When management fails to listen
Dr. Taylor loved working at Kaiser Colorado and used to joke that he had job security as director of revenue cycle because doctors don’t like mixing business with medicine. He earned less money than when he was a family physician but “loved the lifestyle because it gave me time to spend with my wife and two young children.”
He was well thought of by the medical group – they elected him to serve on its board of directors for 4 years (2009-2013), during which time he served 2 years as chairman. They also sent him to Harvard’s executive leadership program.
As a certified risk adjustment coder and EPIC (the electronic medical records system that Kaiser used at that time) certified physician builder, Dr. Taylor had the expertise to recognize problems and fix them.
The audits that Kaiser and Dr. Taylor conducted showed high rates of errors for conditions related to cancer, stroke, and vascular disease.
“I hired a physician to review thousands of stroke codes and catch the false ones and created a filter in EPIC that weeded out incorrect codes before they were submitted,” Dr. Taylor says.
But these changes didn’t last because Kaiser managers would cancel or defund them, says Dr. Taylor. “That’s why I stayed for so many years. I would make one change and it would go very well and then they would shut it down. I would think, ‘This is great, they’re listening,’ but then it was gone. If all that had happened at once, I would have left immediately, but it was over time,” says Dr. Taylor.
He informed Kaiser Colorado’s upper management and its national organization about the problems, but he got nowhere.
Becoming a target
Dr. Taylor’s efforts to stop Kaiser from submitting false diagnosis codes didn’t sit well with the CFO.
Things came to a head in 2014 when Dr. Taylor discovered that a board meeting had been called to push him out of the company. “They said I failed a work improvement plan and that was why they needed to get me out.
“When they started saying that I was part of the problem after all the work I had done to keep their noses clean, I couldn’t tolerate it any longer. That’s when I filed the lawsuit,” says Dr. Taylor.
The stress from the “chaos and craziness” was also starting to affect his health, and he was worried that Kaiser would damage his reputation further.
He resigned in 2015. “I left 14 months before being fully vested in their retirement program.”
Employer retaliation?
Prime first sidelined and then fired Mr. Mansukhani (not for cause) in 2017 just before he filed his lawsuit. It offered him only 30 days of severance pay, which he didn’t accept. He didn’t think his firing was in retaliation for being a whistle-blower because his relationship with the chief operating officer had soured long before, in 2013, and the lawsuit was sealed.
At the time, he owned a nursing home in England that was doing well financially. He worried whether “Prime would try to retaliate against me in the U.K. I was a senior executive in a fairly high-profile position in the health care sector, and lots of informal networks exist,” says Mr. Mansukhani. But that never happened.
He found a new job right away. “At that stage of my life, I was 53 years old, and I wasn’t looking for another job. But College Healthcare in California offered me one as the CFO, which I accepted,” says Mr. Mansukhani.