#outsource reverse engineering services

[cyberstudious]

An Introduction to Cybersecurity

I created this post for the Studyblr Masterpost Jam, check out the tag for more cool masterposts from folks in the studyblr community!

What is cybersecurity?

Cybersecurity is all about securing technology and processes - making sure that the software, hardware, and networks that run the world do exactly what they need to do and can't be abused by bad actors.

The CIA triad is a concept used to explain the three goals of cybersecurity. The pieces are:

Confidentiality: ensuring that information is kept secret, so it can only be viewed by the people who are allowed to do so. This involves encrypting data, requiring authentication before viewing data, and more.

Integrity: ensuring that information is trustworthy and cannot be tampered with. For example, this involves making sure that no one changes the contents of the file you're trying to download or intercepts your text messages.

Availability: ensuring that the services you need are there when you need them. Blocking every single person from accessing a piece of valuable information would be secure, but completely unusable, so we have to think about availability. This can also mean blocking DDoS attacks or fixing flaws in software that cause crashes or service issues.

What are some specializations within cybersecurity? What do cybersecurity professionals do?

incident response

digital forensics (often combined with incident response in the acronym DFIR)

reverse engineering

cryptography

governance/compliance/risk management

penetration testing/ethical hacking

vulnerability research/bug bounty

threat intelligence

cloud security

industrial/IoT security, often called Operational Technology (OT)

security engineering/writing code for cybersecurity tools (this is what I do!)

and more!

Where do cybersecurity professionals work?

I view the industry in three big chunks: vendors, everyday companies (for lack of a better term), and government. It's more complicated than that, but it helps.

Vendors make and sell security tools or services to other companies. Some examples are Crowdstrike, Cisco, Microsoft, Palo Alto, EY, etc. Vendors can be giant multinational corporations or small startups. Security tools can include software and hardware, while services can include consulting, technical support, or incident response or digital forensics services. Some companies are Managed Security Service Providers (MSSPs), which means that they serve as the security team for many other (often small) businesses.

Everyday companies include everyone from giant companies like Coca-Cola to the mom and pop shop down the street. Every company is a tech company now, and someone has to be in charge of securing things. Some businesses will have their own internal security teams that respond to incidents. Many companies buy tools provided by vendors like the ones above, and someone has to manage them. Small companies with small tech departments might dump all cybersecurity responsibilities on the IT team (or outsource things to a MSSP), or larger ones may have a dedicated security staff.

Government cybersecurity work can involve a lot of things, from securing the local water supply to working for the big three letter agencies. In the U.S. at least, there are also a lot of government contractors, who are their own individual companies but the vast majority of what they do is for the government. MITRE is one example, and the federal research labs and some university-affiliated labs are an extension of this. Government work and military contractor work are where geopolitics and ethics come into play most clearly, so just… be mindful.

What do academics in cybersecurity research?

A wide variety of things! You can get a good idea by browsing the papers from the ACM's Computer and Communications Security Conference. Some of the big research areas that I'm aware of are:

cryptography & post-quantum cryptography

machine learning model security & alignment

formal proofs of a program & programming language security

security & privacy

security of network protocols

vulnerability research & developing new attack vectors

Cybersecurity seems niche at first, but it actually covers a huge range of topics all across technology and policy. It's vital to running the world today, and I'm obviously biased but I think it's a fascinating topic to learn about. I'll be posting a new cybersecurity masterpost each day this week as a part of the #StudyblrMasterpostJam, so keep an eye out for tomorrow's post! In the meantime, check out the tag and see what other folks are posting about :D

[techav]

It's been quite some time since I last wrote anything about A/V, despite it being my url and the reason I created this blog in the first place. But I find myself back in that world full-time these days, and the news this week is just disturbing enough to make it past the filter.

As reported by Commercial Integrator, Acuity Brands is set to purchase A/V manufacturer QSC for over $1B.

QSC has been well known for decades in the live events and performance venue A/V verticals, and over the past 15 years has made quite a name for themselves with a solid DSP-turned-control-system platform, Q-Sys.

Acuity is mostly known for lighting and lighting controls. Their proprietary nLight system has been the go-to for renovations and new construction at the last three higher education institutions I worked for.

My work in A/V and my work in IT management has often required working with building trades outside of those two. I've built A/V systems that interfaced with lighting systems. I've helped bring building automation systems online and tied them together. If it has wires, at some point I've probably been responsible for maintaining it and keeping it communicating with something else.

I have used and reverse-engineered proprietary systems. I worked with commercial products with hard-coded back-door passwords. I've supported devices where UI/UX clearly didn't even reach the level of an afterthought. I've installed devices that couldn't actually do even half of what they were advertised to do. I've integrated devices that transmitted passwords cleartext over the network.

And then I met Acuity.

I have had the misfortune of working with a few different lighting control systems that fall under the umbrella of Acuity Brands and I don't feel it's hyperbole when I say, each was worse than the last. Every technological sin imaginable I have met in the unholy abominations that Acuity Brands produces. (And if by chance you're reading this and work in some capacity with Facilities IT, for the love of god get those devices off your network)

I actually liked QSC. They made some decent products. I have CX-series amplifiers that survived decades of abuse and are still in service. Their Q-Sys platform was a joy to use in a segment that was always overly-complicated.

I did have some concerns about the direction of QSC after seeing they were outsourcing engineering and development jobs. But based on my experience with other products from Acuity Brands, I no longer have any faith in the future output of QSC. I expect we will see the brand languish from here, culminating in a scandalous CVE disclosure rivalling that from AMX in 2017.

[pwcsolutions03]

EU Cosmetics Testing

PWC Solutions offers expert EU cosmetics testing, regulatory compliance, and Authorized Representative services. We provide international expertise for cosmetic product registration. EU Cosmetics Testing

About Company:-

Wendy was instrumental in setting up PWC Solutions Limited in 2010 after identifying a gap in the market for offering Technical and Regulatory Support to SME’s. Her career began in 1983 working for Unilever R&D in Port Sunlight where she developed her knowledge and expertise in Analytical Chemistry, specifically the ‘reverse engineering’ of Unilever��s Competitors Products.

In July 2003 the analytical department was outsourced to Intertek. It is here where Wendy developed her skills in the regulatory aspect of the Healthcare and Beauty businesses, working across different business groups supporting the Consumer products sector. #GPDR

https://pwcsolutions.co.uk/

Visit Here - https://pwcsolutions.co.uk/

[astarioslabs]

Reverse Prologue To The Popularity Of Nearshore Outsourcing Companies!

Technology has always been a need of time and, at present, we all can see it has reached a point of culmination. But, those were the times when the tech was only growing, and in the process, many businesses were recognizing their need for innovation. A lot of them understood the requirement of the clock and hopped on to the latest innovation as they knew where their customers were heading! It is why those businesses have turned their head to nearshore outsourcing companies.

The best way to combine cost-cutting business solutions with efficient processing. As a result, they started pitching greater profits and rising in demand as efficient customer service providers in their respective business domains. Tending to software development and outsourcing services did a great deal of merits to those businesses. You can be the next, too!

How Have Nearshore Outsourcing Companies Rise To Trends At Present?

Fetching for help from one of the best nearshore outsourcing companies can provide your business with seamless functioning and efficiency. How? Continue reading to get an answer.

Eliminate The Lag Of Offshore Outsourcing

Cost reduction and putting the right talent to use have always been a target for businesses. This is why efforts have been made to achieve the aim by using the latest technology of that time. In the past, the offshore outsourcing industry showed up to the need of the hour for businesses to reach their aim of cost-cutting and using the most deserving skill. However, that technology too lagged when the brands felt the need for further efficiency. That requirement was not communicated well enough due to differing time zones, language barriers, and culture barriers.

So, the savior? The technology of present times - nearshore outsourcing for software development and outsourcing. This agile technology has helped and is helping many businesses to streamline their business processes with ease.

Need For Innovation With Cheap Alternatives

Suppose you have found a cheap alternative to your business talent acquisition needs. However, have you pondered over how they are going to add value to your organization? Indeed, pocketing enhanced profits is much needed, but you also need innovation coming along with that. This is what nearshore outsourcing companies do with their latest technology! The strategy of these companies lies in their efficiency in locating the correct place and finding appropriate ways to target their operation. Their goal lies in creating value for the business's talent engineering needs besides providing them with a cheaper alternative.

Aroused Commerciality Of Data Analysis

Scrutinizing data through a robustly maintained data analysis system is yet another factor that governs the success of a business. This helps businesses to make informed decisions by being acquainted with a well-organized data system. Furthermore, they save on time and labor that goes behind when their best minds put efforts into fetching the best details out of a rummage.

See, what is coming? They say that time is money for businesses, and you are letting it get saved so that your best talent can put efforts in the right direction. All is done through a well-organized data analysis system made possible with the help of nearshore companies for software development and outsourcing.

Cut Down Cost On Value Addition With Nearshore Outsourcing!

Summing it all up with a note that there is always an added chance to enhance your business processing. One of the ways includes getting help from nearshore outsourcing companies like Astarios. We help you get ahead of time through better data analysis, value-added and cheap talent engineering, and eliminating any language or culture barriers in the process. So, ready to dive into the benefits? Ring a call to us!

[pcbreverseengineering]

SZOROD Technology Announces Commitment to Innovation and Growth in Electronics Manufacturing

SHENZHEN, CHINA –May 2024– SZOROD Technology Co., Ltd., a leading provider of hardware outsourcing and PCBA OEM services, announced its continued dedication to innovation and growth in the electronics manufacturing industry.

Established Expertise in Chip Decryption and PCB Reverse Engineering

Founded in Hong Kong in 2003, SZOROD boasts a long history of technical expertise in high difficulty chip unlocking solution and PCB reverse engineering. They have a successful track record and provide a wide range of services, such as:

Highly Accurate PCB Reverse Engineering: SZOROD achieves a 100% success rate for PCB designs with up to 12 layers, ensuring accurate schematics and Bill of Materials (BOM) generation.

Advanced Chip Decryption: Their team possesses a 90% success rate in unlocking even the most challenging encryption protocols on various microcontrollers (MCUs) from leading manufacturers.

High-Volume Production Capabilities: SZOROD fulfils PCB cloning orders in high quantities, efficiently managing 50-60 PCB copies and 60-70 chip decryptions daily.

Reliable Delivery: They understand the importance of timeliness and consistently meet over 95% of their contracted delivery deadlines.

Global Presence and Continued Investment

SZOROD has established a strong international presence, collaborating with over 1000 partner companies in more than 100 countries across Southeast Asia, Europe, America, and beyond. They are committed to continuous improvement and plan to:

Embrace AI-powered PCB Reverse Engineering: Leveraging cutting-edge technology, SZOROD aims to streamline PCB reverse engineering processes using artificial intelligence.

Upgrade Equipment for Enhanced Precision: The company is dedicated to investing in advanced, high-precision equipment to ensure the highest quality standards.

Pursue Domestic Listing Within Five Years: SZOROD has set an ambitious goal of achieving a domestic listing within the next five years, signifying their commitment to long-term growth and industry leadership.

A One-Stop Solution for Hardware Outsourcing

SZOROD offers a comprehensive suite of services under one roof, encompassing:

PCB Copying

PCB Design

BOM Analysis

Schematic Reverse Engineering

Chip Decryption

Component Procurement

Technical Debugging

Hardware Reverse Research and Guidance

Business Development

By integrating these services with their own board factory, SZOROD provides a seamless one-stop solution for clients seeking high-quality hardware outsourcing and PCBA OEM services.

About SZOROD Technology Co., Ltd.

SZOROD Technology Co., Ltd. is a leading provider of hardware outsourcing and PCBA OEM services, dedicated to empowering innovation in the electronics manufacturing industry. With a global presence, advanced technical expertise, and a commitment to continuous improvement, SZOROD offers a comprehensive suite of services to streamline and expedite the development and production of electronic products.

[v3dtechnologies]

Are 3D scanners worth it?

Whether 3D scanners are worth it depends on your specific needs, industry, and budget. Here are some factors to consider when determining the value of investing in 3D scanners:

Application: Consider how you plan to use the 3D scanner. If your work involves tasks such as reverse engineering, quality control, prototyping, or documentation of physical objects or environments, a 3D scanner may be invaluable. However, if your needs are limited or can be adequately met with traditional measurement methods, the investment may not be justified.

Accuracy Requirements: 3D scanners offer varying levels of accuracy, depending on factors such as the type of scanner, the quality of the equipment, and the scanning environment. If high precision and detail are essential for your applications, investing in a high-quality 3D scanner may be worthwhile.

Time and Efficiency: 3D scanners can significantly reduce the time and effort required for tasks such as data capture, modeling, and analysis compared to traditional methods. If time savings and increased efficiency are important to your workflow, a 3D scanner may offer a significant return on investment.

Cost: Consider the upfront cost of purchasing a 3D scanner, as well as any ongoing costs such as maintenance, software licenses, and training. Compare these costs to the potential benefits and savings that the scanner can provide over its lifetime to determine its overall value.

Industry Trends: Evaluate trends in your industry and the adoption of 3D scanning technology by competitors or peers. If 3D scanning is becoming standard practice or if it offers a competitive advantage in your field, investing in a scanner may be a wise decision to stay ahead of the curve.

Outsourcing Options: In some cases, it may be more cost-effective to outsource 3D scanning services to specialized providers rather than investing in your own equipment. Consider the availability and cost of outsourcing options in your area when making your decision.

Ultimately, the value of 3D scanners depends on how well they align with your specific needs, goals, and budget constraints. It's essential to conduct thorough research, evaluate your options carefully, and consider factors such as accuracy, efficiency, cost-effectiveness, and industry trends before making a decision.

[consystentinfoo]

You Can Rely on the Indian Engineering Service and Data Entry Professionals at Consystentinfo.com

Introduction:

The engineering solutions and data input services offered by Consystentinfo.com are among the most extensive of any service provider in the world. The organization has earned the trust of corporations all around the world because of its dedication to quality and customer service. The purpose of this 1000-word analysis is to look into the many services provided by Consystentinfo.com and to highlight the salient qualities that set them apart from the competition.

Consystentinfo.com is a well-known company in the outsourcing sector, specializing in providing first-rate services in the areas of engineering and data entry. The company's success is based on its crew of highly trained experts who work together to meet the specific requirements of each client. These experts include engineers, data entry specialists, project managers, and customer support representatives.

Consystentinfo.com's Engineering service provider covers a broad spectrum of sectors, from manufacturing and construction to automotive and electronics. Their team of highly skilled engineers is known for coming up with novel approaches to difficult issues. Consystentinfo.com is a leading provider of engineering services, including but not limited to:

The company's primary focus is computer-aided design (CAD) and computer-aided manufacturing (CAM), which it offers to businesses so that they may bring their ideas to life with the aid of comprehensive technical drawings and computational simulations.

Consystentinfo.com's b. Product Design and Development service helps businesses with product ideation, design, development, optimization, and compliance with norms and laws in the market.

To guarantee the dependability and safety of its products, the firm uses cutting-edge FEA techniques to assess the structural integrity, thermal performance, and fluid dynamics of their components and systems.

Their proficiency in 3D modeling and visualization helps clients see their goods as they really are, which improves both decision-making and communication.

To help clients upgrade, replace, or replicate current products or components, Consystentinfo.com provides reverse engineering services.

Prototyping and speedy Prototyping: The firm enables speedy and low-cost product development by employing both physical prototypes and rapid prototyping with state-of-the-art technologies like 3D printing.

Services for entering data accurately and quickly have become more important in the commercial world. Consystentinfo.com is aware of this, which is why they offer streamlined data input solutions to their clientele. Some of the data input tasks they handle are:

Online and Offline Data Entry: The firm facilitates the fast and correct input of data gathered from a wide range of sources, including electronic files, handwritten papers, surveys, and so on.

Consystentinfo.com also provides data conversion services, transforming information from one format to another for improved readability and use, including PDF to Excel and picture to text.

Data Cleansing: They do data cleansing operations to find and fix mistakes, duplication, and inconsistencies so that the quality of the data may be maintained.

Online shopping By entering data such as pricing, descriptions, and stock levels, the company helps e-commerce enterprises manage their product catalogs and fulfill consumer orders.

Form processing, picture processing, survey processing, and more are just some of the data processing solutions offered by Consystentinfo.com. 

Data Mining and Web Research: Using their research skills, they compile pertinent information from the web and other sources for their clients.

Consystentinfo.com uses cutting-edge tools and infrastructure to provide its users with the best possible experience. They have strict safety protocols in place to secure user information and prevent unauthorized access. The firm is able to keep ahead of the competition because to its dedication to constantly improving its tools and software to reflect the most recent developments in the industry.

Customer Focus: Consystentinfo.com's focus on its customers is a major differentiator. Since every client has different demands and problems, they customize their solutions accordingly. Throughout the duration of a project, the organization keeps lines of communication open with its customers, welcomes their input, and publishes honest status updates.

Consystentinfo.com guarantees high-quality service in every facet of its operations. They have a specialized QA crew that double-checks and triple-checks everything before it is released, so you know it will be accurate and trustworthy. The firm is committed to providing services of the highest possible quality Data Entry company India in accordance with established global benchmarks.

Conclusion:

Consystentinfo.com is an industry giant in India, where it provides engineering services and is also a top data input firm. They have established themselves as a trustworthy outsourcing partner by prioritizing quality, originality, and client happiness. Consystentinfo.com is the top choice for businesses that need top-notch results from their projects, whether they require engineering services like CAD/CAM or FEA, or data entry services like data conversion or online/offline data input.

[technicallyhershark]

We deliver the best in class Reverse Engineering Services across Bangalore, India. We are specialised in delivering high-profile projects - Prolotek

[3engineerservices]

3Engineer delivers best Reverse Engineering Services with professional and experienced team.

[cadamenservices-blog]

CAD Amen Engineering Consultant is a dynamic and focused company that has been offering Mechanical Engineering Services in all around the world.  We are also providing Reverse Engineering, Value Engineering, Product design and drafting etc. Services. Our Mechanical Engineering Services accelerate complex product and mechanical design development as well as reduce the time to market the product.

For More Details : - Website : - https://www.cadamen.com Email : - info@cadamen.com Phone No:- +91-9512386955

[pwcsolutions03]

Cosmetic Product Services South Africa

PWC Solutions offers expert EU cosmetics testing, regulatory compliance, and Authorized Representative services. We provide international expertise for cosmetic product registration. Cosmetic Product Services South Africa

About Company:-

Wendy was instrumental in setting up PWC Solutions Limited in 2010 after identifying a gap in the market for offering Technical and Regulatory Support to SME’s. Her career began in 1983 working for Unilever R&D in Port Sunlight where she developed her knowledge and expertise in Analytical Chemistry, specifically the ‘reverse engineering’ of Unilever’s Competitors Products.

In July 2003 the analytical department was outsourced to Intertek. It is here where Wendy developed her skills in the regulatory aspect of the Healthcare and Beauty businesses, working across different business groups supporting the Consumer products sector. #GPDR

https://pwcsolutions.co.uk/

Visit Here - https://pwcsolutions.co.uk/

[pcbreverseengineering]

Insights of PCB Reverse Engineering Services Highlighting Its Benefits

PCB reverse engineering services or Printed Circuit boards have emerged as a crucial solution in the world of electronics. Essentially, it involves dissecting and analyzing the design and functionality of a PCB to reconstruct its schematics, layout, and components. This carefully designed process enables engineers to comprehend the intricacies of existing circuit boards without the aid of original documentation. While it may sound like a daunting task, SZOROD has made it easy for you! Delve into the world of PCB reverse engineering services including the benefits it offers that are substantial and multifaceted.

Unraveling Design Mysteries for Innovation

One of the primary advantages of our PCB reverse engineering services lies in its ability to create innovation. By unraveling the design mysteries of legacy PCBs or proprietary systems, our engineers gain invaluable insights into the underlying technology. This knowledge serves as a springboard for innovation, allowing us to develop enhanced versions of existing products or devise entirely new solutions based on proven designs. Whether it's optimizing performance, reducing costs, or adding new features, SZOROD empowers your businesses to stay competitive in dynamic markets.

Facilitating Legacy Product Support and Maintenance

In today's technological landscape, obsolescence is a constant challenge, particularly for legacy products. PCB reverse engineering services by SZOROD offer a lifeline in such scenarios by enabling the recreation of obsolete or discontinued circuit boards. This not only ensures continuity in product support but also extends the lifespan of your valuable assets, which ultimately saves time and resources in the long run.

Enhancing Supply Chain Flexibility and Resilience

The global supply chain is susceptible to various disruptions, ranging from component shortages to geopolitical tensions. In such volatile environments, having alternatives is paramount for business continuity. Our PCB reverse engineering services provide a strategic advantage by offering an alternative source for critical components or assemblies. By our reverse engineering PCBs, you can mitigate supply chain risks, reduce dependency on single suppliers, and maintain production continuity even in the face of unforeseen challenges.

Enabling Intellectual Property Protection and Compliance

Protecting intellectual property (IP) is a top priority for companies across industries. In an interconnected world, safeguarding proprietary designs can be challenging, especially when outsourcing manufacturing or collaborating with third-party vendors. SZOROD’s PCB reverse engineering services play a pivotal role in IP protection by enabling your company to assess the security of its designs and detect any potential vulnerabilities. Also, our reverse engineering can aid in ensuring compliance with industry standards and regulations, thus mitigating legal risks and liabilities.

Driving Cost-Efficiency and Time Savings

Last but not least, our PCB reverse engineering services offer significant cost-efficiency and time-saving benefits. Instead of starting from scratch, which involves extensive research, prototyping, and testing, our services will allow your company to leverage existing designs as a foundation. This streamlined approach reduces development cycles, accelerates time-to-market, and ultimately lowers overall project costs.

[jackjessie43]

Mcu cloning service Circuit Engineering CO.,LTD provides IC extract, MCU Read, Microcontroller Copy service.Extract IC, Read MCU, Copy Microcontroller 

Read More:- http://www.extract-ic.com/ Outsourcing your IC extract, MCU Read, or any other Microcontroller Copy needs is a critical decision for your company. We understand that you have many companies to choose from, but if you are looking for a company that can provide customer satisfaction, you have chosen the right one, Circuit Engineering Co.,Ltd. Circuit Engineering Co.,Ltd offers a full range of IC extract, MCU Read and Microcontroller Copy technology designed for quick set-up. If your disassembly or assembly requires extensive hand labor, our skilled workforce can provide detailed hand assembly according to IPC-A-610 Class II. At Circuit Engineering Co.,Ltd, we are well equipped to IC extract, MCU Read, or any other Microcontroller Copy and Printed Circuit Board Reverse Engineering, including customized packaging. Our goal at Circuit Engineering Co.,Ltd is to achieve customer satisfaction with superior service and products. Two-way communication is a very vital part of a quality product and together we can determine the most effective solutions to your needs, whether that means a face-to-face meeting, telephone call or email. #copymcufirmware #copymicrocontrollerbinary #copyicchipcontent #readmcuprogram #readmicrocontrollersoftware #readicchipfile #MemoryBinaryCopying #copymicrocontrollerextractIC #copymicrocontrollerservice #microcontrollerreverseengineer #reverseengineermcucode #clonearmmicrocontroller #clonemicrocontrollerchip #mcucloningservice #microcontrollericclone #mcucodedecoder #unlockbreakIC

[tanadrin]

via @sophia-epistemia’s recommendation (emphasis added):

This is a pattern of introducing middle-men that has proliferated throughout the finance side of health care: “Hmm, this part of our enterprise sure is expensive! Why don’t we spin it off as an independent business or outsource it? Surely some enterprising entrepreneur can figure out a way to do it more cheaply than we can, so we’ll just black box the problem and pick the lowest bidder to solve it for us.”

Here’s another example of that pattern. Medicare, the Federal health insurance for the elderly, insures people directly. But the Federal program for the poor, Medicaid, does not. Instead the Feds give the money to the state to run a Medicaid program. Here in Massachusetts, ours is called MassHealth. The federal government has outsourced the actual insuring of poor people to the state.

So the state insures poor people? Not exactly, here in Massachusetts. MassHealth is (mostly) not an insurance program. MassHealth funds insurance. It’s an insurance subsidy program. The actual providers of insurance are commercial insurers who offer MassHealth-approved plans.

This, by the way, is the big crucial concession of first Romneycare and then Obamacare to the health insurance industry: the state wouldn't take over insuring people directly, thereby putting the insurance companies out of business. The state would pay the insurance companies that already existed to do the job for the state. And the citizenry would have a choice of insurance products from a market place of multiple insurance companies. That is what made these plans the conservative answer to the liberal preference to single-payer. Back when they were considered conservative.

So when you get on MassHealth you get a choice of providers/plans. There are, last I checked, five. So your MassHealth-approved and –funded insurance company provides you health insurance?

Mostly.

If you choose Neighborhood Health Plan, and you require mental health care (one of several types of health care for which something similar is true) you will quickly discover that Neighborhood Health Plan (which, btw, is the name of the insurance company not the insurance plan) doesn’t have a network of psychiatrists and psychotherapists. They have outsourced the mental health component of their insurance product to another company, named Beacon Health Strategies.

I mean Beacon Health Options. They were just acquired by/merged with Value Options, and that’s the new name.

I assume all this divisioning is saving someone money, over what they think they’d be spending otherwise. But I can’t help but note that some share of the wages for at least one Medicaid employee, one MassHealth employee, one Neighborhood Health Plan employee and one Beacon Health Whatevers employee – minimum – have to come out of the premium for that patient, regardless of whoever is paying it.

Because it has to. There is no other money input into the insurance side of the system, besides the premiums. But I get ahead of myself.

The proposition that multiplying the number of parties and institutions that have to get a cut of every premium somehow reduces expenses is... eyebrow-raising. I’m not saying it’s not true, I’m saying that if it is, it says something pretty appalling about the comparison case.

...

But what I want to discuss is not the most charitable description, because I think these things weren’t just ineffective at keeping costs down. They were more like boring holes in the hull.

Here's a thing you need to know about The Beer Game: the reliably produced behaviors in the game are the product of humans being reliably human. The chaotic results are not required or enforced by the game. Rather the players in the game respond to the game's stimuli in a counterproductive way. There is an alternative way to behave (the theoretical maximal condition of losing only $200) that is vastly better. But people reliably don't do that because they have certain beliefs, intuitions, guesses, assumptions, and biases.

The whole point of the exercise is to bring to conscious attention these unconscious beliefs, intuitions, guesses, assumptions, and biases, so that they can be unlearned.

Allow me a digression from the whole of health care into that special mess with which I am most familiar: mental health care.

The DSM-III came out in 1980. This was Spitzer's DSM, the New! Impoved! Scientific! DSM for a new rational age. Insurers promptly adopted it – and promptly went through it and decreed certain diagnoses to be things they would and, more importantly, wouldn't pay for.

The following will be Sanskrit to many of you, but: DSM-III introduced the multiaxial diagnosis system. The payers took one look at Axis II and said, "Heeeeeeey, you can't actually treat that stuff can you?" and psychiatry said, "No, that's the stuff that's permanent," and payers said, "Oh, cool. Thanks!" and promptly made the presence of an Axis II disorder diagnosis grounds for terminating (paying for) mental health care, because, hey, Axis II disorders "aren't curable", so money spent of them – or on someone who had one – was "wasted".

This is how a diagnosis of Borderline Personality Disorder – introduced with DSM-III – became so deeply prejudicial and stigmatizing: putting it on someone's paperwork could basically terminate their insurance. (Also, I have a hunch this is one of the things behind the idea that mentally retarded people can't be benefited by psychotherapy; mental retardation is also an Axis II disorder and I wonder if the Axis II == “no mental health treatment allowed” thing played out there, as well, but that's outside my orbit.)

This failed to rein in costs. (Actually, I'm confident the Axis II thing bit them in the ass really hard: people with untreated BPD/o generally consume emergency room resources like whoa.) So they examined the problem and they noticed something that I posted about: that you can't tell how well someone is functioning just from a diagnosis. Ah, okay, we’ve had been asking for the wrong information! Screw diagnosis! If Susie is stable on her meds and getting along fine, why should we pay for her to get psychotherapy just because she "Has Major Depressive Disorder"? Sammy's depression isn't so well controlled, so, sure, we'll pay for psychotherapy for Sammy, but, clearly, we need to know how impaired the patient is.

What happened next is that the insurance industry moved to what is known as the "impairment model". It wasn't enough for a treater to tell the payer what the patient's diagnosis is, the treater was expected to indicate the present impairments. Apparently, payers came up with their own lists of what impairments they would pay for mental health services to treat.

I say, "apparently", because they didn't tell the treaters. However, clinicians surmised these lists existed and some enterprising folks reverse engineered the lists.

Now, on one hand, this impairment model approach sounds very enlightened: diagnoses are deprecated, and understanding the presentation of a person's actual mental health condition is centralized. The problem is, however, that the other hand is trying to pick your pocket. We're still talking about payers (insurers) trying to figure out reasons they shouldn't have to pay for medical care. And their justification here isn't just that if you're doing fine with your Major Depressive Disorder, you don't need therapy, it's that if you are getting out of bed in the morning, getting to work, doing a job, earning a living, and meeting most of your obligations, and managing to eat and sleep and bathe, then that is the definition of "fine" and you are doing fine, no matter what you feel like. The impairment model is concerned with, duh, impairments: about what you can do, or more properly what you can't. It is unconcerned with suffering. It is unconcerned with subjective experiences. Feel worthless, numb, miserable, can't stop thinking of all the people you loved who have died? They don't pay for that to be treated if you're still keeping it together.

...

Now, note that in the diagnosis model, the treater can just write "major depressive d/o, recurrent, moderate" on the bill and be done with it. But that's not how the impairment model works. They didn't say, "Here's the list of things we'll pay for you to treat"; they were all cagey. Instead, they said, "Give us a little report on the patient, explaining why the patient needs treating." So now, clinicians are doing substantially more documenting just out of the gate and because they're then subsequently playing "20 Questions" with the payer to get payed, there's more back-and-forth.

Well, gee, that didn't get costs under control, either.

“Okay, look,” said some insurance companies. “This isn’t working. You guys keep explaining how all these patients are being so impaired by their conditions, and that can’t be right. Surely there can’t be that many behaviorally impaired people among our customers! [Clinicians everywhere: “BWAHAHAHA”] So from now on, we want you to explain not just what the problem is, but what you propose to do about it, and how its been going so far. No, we know you wrote a treatment plan, yeah, we required you to do that, no, we want a new thing on a different form. In addition.”

And on it goes. When I started at psyjob five years ago, we had to do treatment plans with both the diagnosis and impairment models, but then also fill out the insurance company's form ("unit requests") every so often to justify further treatment. Just as I showed up, I was informed that the new thing is that we needed to add a symptom checklist to the treatment plan. Okay. We were told that some of our payers are now demanding that we also track patient status with a standardized outcomes measure (think: a one page questionnaire the patient fills out), so we've added that, too. Okay. We were told that one of our insurers now requires that we fill out a two-party form for coordinating care with the patient's PCP: we fill out the mental health half, send it to the PCP, who is supposed to fill it out and send it back to us. We already requested an annual physical report, but we have to do this, too, now.

Seeing children on MassHealth? You now have to fill out a CANS assessment every 3 months. In addition to all the other paperwork already required by the state.

Who knows what new documentation tomorrow will bring? Nobody knows what it will be, but we all know it will be something, because the people trying to control costs are certain that if they just get enough information out of treaters, they will be able to figure out how to pay less for treatment.

As attentive readers will have long been noticing, I’m talking about coordinative communication.

This was, in fact, the place that the previously published Massless Ropes, Frictionless Pulleys: Coordinative Communication originally was going to go, before I factored it out. If you haven’t read it, you might want to go do that before proceeding. If you have read it, you might want to re-read it here.

What I’m describing in the two histories I’ve just shared – one about healthcare over all, and one about mental health specifically – are examples of how the demands for coordinative communication in the healthcare sector in the US absolutely exploded over the course of the last 40 years. The first also illustrates payers, both insurers and the state, recoursing to organ-ization in an attempt to manage the proliferating costs of coordinative communication, and, apparently, it failing to do so.

My hypothesis is this: that two things happened.

The first thing is that the expenditures on health care began to escalate exponentially as a function of the increased health care available to buy, and this process, which had been slowly gathering steam through the 19th century and into the 20th started rounding the curve of the hockey stick in the 1960s and 1970s.

Which brings us to the second thing that happened: the response. Just like in The Beer Game, players in the game reacted to the surge in demand, by attempting to do things to reduce costs. Wrong things. Precisely the wrong things.

There is a quote, famous among system dynamicists, from Jay Forrester, father of the field:

   “People know intuitively where leverage points are. Time after time I’ve done an analysis of a company, and I’ve figured out a leverage point — in inventory policy, maybe, or in the relationship between sales force and productive force, or in personnel policy. Then I’ve gone to the company and discovered that there’s already a lot of attention to that point. Everyone is trying very hard to push it IN THE WRONG DIRECTION!”

It is my contention that in the US, the naïve response to the phenomenon of rising health care costs due to medical innovation was to increase coordinative communication, which counterintuitively caused costs to increase even more, and because that cost increase was not attributed properly to the increased coordinative communication, the answer to the problem of rising costs was seen to be ever more coordinative communications.

This was an economic death-spiral.

(source)

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