The ever-insightful Charles Hugh Smith describes the “S-Curve of Centralization.” Bloomberg reports on the financial distress and consolidation in the healthcare sector, leading to the question: On the “S-Curve of Centralization”, where is healthcare? Which leads to even harder questions: Given your massive investment in training, what are the implications for your future career plans? How will you leverage your investment for maximum...
Read MoreThe Lexicon of Value The Law of the ATOM* An immutable and all-powerful truth. Whenever anything becomes too expensive relative to the value provided, particularly if the inflated price is the result of artificial government intervention in markets, a technological solution invariably replaces the expensive, cumbersome incumbent, no matter what the incumbent’s advantages in money and influence. And the incumbent invariably meets the technologic solution with the same series of defensive...
Read MoreFine, Dr. Davis. If I don’t want to deal with all the headaches of MACRA, I should buy my own healthcare. But I don’t have any money for that. None. What should I do then? The same thing. Nearly all of these clinicians have a certain number of slots set aside as “scholarships.” They’re intended specifically for people who can’t pay the full rate. That’s how these...
Read MoreThere’s nothing wrong if you want to work within corpmed—as long as you’ve decided to do so intentionally and did not just sleep-walk into your position. And because I’m concerned about your personal and professional success, I’ve urged you to read the book “The Dictator’s Handbook“—a roadmap for your survival in any large organization and a fascinating, impactful read. The book draws on published, peer-reviewed research, using governments and large businesses...
Read MoreTime for another edition of my wildly popular “Success Codes” series. If you haven’t already, you may want to review my world-class, yet humbly simple (yes, really) explanation of RAF scoring—it’ll help you understand some of the shorthand terminologies below. It’s the only one on the web written by a PCP who’s been in the trenches blocking and tackling since Medicare Advantage first arrived on the scene 20+ years ago—and done so with incredible results. ...
Read MoreIt doesn’t matter how large the reward of success if the cost of failure is too great to bear. That’s called skewness. More and more clinicians are about to see it. Here’s what it is and what you can do. Many ACOs and Medicare Advantage organizations (MAOs) are moving toward total-risk models of compensation for their clinicians. Under these plans, clinician compensation will consist...
Read MoreWhat the administrator says to the PCP: “You know, we really need you to spend extra time risk-coding, but we’re not able to put it in your comp plan. Really, it’s no different than asking an orthopedist to use a less expensive implant in the OR.” What the PCP hears: “We have to rely on uncompensated professional labor to sustain our cash flow…and since we really don’t understand or respect the work...
Read MoreMACRA changes how medical care is paid for. Instead of being paid for delivering a unit of service, the professionals who care for you will be paid by your insurer based on the data they submit. Data, not care. What you pay for is what you get. Insurers want data, they’re going to get data. The patient wants care; they’re going to get data. ...
Read MoreSerena was a puzzle. And the source of her superpower was surprising. It lead me to write these words to share her wisdom. I first met Serena in her office. A physician, a generation younger than myself, she was smart and pleasant and friendly. And content. Very, very content. For that matter, those same words described her office and her staff....
Read MoreTime for another edition of my wildly popular “Success Codes” series. If you haven’t already, you may want to review my world-class, yet humbly simple (yes, really) explanation of RAF scoring—it’ll help you understand some of the shorthand terminologies below. It’s the only one on the web written by a PCP who’s been in the trenches blocking and tackling since Medicare Advantage first arrived on the scene 20+ years ago—and done so with incredible results....
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