Posted on November 30, 2018 by Tom Davis

Family Medicine is the Most Lucrative Specialty

If you become facile with Medicare Advantage you can write your own ticket. You might start your own home-visit-only practice, you might join a group of like-minded primes, or you might choose employment with Optum or a venture capital-funded organization looking to take advantage of the financial opportunities Medicare Advantage generates. Either way, you can earn more than the 99th percentile of your specialty with far less effort than you do now. ...

Posted on November 30, 2018 by Tom Davis

Use the term “sulfa”

When you’re prescribing medication during a telemedicine visit and you’re using a brand name sulfa med such as Bactrim or Septra—throw in the fact that these are “sulfa” antibiotics. You could have gone through your whole visit protocol, asked them about allergies and medication intolerance, but when you mention the word “sulfa,” you’d be amazed at how many folks chime in with “Oh, I can’t take sulfa.” You don’t have to do it...

Posted on November 29, 2018 by Tom Davis

Telemedicine Thursday—The Anatomy of a Telemedicine Offer

Welcome to Telemedicine Thursday Every Thursday, I’ll be exploring new topics to make you the most successful telemedicine clinician ever. The Institute for Telemedicine Mastery will be opening soon—and you’ll be able to find everything you need to create and run a highly successful telemedicine practice. One that will suit any need. Just got off the phone from a recruiter with an offer of a full-time telemedicine position—let’s dissect it as I...

Posted on November 28, 2018 by Tom Davis

Medicare Advantage and Pre-Existing Illnesses

If you decide Medicare Advantage is not for you and go back to traditional Medicare, some of your pre-existing illnesses may not be covered by any “medi-gap” insurance you purchase. It’s actually pretty common for this to happen. If you have traditional Medicare and a “medi-gap” insurance supplement and are thinking of enrolling in Medicare Advantage, make sure you ask your insurance agent what happens to your coverage if you decided...

Posted on November 28, 2018 by Tom Davis

You can change your insurance anytime once a year, but you can change your PCP anytime you want

The title says it all. You may be locked into a Medicare Advantage plan for a year from open enrollment period to open enrollment period—but you can change PCPs anytime on a month-to-month basis. If you’re not satisfied with your PCP, or think they’re inappropriately withholding access to care, change. Your insurance home can guide you. If you don’t have one, get one—but until then call the number on the back of...

Posted on November 27, 2018 by Tom Davis

Your Medicare Advantage Panel: How Many Patients Do You Need?

A minimum of 100. Based on the math and experience, that’s how many you need to decrease the risk that a small number of severely ill patients will result in negative financial performance year-after-year. After that, the top number is based on your skill, time commitment, and interest. So if you have a panel of fewer than 100 patients and are bemoaning your lack of performance, there is only one way forward—get...

Posted on November 26, 2018 by Tom Davis

Your Medicare Advantage Panel: How Many Patients Do You Need

A minimum of 100. Based on the math and experience, that’s how many you need to decrease the risk that a small number of severely ill patients will result in negative performance year-after-year. After that, the number is based on your skill, time commitment, and interest. So if you have a panel of fewer than 100 patients and are bemoaning your lack of performance, there is only one way forward—get more patients....

Posted on November 26, 2018 by Tom Davis

Targeted Care Management

Assign a care manager one or more doctors. Based on your budget, allow each PCP a specific number of active cases–3% or 4% of their panel. Let the care manager work directly with the PCP on specific tasks that will decrease the patient’s overall care costs. Forget all the rest. Like so many other systems, care management can become a bloated, ineffectual and self-perpetuating mess. There is already a pushback...

Posted on November 25, 2018 by Tom Davis

Sunday Links

Even during Thanksgiving!?!?!?!?!? Humana rides the Medicare Advantage wave. First United, now Humana—can the Coventry and the Blues be far behind Proposed revisions to Medicaid managed care rules No matter what they do, it still won’t be profitable unless the insurers restrict access to needed care—Medicaid is simply too underfunded. Maybe they should risk-share with their primes? Hounding state legislatures for more money is getting tiresome. First summary of Medicare...

Posted on November 24, 2018 by Tom Davis

Saturday Quiz

Designed to Amaze and Enlighten Can you diagnose ventricular fibrillation on the basis of a patient’s defibrillator interrogation? The “shocking” answer below. x x x x x x x x x x x x x The answer: Yes. If the report indicates an episode of vfib took place and the patient was shocked, go ahead and submit the diagnosis at the time you see the patient and address the issue. Make it your...