayage dure 801 000 milles et a remplacé prophylactiquement la chaîne de distribution à 700 000 milles. Le radiateur et l'alternateur étaient relativement de mauvaise qualité et ne réussissaient qu'à parcourir 450 000 miles avant de devoir être remplacés. Avec ce type de kilométrage, je voudrais installer l'un de ces sièges à absorption d'air que les conducteurs d'autobus et les camionneurs long-courriers utilisent. Mais Brian a assis son cul dans le siège d'usine Nissan pendant tout ce temps. Finalement, obtenir un siège d'usine de remplacement à environ le demi-million. Vraisemblablement, le camion a besoin d'un autre siège maintenant. «Brian Murphy est le parfait client Frontier. Il est encourageant d'entendre des histoires exceptionnelles comme celle-ci et de savoir que nos véhicules servent les clients de manière fiable - et encore moins pour un million de kilomètres », a déclaré Tiago Castro, directeur, Nissan Commercial Vehicles. Murphy est chauffeur-livreur depuis 45 ans dans la grande région de Chicago. Il a commencé à travailler comme chauffeur indépendant indépendant en 2007 en achetant ce camion. Murphy dit qu'il n'a jamais utilisé une application de recherche de routage ou un appareil GPS, et il n'a également jamais reçu de citation pour des violations de mouvement. Murphy a 63 ans maintenant, et le camion est probablement prêt à être mis en pâture dans un musée Nissan ou quelque chose comme ça. Lui et sa famille ont été invités au Chicago Auto Show par Nissan. Je suppose que l'entreprise présentera à Murphy une nouvelle frontière, mais ne serait-ce pas plus cool si elle proposait simplement de payer Brian pour qu'il ne soit plus obligé de travailler? Peut-être qu'il pourrait être une sorte de porte-parole de la marque qu'il connaît intimement. Si Nissan envisageait d'introduire une toute nouvelle Frontier dans un avenir proche, ne serait-ce pas une bonne idée d'avoir M. Murphy comme preuve testamentaire des capacités d'une Frontier? "Mon camion mérite de se reposer, mais je dois rester occupé", a déclaré Murphy. C’est la citation la plus triste que je pense avoir jamais vue. Bradley Brownell publie sur Twitter un contributeur Jalopnik avec un amour pour tout ce qui est sommaire et éclectique. Partagez cette histoire h4 Abonnez-vous Plus de Jalopnik GM n'était pas de confiance pour ne pas virer à l'administration Trump: Signaler quand les clignotants sont passés du blanc à l'ambre "Une agitation inattendue" s'est emparée de la nation La Cadillac Escalade 2021 est de bon goût et très technologique Partager Tweet
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lauramalchowblog · 5 years ago
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9 Healthcare Companies Who Changed the 2010s
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By ANDY MYCHKOVSKY
In order to celebrate the next decade (although the internet is confused whether its actually the end of the decade…), we’re taking a step back and listing our picks for the 9 most influential healthcare companies of the 2010s. If your company is left off, there’s always next decade… But honestly, we tried our best to compile a unique listing that spanned the gamut of redefining healthcare for a variety of good and bad reasons. Bon appétit!
1. Epic Systems Corporation
The center of the U.S. electronic medical record (EMR) universe resides in Verona, Wisconsin. Population of 13,166. The privately held company created by Judith “Judy” Faulkner in 1979 holds 28% of the 5,447 total hospital market in America. Drill down into hospitals with over 500-beds and Epic reigns supreme with 58% share. Thanks to the Office of the National Coordinator for Health Information Technology (ONC) and movement away from paper records (Meaningful Use), Epic has amassed annualized revenue of $2.7 billion. That was enough to hire the architects of Disneyland to design their Google-like Midwestern campus. The other amazing fact is that Epic has grown an average of 14% per year, despite never raising venture capital or using M&A to acquire smaller companies.
Over the years, Epic has been criticized for being expensive, non-interoperable with other EMR vendors, and the partial cause for physician burnout. Expensive is probably an understatement. For example, Partners HealthCare (to be renamed Mass General Brigham) alone spent $1.2 billion to install Epic, which included hiring 600 employees and consultants just to build and implement the system and onboard staff. With many across healthcare calling for medical record portability that actually works (unlike health information exchanges), you best believe America’s 3rd richest woman will have ideas how the country moves forward with digital medical records.
My very first interview out of undergrad was for a position at Epic. I chose a different path, but have always respected and followed the growth of the company over the past decade. In a world where medical data seems like tomorrow’s oil, a number of articles have speculated whether Apple or Alphabet would ever acquire Epic? I don’t buy it. I’m thinking it’s much more likely that 2020 is the first year they acquire a company. How you doing Athenahealth?
2. Theranos
No one can argue Theranos didn’t change the game in healthcare forever… for the worse. I do my best to give all healthcare founders the benefit of a doubt, but Elizabeth Holmes and Ramesh Balwani make that nearly impossible. Turns out that an all-star cast of geopolitical juggernauts on your Board of Directors and the black turtleneck of Steve Jobs is not the recipe for success. Founded by 19-year Elizabeth Holmes, Theranos raised over $700 million at a peak valuation of $9 billion. In retrospect, they have become the poster-child for Silicon Valley’s over-promise and under-deliver mantra. The only problem is that instead of food delivery, their failures resulted in invalid blood testing that could’ve really hurt people.
Despite this failure, the mission and purpose would’ve been tremendously impressive. Cheaper blood tests that require only 1/100 to 1/1,000 the amount of blood that LabCorp or Quest Diagnostics needed. I think the craziest part of the whole saga was that seemingly sophisticated healthcare leaders thirsted for the new technology to beat competitors and improve patient convenience. Before the technology was proved defunct, Theranos convinced Safeway to invest $350 million to retrofit 800 locations with clinics that would offer in-store blood tests. Theranos convinced Walgreens to invest $140 million to develop a partnership that would help beat CVS. Theranos partnered with Cleveland Clinic to test its technology and was working with AmeriHealth Caritas and Capital BlueCross to become their preferred lab provider.
To be clear, they weren’t the first, and won’t be the last healthcare company to fail. I only hope that this extremely well documented (thanks Hollywood) experience has re-focused founders and investors towards building sustainable growth companies that actually help patients live higher quality lives, not just make people money as quickly as possible.
3. One Medical
Thanks to Tom Lee and the One Medical crew, primary care is now investable. Whether you’re talking about private equity or venture capitalists, many have dived head first into the space in search of value-based care treasure. One Medical is the most well-known tech-enabled primary care practice, with 72 clinic locations across seven states, and new locations opening in Portland, Orange County, and Atlanta. The Carlyle Group liked the company so much that it invested $350 million in August 2018, at a reported $1.5 billion valuation. This has led to a number of primary care focused companies (ChenMed, Iora Health, Forward) to amass significant valuations that historically would’ve seemed optimistic. However, the elevation of the primary care provider from the “punter” to the “quarterback” of a patient’s medical journey has lifted all boats.
Interestingly, One Medical has unique differentiators over the traditional primary care competitors. For example, One Medical limits doctors to seeing 16 patients a day, versus the average physician seeing 20-30 patients a day. One Medical also built its own medical records in hopes of a more user friendly experience, instead of outsourcing to practice-based EMRs. One Medical charges $199 annually to each patient to help make up for lower volume, and in return provides same-day appointments, onsite lab draws, and a slick app that allows online appointment scheduling and telehealth consults with providers 24/7. They are also adding capabilities and services to cover mental health and pediatric services to increase revenue.
This change is remarkable. Historically, primary care has been a low-margin business with high administrative and staffing costs, along with physician burnout and regulatory burden. One Medical pioneered the concept of a more modern primary care experience, and I am looking forward to their initial public offering (IPO) targeted for early 2020 and whatever Tom Lee is cooking up at Galileo.
4. Centene
Centene is my favorite health plan to study over the past decade. You would never know that the second largest publicly-traded company headquartered in Missouri was originally started by Elizabeth “Betty” Brinn in Milwaukee, Wisconsin. Under-hyped, which is rare in healthcare nowadays, Centene has quietly grown to become the largest player in both the Medicaid managed care and Affordable Care Act (ACA) exchanges. Under Michael Neidorff’s leadership, Centene now serves 32 states with over 15 million lives and 53,600 employees. They were most recently ranked #51 on the Fortune 500 list. In addition, they are about to grow with the $17.3 billion acquisition of WellCare. Here’s a brief rundown of some major events that demonstrate why I’m so bullish on Centene dominating another decade:
April 2018: WellCare and Centene awarded Medicaid managed care contracts in Florida.
July 2018: Centene acquires Fidelis Care and their 1.6 million New Yorkers for $3.75 billion. This single-handedly gives Centene the leading Medicaid share in the state.
September 2018: WellCare acquires Meridian Health Plan and their 1.1 million lives in Michigan, Illinois, Indiana, and Ohio, for $2.5 billion.
February 2019: Centene and WellCare awarded Medicaid managed care contracts in North Carolina.
December 2019: WellCare awarded Medicaid managed care contract in WellCare (re-procurement underway)
In addition, Texas Medicaid is set to award their STAR contracts for 3.4 million lives between Medicaid and CHIP, of which Centene already won a contract to serve the STAR+PLUS (aged, blind, and disabled population). Seems like a pretty solid guess that Centene will fair pretty well in the STAR RFP rankings. Next decade, I look for Centene to significantly increase their efforts to recruit Medicare Advantage (MA) lives, and I wouldn’t bet against them.
5. Mylan
One word. EpiPen. Mylan, the $10 billion market cap pharmaceutical manufacturer and producer of the epinephrine auto-injector product, EpiPen, became the lightning rod in a consumer and political drug pricing debate in 2016. For those who were living under a rock, here’s the quick recap. Epinephrine auto-injectors are used to treat anaphylaxis (severe allergic reaction). Prior to 2016, Mylan held absolute dominant share of the auto-injector market, hovering around 90% for the first half of the 2010s. The only real competitor was Adrenaclick, produced by Lineage Therapeutics, but they were barely considered a competitor despite having cheaper prices. In 2016, news outlets caught wind of Mylan’s 500% list price increase over a decade ($100 to $600) and a nationwide discussion about drug prices began.
If you asked the Mylan CEO, Heather Bresch, she would tell you that the reason brand EpiPen’s list price increased 500 percent over 7 years is because they invested billions of dollars to significantly increase access in schools and employers across America. These efforts increased the number of EpiPen prescriptions in the U.S. from 2.5 million to more than 3.5 million between 2011 and 2015. She would also tell you that there is a big difference between wholesale acquisition cost price (list price) and net price. This part is often misunderstood by media. The net price takes into account discounts, prescription savings cards, and rebates that Mylan provides to purchasers (PBMs, Employers, Plans). The exact negotiated rebate or discount is different by line of business and organization. However, safe to say that Mylan made a good amount of profit with increasing volume.
At the end of the day, Mylan settled with the U.S. Justice Department for $465 million over claims it overcharged the government. Mylan kept their $600 list price brand EpiPen product with rebates, and added a generic version of EpiPen for $300 list price without rebates and requiring commercial insurance. According to a GoodRx analysis in 2018, the epinephrine auto-injector market now looks much different, with 60% of the market moving to the generic version of EpiPen, 10% of the market remaining with brand EpiPen, and 30% of the market switching to the generic version of Adrenaclick. However, whether generic or brand EpiPen, Mylan makes strong profits and American will continue to discuss the best strategy forward to control drug spend.
6. Evolent Health
First let me caveat. I’ve worked for Evolent Health for the past 5 years and seen it grow from a Series B startup to a publicly-traded company (NSYE: EVH). However, the reason they’re on this list is because Evolent Health has forever changed the game for future value-based care startups. When Frank Williams, Seth Blackley, and Tom Peterson founded the company in 2011 with the help of UPMC Health Plan and The Advisory Board Company, concepts like the Medicare Shared Savings Program (MSSP) did not even exist. Fast forward a decade later, and Evolent Health now serves approximately 3.7 million lives across 35 different U.S. healthcare markets. The mission of Evolent Health is to, “Change the health of a nation, by changing the way healthcare is delivered.” To do this, you need both the technology, clinical, financial, and operational capacity to empower providers to confidently move away from fee-for-service towards fee-for-value.
With the implementation of MACRA and the continued perseverance of CMS under this new administration, value-based care is still full steam ahead (good luck incoming CMMI Director, Brad Smith). Despite the naysayers of value-based care, find me a better way to control medical inflation that is accepted by nearly all healthcare institutions and doesn’t negatively impact patient outcomes, and we can talk. I will mention the importance of “significant” downside risk to actually change provider culture, strategy, and operations. I don’t want the primary purpose of setting up a clinically integrated network (CIN) to be negotiating higher fee-for-service commercial rates for independent physicians aligned to tertiatiary academic medical centers.
I wholeheartedly believe that providers will continue to seek partner options (not vendors with high fees independent of performance) who are not wholly-owned by the large for-profit health plans (Optum…). Of all the available options, Evolent Health is the market leader across a variety of areas. In 2020, I look forward to watching how the 3,000+ Evolenteers push the boundaries of downside risk value-based care with both payers and providers.
7. Livongo
To me, Livongo represents Daenerys Targaryen in Game of Thrones. Not the blood-thirsty character towards the end, but the only person to bring back dragons to the world of Westeros. Except in this example, the dragon is a successful digital health IPO. This was a big deal. Going public rewarded early investors who believed in the nascent digital health and chronic condition space. It allowed public investors an opportunity to peak under the hood of the financials and get comfortable with future economics of the industry. And it provided a legitimacy and a peer valuation to other leading digital health companies like Omada Health. All-in-all, 207,000 members use Livongo for Diabetes management solutions, including a connected glucose monitor, unlimited test strips, and personalized health coaching. This number is expected to grow significantly, with the announcement of a new, two-year diabetes contract with the BlueCross BlueShield Federal Employee Program (FEP). They anticipate the partnership will add an additional $50-60 million in revenue across 2020 and 2021
Livongo has done a brilliant job marketing itself as building a full-stop solution for the 147 million Americans with a chronic condition. According to their estimates, their immediately addressable markets for managing diabetes and hypertension represents a $46.7 billion opportunity. Digging into the unit economics, Livongo estimates that diabetes is worth $900 per patient per year and $468 per patient per year. Since they’re focused on chronic conditions, the business model is subscription-based. In the Q3 quarterly report, Livongo provided full year guidance of $168.5 million on the low end and $169 million on the high end. In either scenario, FY2019 Adjusted EBITDA is projected to lose around $26 million for the year.
Livongo has smartly started with addressing diabetes, given the downstream health impacts of mismanagement of blood sugar and the ability to impact spend with regular insulin, diet, and exercise. They also are very smart to efficiently sell into self-funded large employers using existing channel partners like Express Scripts, CVS, Health Care Services Corporation (HCSC), Anthem, and Highmark BCBS. I know that the stock is down 35% since IPO, but I fundamentally believe chronic conditions are not going away and over time, Livongo will add supplementary clinical programs to expand revenue growth.
8. Optum
UnitedHealth Group is the single largest healthcare company in the world with a $280 billion market cap. It owns UnitedHealthcare, the country’s largest private insurer serving Medicare Advantage, managed Medicaid, employer-sponsored insurance, and ACA exchanges. And yet in 2020, more than 50% of the company’s earning and $112 billion in revenue will come from the lesser known side of the business, Optum. It is difficult to describe Optum because they do so much, but they technically split their business into three units: OptumHealth, OptumInsight and Optum Rx. OptumHealth provides care delivery (primary, specialty, urgent care) and care management to address chronic, complex, and behavioral health needs. OptumInsight utilizes data, analytics, and clinical information to support software, consulting, and managed services programs. OptumRx is a pharmacy benefit management (PBM) to create a more streamlined pharmacy system. In total Optum estimates the U.S. addressable market for its services to exceed $850 billion. If that wasn’t enough, here’s some fun facts why they made the list:
Works with 9 out of 10 U.S. hospitals, more than 67,000 pharmacies, and more than 100,000 physicians, practices, and other providers.
Added 10,000 physicians in the past year, growing its network to 46,000 physicians.
Includes 180,000 team members and serves 120 million customers.
Serves 80% of health plans to reduce total cost of care.
Works with 9 out of 10 Fortune 100 companies.
Pretty remarkable for a business unit that was only technically created in 2011, by merging existing pharmacy and care deliver services into one brand. As chronic disease increases and value-based care is here to stay, Optum is focused on comprehensively treating patients and coordinating their care to improve quality and lower costs. With UnitedHealthcare under the corporate umbrella, Optum has the adequate scale to test any new clinical initiatives before rolling out to other health plans.
9. Purdue Pharma
Purdue Pharma is a privately owned drug company owned by the Sackler Family and most well known for creating OxyContin in 1996. OxyContin represents 90% of Purdue Pharma’s revenue and was aggressively marketed to doctors for use in patients with chronic pain. According to court records, Purdue Pharma has grossed an estimated $35 billion. This is the same prescription painkiller that many experts say fueled the U.S. opioid crisis that has resulted in more than 130 deaths each day after overdosing on opioids. To be clear, the deaths are caused by prescription pain relievers, heroin, and synthetic opioids (fentanyl), however, the initial addiction to opioids is often caused by OxyContin and other prescription drugs. All but two U.S. states and 2,000 local governments have taken legal action against Purdue, other drug makers and distributors.
The Sackler family is the 19th richest family and is well known for supporting the fine arts, including the Sackler Wing at the Metropolitan Museum of Art in New York City where the Ancient Egyptian Temple of Dendur sits. I’ve seen a number of articles persecuting the entire Sackler family, but I want to be a little more nuanced. In 1952, three Sackler brothers (Arthur, Raymond, and Mortimer) bought a drug company called Purdue Frederick. Arthur’s branch of the family got out of the company after his death in 1987. The Raymond and Mortimer branches of Sacklers, who own it, founded affiliate Purdue Pharma in the early 1990s. According to a 2017 article from The New Yorker, there are 15 Sackler children in the generation following the founders of Purdue. Some family members have served on the Board of Directors, while others (most notably descendants from Arthur Sackler who died before OxyContin was invented), have distanced themselves from the company and condemned the OxyContin-based wealth.
Purdue Pharma filed for bankruptcy in September 2019 as part of a tentative settlement related to misleading marketing of the controversial painkiller. The settlement requires the owners of Purdue Pharma and the Sackler family to pay out $3 billion of their own fortune in cash over the next seven years. The only problem is that some family members have reportedly moved $10.7 billion from Purdue Pharma to trusts and holding companies across the world between 2008 and 2017. And all we’re left with is a complicated web of holding companies and offshore bank accounts, ravaged communities, and the leading cause of injury-related death in the U.S.
Andy Mychkovsky is a Director at Evolent Health and the Founder of a healthcare startup and innovation blog, Healthcare Pizza. This post originally appeared on Healthcare Pizza here.
The post 9 Healthcare Companies Who Changed the 2010s appeared first on The Health Care Blog.
9 Healthcare Companies Who Changed the 2010s published first on https://venabeahan.tumblr.com
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kristinsimmons · 5 years ago
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9 Healthcare Companies Who Changed the 2010s
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By ANDY MYCHKOVSKY
In order to celebrate the next decade (although the internet is confused whether its actually the end of the decade…), we’re taking a step back and listing our picks for the 9 most influential healthcare companies of the 2010s. If your company is left off, there’s always next decade… But honestly, we tried our best to compile a unique listing that spanned the gamut of redefining healthcare for a variety of good and bad reasons. Bon appétit!
1. Epic Systems Corporation
The center of the U.S. electronic medical record (EMR) universe resides in Verona, Wisconsin. Population of 13,166. The privately held company created by Judith “Judy” Faulkner in 1979 holds 28% of the 5,447 total hospital market in America. Drill down into hospitals with over 500-beds and Epic reigns supreme with 58% share. Thanks to the Office of the National Coordinator for Health Information Technology (ONC) and movement away from paper records (Meaningful Use), Epic has amassed annualized revenue of $2.7 billion. That was enough to hire the architects of Disneyland to design their Google-like Midwestern campus. The other amazing fact is that Epic has grown an average of 14% per year, despite never raising venture capital or using M&A to acquire smaller companies.
Over the years, Epic has been criticized for being expensive, non-interoperable with other EMR vendors, and the partial cause for physician burnout. Expensive is probably an understatement. For example, Partners HealthCare (to be renamed Mass General Brigham) alone spent $1.2 billion to install Epic, which included hiring 600 employees and consultants just to build and implement the system and onboard staff. With many across healthcare calling for medical record portability that actually works (unlike health information exchanges), you best believe America’s 3rd richest woman will have ideas how the country moves forward with digital medical records.
My very first interview out of undergrad was for a position at Epic. I chose a different path, but have always respected and followed the growth of the company over the past decade. In a world where medical data seems like tomorrow’s oil, a number of articles have speculated whether Apple or Alphabet would ever acquire Epic? I don’t buy it. I’m thinking it’s much more likely that 2020 is the first year they acquire a company. How you doing Athenahealth?
2. Theranos
No one can argue Theranos didn’t change the game in healthcare forever… for the worse. I do my best to give all healthcare founders the benefit of a doubt, but Elizabeth Holmes and Ramesh Balwani make that nearly impossible. Turns out that an all-star cast of geopolitical juggernauts on your Board of Directors and the black turtleneck of Steve Jobs is not the recipe for success. Founded by 19-year Elizabeth Holmes, Theranos raised over $700 million at a peak valuation of $9 billion. In retrospect, they have become the poster-child for Silicon Valley’s over-promise and under-deliver mantra. The only problem is that instead of food delivery, their failures resulted in invalid blood testing that could’ve really hurt people.
Despite this failure, the mission and purpose would’ve been tremendously impressive. Cheaper blood tests that require only 1/100 to 1/1,000 the amount of blood that LabCorp or Quest Diagnostics needed. I think the craziest part of the whole saga was that seemingly sophisticated healthcare leaders thirsted for the new technology to beat competitors and improve patient convenience. Before the technology was proved defunct, Theranos convinced Safeway to invest $350 million to retrofit 800 locations with clinics that would offer in-store blood tests. Theranos convinced Walgreens to invest $140 million to develop a partnership that would help beat CVS. Theranos partnered with Cleveland Clinic to test its technology and was working with AmeriHealth Caritas and Capital BlueCross to become their preferred lab provider.
To be clear, they weren’t the first, and won’t be the last healthcare company to fail. I only hope that this extremely well documented (thanks Hollywood) experience has re-focused founders and investors towards building sustainable growth companies that actually help patients live higher quality lives, not just make people money as quickly as possible.
3. One Medical
Thanks to Tom Lee and the One Medical crew, primary care is now investable. Whether you’re talking about private equity or venture capitalists, many have dived head first into the space in search of value-based care treasure. One Medical is the most well-known tech-enabled primary care practice, with 72 clinic locations across seven states, and new locations opening in Portland, Orange County, and Atlanta. The Carlyle Group liked the company so much that it invested $350 million in August 2018, at a reported $1.5 billion valuation. This has led to a number of primary care focused companies (ChenMed, Iora Health, Forward) to amass significant valuations that historically would’ve seemed optimistic. However, the elevation of the primary care provider from the “punter” to the “quarterback” of a patient’s medical journey has lifted all boats.
Interestingly, One Medical has unique differentiators over the traditional primary care competitors. For example, One Medical limits doctors to seeing 16 patients a day, versus the average physician seeing 20-30 patients a day. One Medical also built its own medical records in hopes of a more user friendly experience, instead of outsourcing to practice-based EMRs. One Medical charges $199 annually to each patient to help make up for lower volume, and in return provides same-day appointments, onsite lab draws, and a slick app that allows online appointment scheduling and telehealth consults with providers 24/7. They are also adding capabilities and services to cover mental health and pediatric services to increase revenue.
This change is remarkable. Historically, primary care has been a low-margin business with high administrative and staffing costs, along with physician burnout and regulatory burden. One Medical pioneered the concept of a more modern primary care experience, and I am looking forward to their initial public offering (IPO) targeted for early 2020 and whatever Tom Lee is cooking up at Galileo.
4. Centene
Centene is my favorite health plan to study over the past decade. You would never know that the second largest publicly-traded company headquartered in Missouri was originally started by Elizabeth “Betty” Brinn in Milwaukee, Wisconsin. Under-hyped, which is rare in healthcare nowadays, Centene has quietly grown to become the largest player in both the Medicaid managed care and Affordable Care Act (ACA) exchanges. Under Michael Neidorff’s leadership, Centene now serves 32 states with over 15 million lives and 53,600 employees. They were most recently ranked #51 on the Fortune 500 list. In addition, they are about to grow with the $17.3 billion acquisition of WellCare. Here’s a brief rundown of some major events that demonstrate why I’m so bullish on Centene dominating another decade:
April 2018: WellCare and Centene awarded Medicaid managed care contracts in Florida.
July 2018: Centene acquires Fidelis Care and their 1.6 million New Yorkers for $3.75 billion. This single-handedly gives Centene the leading Medicaid share in the state.
September 2018: WellCare acquires Meridian Health Plan and their 1.1 million lives in Michigan, Illinois, Indiana, and Ohio, for $2.5 billion.
February 2019: Centene and WellCare awarded Medicaid managed care contracts in North Carolina.
December 2019: WellCare awarded Medicaid managed care contract in WellCare (re-procurement underway)
In addition, Texas Medicaid is set to award their STAR contracts for 3.4 million lives between Medicaid and CHIP, of which Centene already won a contract to serve the STAR+PLUS (aged, blind, and disabled population). Seems like a pretty solid guess that Centene will fair pretty well in the STAR RFP rankings. Next decade, I look for Centene to significantly increase their efforts to recruit Medicare Advantage (MA) lives, and I wouldn’t bet against them.
5. Mylan
One word. EpiPen. Mylan, the $10 billion market cap pharmaceutical manufacturer and producer of the epinephrine auto-injector product, EpiPen, became the lightning rod in a consumer and political drug pricing debate in 2016. For those who were living under a rock, here’s the quick recap. Epinephrine auto-injectors are used to treat anaphylaxis (severe allergic reaction). Prior to 2016, Mylan held absolute dominant share of the auto-injector market, hovering around 90% for the first half of the 2010s. The only real competitor was Adrenaclick, produced by Lineage Therapeutics, but they were barely considered a competitor despite having cheaper prices. In 2016, news outlets caught wind of Mylan’s 500% list price increase over a decade ($100 to $600) and a nationwide discussion about drug prices began.
If you asked the Mylan CEO, Heather Bresch, she would tell you that the reason brand EpiPen’s list price increased 500 percent over 7 years is because they invested billions of dollars to significantly increase access in schools and employers across America. These efforts increased the number of EpiPen prescriptions in the U.S. from 2.5 million to more than 3.5 million between 2011 and 2015. She would also tell you that there is a big difference between wholesale acquisition cost price (list price) and net price. This part is often misunderstood by media. The net price takes into account discounts, prescription savings cards, and rebates that Mylan provides to purchasers (PBMs, Employers, Plans). The exact negotiated rebate or discount is different by line of business and organization. However, safe to say that Mylan made a good amount of profit with increasing volume.
At the end of the day, Mylan settled with the U.S. Justice Department for $465 million over claims it overcharged the government. Mylan kept their $600 list price brand EpiPen product with rebates, and added a generic version of EpiPen for $300 list price without rebates and requiring commercial insurance. According to a GoodRx analysis in 2018, the epinephrine auto-injector market now looks much different, with 60% of the market moving to the generic version of EpiPen, 10% of the market remaining with brand EpiPen, and 30% of the market switching to the generic version of Adrenaclick. However, whether generic or brand EpiPen, Mylan makes strong profits and American will continue to discuss the best strategy forward to control drug spend.
6. Evolent Health
First let me caveat. I’ve worked for Evolent Health for the past 5 years and seen it grow from a Series B startup to a publicly-traded company (NSYE: EVH). However, the reason they’re on this list is because Evolent Health has forever changed the game for future value-based care startups. When Frank Williams, Seth Blackley, and Tom Peterson founded the company in 2011 with the help of UPMC Health Plan and The Advisory Board Company, concepts like the Medicare Shared Savings Program (MSSP) did not even exist. Fast forward a decade later, and Evolent Health now serves approximately 3.7 million lives across 35 different U.S. healthcare markets. The mission of Evolent Health is to, “Change the health of a nation, by changing the way healthcare is delivered.” To do this, you need both the technology, clinical, financial, and operational capacity to empower providers to confidently move away from fee-for-service towards fee-for-value.
With the implementation of MACRA and the continued perseverance of CMS under this new administration, value-based care is still full steam ahead (good luck incoming CMMI Director, Brad Smith). Despite the naysayers of value-based care, find me a better way to control medical inflation that is accepted by nearly all healthcare institutions and doesn’t negatively impact patient outcomes, and we can talk. I will mention the importance of “significant” downside risk to actually change provider culture, strategy, and operations. I don’t want the primary purpose of setting up a clinically integrated network (CIN) to be negotiating higher fee-for-service commercial rates for independent physicians aligned to tertiatiary academic medical centers.
I wholeheartedly believe that providers will continue to seek partner options (not vendors with high fees independent of performance) who are not wholly-owned by the large for-profit health plans (Optum…). Of all the available options, Evolent Health is the market leader across a variety of areas. In 2020, I look forward to watching how the 3,000+ Evolenteers push the boundaries of downside risk value-based care with both payers and providers.
7. Livongo
To me, Livongo represents Daenerys Targaryen in Game of Thrones. Not the blood-thirsty character towards the end, but the only person to bring back dragons to the world of Westeros. Except in this example, the dragon is a successful digital health IPO. This was a big deal. Going public rewarded early investors who believed in the nascent digital health and chronic condition space. It allowed public investors an opportunity to peak under the hood of the financials and get comfortable with future economics of the industry. And it provided a legitimacy and a peer valuation to other leading digital health companies like Omada Health. All-in-all, 207,000 members use Livongo for Diabetes management solutions, including a connected glucose monitor, unlimited test strips, and personalized health coaching. This number is expected to grow significantly, with the announcement of a new, two-year diabetes contract with the BlueCross BlueShield Federal Employee Program (FEP). They anticipate the partnership will add an additional $50-60 million in revenue across 2020 and 2021
Livongo has done a brilliant job marketing itself as building a full-stop solution for the 147 million Americans with a chronic condition. According to their estimates, their immediately addressable markets for managing diabetes and hypertension represents a $46.7 billion opportunity. Digging into the unit economics, Livongo estimates that diabetes is worth $900 per patient per year and $468 per patient per year. Since they’re focused on chronic conditions, the business model is subscription-based. In the Q3 quarterly report, Livongo provided full year guidance of $168.5 million on the low end and $169 million on the high end. In either scenario, FY2019 Adjusted EBITDA is projected to lose around $26 million for the year.
Livongo has smartly started with addressing diabetes, given the downstream health impacts of mismanagement of blood sugar and the ability to impact spend with regular insulin, diet, and exercise. They also are very smart to efficiently sell into self-funded large employers using existing channel partners like Express Scripts, CVS, Health Care Services Corporation (HCSC), Anthem, and Highmark BCBS. I know that the stock is down 35% since IPO, but I fundamentally believe chronic conditions are not going away and over time, Livongo will add supplementary clinical programs to expand revenue growth.
8. Optum
UnitedHealth Group is the single largest healthcare company in the world with a $280 billion market cap. It owns UnitedHealthcare, the country’s largest private insurer serving Medicare Advantage, managed Medicaid, employer-sponsored insurance, and ACA exchanges. And yet in 2020, more than 50% of the company’s earning and $112 billion in revenue will come from the lesser known side of the business, Optum. It is difficult to describe Optum because they do so much, but they technically split their business into three units: OptumHealth, OptumInsight and Optum Rx. OptumHealth provides care delivery (primary, specialty, urgent care) and care management to address chronic, complex, and behavioral health needs. OptumInsight utilizes data, analytics, and clinical information to support software, consulting, and managed services programs. OptumRx is a pharmacy benefit management (PBM) to create a more streamlined pharmacy system. In total Optum estimates the U.S. addressable market for its services to exceed $850 billion. If that wasn’t enough, here’s some fun facts why they made the list:
Works with 9 out of 10 U.S. hospitals, more than 67,000 pharmacies, and more than 100,000 physicians, practices, and other providers.
Added 10,000 physicians in the past year, growing its network to 46,000 physicians.
Includes 180,000 team members and serves 120 million customers.
Serves 80% of health plans to reduce total cost of care.
Works with 9 out of 10 Fortune 100 companies.
Pretty remarkable for a business unit that was only technically created in 2011, by merging existing pharmacy and care deliver services into one brand. As chronic disease increases and value-based care is here to stay, Optum is focused on comprehensively treating patients and coordinating their care to improve quality and lower costs. With UnitedHealthcare under the corporate umbrella, Optum has the adequate scale to test any new clinical initiatives before rolling out to other health plans.
9. Purdue Pharma
Purdue Pharma is a privately owned drug company owned by the Sackler Family and most well known for creating OxyContin in 1996. OxyContin represents 90% of Purdue Pharma’s revenue and was aggressively marketed to doctors for use in patients with chronic pain. According to court records, Purdue Pharma has grossed an estimated $35 billion. This is the same prescription painkiller that many experts say fueled the U.S. opioid crisis that has resulted in more than 130 deaths each day after overdosing on opioids. To be clear, the deaths are caused by prescription pain relievers, heroin, and synthetic opioids (fentanyl), however, the initial addiction to opioids is often caused by OxyContin and other prescription drugs. All but two U.S. states and 2,000 local governments have taken legal action against Purdue, other drug makers and distributors.
The Sackler family is the 19th richest family and is well known for supporting the fine arts, including the Sackler Wing at the Metropolitan Museum of Art in New York City where the Ancient Egyptian Temple of Dendur sits. I’ve seen a number of articles persecuting the entire Sackler family, but I want to be a little more nuanced. In 1952, three Sackler brothers (Arthur, Raymond, and Mortimer) bought a drug company called Purdue Frederick. Arthur’s branch of the family got out of the company after his death in 1987. The Raymond and Mortimer branches of Sacklers, who own it, founded affiliate Purdue Pharma in the early 1990s. According to a 2017 article from The New Yorker, there are 15 Sackler children in the generation following the founders of Purdue. Some family members have served on the Board of Directors, while others (most notably descendants from Arthur Sackler who died before OxyContin was invented), have distanced themselves from the company and condemned the OxyContin-based wealth.
Purdue Pharma filed for bankruptcy in September 2019 as part of a tentative settlement related to misleading marketing of the controversial painkiller. The settlement requires the owners of Purdue Pharma and the Sackler family to pay out $3 billion of their own fortune in cash over the next seven years. The only problem is that some family members have reportedly moved $10.7 billion from Purdue Pharma to trusts and holding companies across the world between 2008 and 2017. And all we’re left with is a complicated web of holding companies and offshore bank accounts, ravaged communities, and the leading cause of injury-related death in the U.S.
Andy Mychkovsky is a Director at Evolent Health and the Founder of a healthcare startup and innovation blog, Healthcare Pizza. This post originally appeared on Healthcare Pizza here.
The post 9 Healthcare Companies Who Changed the 2010s appeared first on The Health Care Blog.
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weddingdressespromdresses · 5 years ago
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maternityeveningdresses · 6 years ago
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griceshopequipment-blog · 7 years ago
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There are so many auto lifts available on the market that may get confused which lift to buy. Auto lifts have different utilities and purposes. They're designed based on the requirement and needs of the automotive workshop or home garage. Some lifts are designed to increase shop floor space, while others are made to easily access the vehicle's underside for simplified repair labor. You need to be aware of the different kinds of lifts that are available so that you can purchase the right one for your professional workshop or home garage. This blog provides valuable information on the types of automotive lifts that are available on the market. To learn more, please visit: Kinds of Automotive Lifts Available - Find One That Meets Your Needs
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charlesccastill · 7 years ago
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Polar Design Build Awarded 39,667 SF Ground-Up Auto Dealership for Sullivan Toyota in Kingston, MA
BRAINTREE, MA– Polar Design Build, a construction management firm, has been selected to build a 39,667 square-foot  auto dealership from the ground-up for Sullivan Toyota in Kingston, MA. The project team is comprised of owner’s representative Richard Vazza, architects The Curtis Architectural Group, civil engineers McKenzie Engineering Group, structural engineers Flood Consulting, and MEP engineers CBC Engineering.
Sullivan Toyota is one of the highest volume car dealerships in New England. Sullivan Brothers have been selling and servicing vehicles to customers in the Cape Cod and South Shore regions for three decades. The family owns and operates Sullivan Toyota, Sullivan Nissan, Sullivan Brothers Rental Car, and Sullivan Brother Collision Center off Route 3 South.
Sullivan Toyota is located at 5 Cranberry Road in Kingston, MA. The dealership has over 75 personnel, sells an average of 100 vehicles per week and services an average of 250 vehicles per week. Polar Design will construct the new auto dealership on its current parcel while it continues its active operations in the main building. The firm will implement a modern design on both the exterior and interior consistent with the Toyota Design Intent Directive (D.I.D.), and the Sullivan Brothers brand.
Polar Design’s construction management services will occur in phases. Phase I will commence with the demolition of the two existing buildings on site. The construction team will perform Geotech ground improvement that involves the installation of Geopiers before the foundation is poured. The site will also include a new full septic system and groundwater recharge systems that meet the stringent code of new development in the State of Massachusetts.
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The new two-story dealership will be constructed using structural steel with ACM and metal insulated panels on the exterior. The 1st floor will be 33,721 s.f. and consist of a showroom enclosed with a glass curtain wall, and a customer waiting area with amenities including a built-in fireplace. There service area will include high-speed roll up doors, 28 vehicle lifts, internal trench drains, and a designated space for Sullivan’s new car detail service. The 2nd floor will be 5,946 s.f. and include an Owner’s office, break room, conference room, and storage area to support Sullivan’s office and administrative functions. The interior will also feature an elevator with access to each floor.
In Phase II, Sullivan Toyota’s operations will shift to the new building while its old dealership is demolished.  There will be a replacement parking lot constructed, and associated sitework will be performed following the demolition and clean-up. The area will house 310 parking spaces created for new and used vehicle storage, customers, and personnel. The Sullivan Toyota dealership is due for completion by March 2018.
from Boston Real Estate http://bostonrealestatetimes.com/polar-design-build-awarded-39667-sf-ground-up-auto-dealership-for-sullivan-toyota-in-kingston-ma/
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pcbeducation · 5 years ago
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AIOU Solved Assignment MA code 672 Spring 2020 Assignment 1& 2  Course:Perspectives of Special Education (Code 672) MA/M.Ed, Special Education Spring 2020. AIOU past papers
AIOU SOLVED ASSIGNMENT Code 672 No:  1& 2 Perspectives of Special Education (Code 672) MA/M.Ed, Special Education Spring, 2020
AIOU Solved Assignment 1 & 2 Code 672 Spring 2020
Education sector Like all other sectors the education sector has also been commercialized. To get education for a disable person is only a dream. So a legal provision should be made that all the disable persons who get admission in all universities should be provided education free of cost in such a way that these persons did not consider themselves low among other students. In all Government educational institutions hostel facility is available able. Provision should be made that all disable persons who come from other cities and are not in a positions to go home daily should be provided hostel facility without considering that their admission is in morning , afternoon or evening session. in Punjab university, university authorities refused to provide me hostel that my admission is not in morning session . Check Also: aiou Educational institutions Most of the educational institutions and business offices are multiple storey buildings. In most of these buildings there are no lifts installed. So disable persons face a lot of difficulties to go on other floors. So it should be made compulsory to install lifts in all multiple storey buildings so that disable students as well as employees can be facilitated. If in any educational institution it is not possible to install lifts all disable students should be facilitated and accommodated on ground floors.
AIOU Solved Assignment 1 Code 672 Spring 2020
In Pakistan for jobs 2 % seats are reserved for disable persons which means that they can get one job in an organization where 50 persons are working which is not good situation. In Pakistan most of the organizations are small so disable person after getting education are also not in a position to get a job And spend life as a respectable citizen. According to my opinion the quota should be increased to 5% so that disable person can get job in an organization where 20 employees are working. For that time the problems cannot be solved until real representatives are not present at every stage. It is amazing that at the legislation stage in senate and national and provincial assemblies there are no seats reserved for disable persons than how their problems can be solved. According to my opinion some seats should be reserved in all these institutions so that real representation of a large portion of community can be made. Check Also: aiou tutor Solution in federal and provincial government 9-In federal public service commission exam (css) no seats are reserved for disable persons despite the fact that they have proved their capabilities in recent years by competing the other students in these exams. so proper quota should be reserved for disable persons in c.s.s. so that they can also impart their role in society. point out a mismanagement problem in Punjab university. In Punjab university lifts are installed in the what road examination halls and in some departments also but they are not being operated. If a disable person want to go on second floor for examination and to attend class he has to face a lot of difficulty. . Any higher authority has not considered this issue. notice because this is a very simple issue and can be resolved easily. 11-For those persons e.g. deaf &blind who cannot get education in educational instructions for normal persons special institutions should be established at union council level throughout Pakistan.
AIOU Solved Assignment 2 Code 672 Spring 2020
If a disable person starts a small business like shop etc many Govt. officials like market committees WAPDA disturbs that person prior to this that what is his income. Legal protection should be given so that these persons can earn their livelihood in a respectable way. 13-In all educational institutions and other public places all the facilities suitable for special persons such as washroom etc. provided so that disable persons can feel satisfaction on these places performing routine activities. 14-In all public libraries and educational institutions libraries disable persons should be facilitated so that they can benefit from these libraries. The library staff should be trained to cooperate with special persons during library visits. If attention should be given to above highlighted problems and proper legislation should be made and its effective implementation should be made than we can make disable persons useful citizen. These persons can impart properly in progress of the country and lot of money which we spend on life time rehabilitation can be saved.
AIOU Solved Assignment Code 672 Spring 2020
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AIOU Solved Assignment Code 672 Spring 2020
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Now Get AIOU Solved Assignment 1 & 2 Code 672 Spring 2020 Free AIOU Solved Assignment MA code 672 Spring 2020 Assignment 1& 2  Course:Perspectives of Special Education (Code 672) MA/M.Ed, Special Education…
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4wdaccessoriesblog-blog · 5 years ago
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Essential Aspects to Consider Before Buying a 4WD suspension Kit for Your Vehicle
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  Unlike passenger vehicles, 4x4 vehicles tend to have a special type of suspension. While 4x4 suspension tend to come in a kit, there is no single kit that is right for all type of vehicles.  Just like 4WD suspension kits tend to vary, different people tend to have different tastes and preferences. One would need to know some of the advantages that tend to come with a good 4x4 suspension kit.
 Among the benefits include enhancing the vehicles handling ability, improve riding comfort as well as improve safety.  With a good 4WD suspensionkit, you would be assured of ground clearance as well as stability of your 4X4 vehicle.
 It would be critical to remember that different countries tend to come with different laws on matters to do with 4x4 vehicles suspension. You would need to make sure that the lift kit is legal in your country roads. You would also need to remember that simply because a 4x4 suspension kit is compliant in one country, it does not mean it is compliant in your country. Once in a while, it would be essential to call an expert to guide you on what is allowed and what is not allowed. You would need to make an effort of investing in compliant 4x4 vehicles suspension.
 It may also be essential to take note of some of the 4x4 suspensionkits you ma invest in and also take your time to know what they are. 4X4 suspension kits range from coil springs, leaf springs, bush kits, shackles, and pins, strut caps among others. In a case where you invest in a good 4X4 suspension kit, you would be assured of great ground clearance even on an uneven road. It may not be necessary especially in a case where you never get of tarmac. You may need to consider investing in a well searched 4X4 suspension kit especially in a case where you are in the habit of getting off the beaten track. Know more facts at http://www.huffingtonpost.com/gunjan-bagla/switching-to-high-gear-in_b_7766102.html.
 It may be essential to make sure that you invest in a good 4x4 suspension kit especially in a case where you want to thoroughly enjoy an off-road driving experience. You would need to need to give your 4X4 vehicle the dignity it deserves by investing in the right 4X4 suspension kit. You would also need to know of the air suspension kit which tends to make it possible to either lower or lift your car by letting in or out the air into the suspension kit.
 You would need to make your investment worth it by investing in the right 4WD suspension Kit and at the same time make sure that the kit in question is installed the right way.What You Need to Have in Mind When Looking for a Professional RidePro Suspension Installation Company
You will have many benefits to enjoy hem you install a RidePro suspension on your car. Vehicles have been a common means of transport for centuries. People have looked for all means to own a vehicle. It can always be scary to be on the road and have some breakdowns. It is apparent that there should be a parking lot for this automotive. It is important to consider a place where the vehicles can be stored safely and efficiently.
 People have a hard time deciding on the ideal car repair services to hire. You should choose auto repair services carefully since faulty services can lead to a lot of problems. There are several advantages of owning a vehicle. Destinations have been a problem to cover by human beings. Automotive services involve repairs and maintenance.This the article will thus explain some of the adavntages of installing ridepro to your car.
Realizing the benefits of the RidePro suspensions, you will want to buy some. You will want to choose the specific RidePro suspension you want to buy, like the roof RidePro suspensions, or the tubular or venting RidePro suspensions. You will also want to consider hiring a RidePro suspension installation company for the installation process. You will want to consider a RidePro suspension installation company that is professional so that you can reduce damages. There are many RidePro suspension installation companies in the industry, though not all will be ideal for you. More so, if it is the first time you are looking for a RidePro suspension installation company, you will find it a more challenging task. Choosing a RidePro suspension installation company will ten mean that you have some considerations in mind. The article that you are about to read will then explain to you all you need to have in mind when looking for a RidePro suspension installation company.
One of the things you will want to have in mind when choosing a RidePro suspension installation company is the reputation. When you choose a RidePro suspension installation company, you will want to consider the level of professionalism. Therefore, you will want to read more on the comments made by the past clients to find out more about the reputation. The past clients will only be appreciative to the RidePro suspension installation company if they were of help to them. Finding an ideal RidePro suspension installation company will also mean that you consider referrals from your friends and relatives. The reason why referrals from these people will be best is that they are closer to you so you trust them most.
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justriteequip · 5 years ago
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Which Type of Loading Dock Leveler is Suitable for Your Business in Baltimore, MD?
Longing to simplify or sustain the flow of your business operations, one of the basic steps to do first is selecting one of the most trusted brands that you are going to work with. It is about making sure that the company brand has high-quality products and dependable customer service too – offering a team of exceptionally-trained professionals.
 If you are doing business in Baltimore, MD which needs superior brands of Loading Dock Levelers, Just-Rite Equipment, a division of DuraServ Corp is simply a call away. Their loading dock levelers and lifts can perfectly help your dock loading and unloading process become smooth and efficient. 
 They have Mechanical Dock Levelers, Hydraulic Dock Levelers, Airpowered Dock Levelers, Specialty Dock Levelers, Loading Dock Options, and Dock and In-Plant Lifts that come with innumerable capabilities and movement mechanisms that fit the specific needs of your business. 
 To give an overview of the loading dock equipment by Just-Rite Equipment, here are some of the products with its design highlights:
 A. Mechanical Dock Leveler Model WL 
Standard Capacity – 30k and 35k
Unlimited Float Hold-down
Exclusive Hydra Cam (Plus Automatic Lip Extension)
Clean Frame
Single Adjustment Point Extension Spring Counterbalance
High Tensile Steel Lip, Deck & Beams
Structural Steel Safety Legs
Working Range Toe Guards
Below-dock End-loading Capability
Integral Maintenance Strut & Lip Support Latch
Heavy-duty Dock Bumpers
 B. Serco Hydraulic Dock Leveler Model HLQ
Powered-in/Powered-out Lip Extension
Regenerative Hydraulics
Yieldable Hydraulic Lip
Non-Metallic Push-button Control Panel (Non-Interlock Capable)
Single Phase or Three Phase Power
Hydraulic Velocity Fuse Safety Stop
Full Operating Range Toe Guards
Below-dock End-loading Capability
Integral Maintenance Strut & Lip Support Latch
Mushroom-style Stop Button
Independent Hydraulic Lip Control (Quick Cycle)
Steel NEMA 12 Control Panel (Interlock Capable)
 C. Serco Air Powered Edge-of-Dock Model
Push-button operation 
Patented high volume, low pressure air bag lift system
Lift system fully operational under extreme temperatures
Exclusive Lug Style Lip Hinge 
High Strength Steel Tread Plate (Ramp & Lip)
Robotic Welding
Lower Profile Design 
Beveled Lip Edge 
Tire Laminated Bumpers
Exclusive EZ-Hang installation system simplifies install
Integral Maintenance / Service Strut
 D. Serco Versadock Dock Leveler
 Full 9′ Wide Below-dock Access
Regenerative Hydraulics
Yieldable Hydraulic Lip
Auto Return-to-Dock
Push-button Quick Cycle Lip Extension
Steel NEMA 12 Push-button Control Panel
Hydraulic Velocity Fuse Safety Stop
Full Operating Range Toe Guards
Below-dock Endloading Capability
Full Pit Steel Kit Including Pit Floor Embeds
 Call us for more inquiries regarding loading dock levelers Baltimore, MD, loading dock levelers New Haven CT, loading dock levelers Sterling, VA, loading dock levelers Jamesburg, NJ, loading dock levelers Springfield, MA.
 We want to work with any commercial setting that involves dock specializing in food distribution, retail, and manufacturing. We are servicing Service Areas: Sterling, VA, Baltimore, MD, Jamesburg, NJ Delaware, Eastern Pennsylvania, New Haven, CT, Farmington, CT, Windsor, CT, Hartford, CT, Fairfield, CT, and Springfield, MA. You may reach us with these contact details: Sterling, VA (703) 450-2800, Baltimore, MD (410) 536-0505, Jamesburg, NJ (609) 448-6550. You may also visit our sites: https://www.justriteequip.com/contact/ and https://www.justriteequip.com/service-request/. 
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