There is enough money in the Medicare Advantage revenue stream to pay your clinicians for meeting metrics that improve the overall contract’s success—even if you don’t want to risk-share with them directly. The best I saw was a $10 per patient bonus for meeting this measure for 12 straight months: Have 95% of the patients on your panel completed an annual wellness visit in the past 12 months? Simple,...
Read MoreThe Source of Your Power Lyft Expands Rideshare Partnerships with MA Plans This is a key, key tactic to improve compliance and prevent no-shows—especially for yearly visits. I’ve been advocating this with my clients for more than three years now, and it’s the best performing intervention I’ve ever recommended. Medicare transport has long been a benefit under MA. It’s also long been poorly delivered by third-party vendors—they’re late (when they show up...
Read MoreSara M asks a follow-up to last week’s question First here’s last week’s query: Dr. Tom When a patient is seen outside of the office and their x-ray with a reading of pneumonia comes through my in-box, do I really have to have them come in for a visit to make sure it’s submitted? Can’t I just code it from the x-ray? Sara Excellent (and common) question. No. You can’t submit codes...
Read MoreWe had a front office employee who stole from us. On a regular basis. For over a year. After taken care of the situation, we brought in a consultant to help us keep it from happening again. She told us the embezzlement was our fault. We didn’t have the processes in place to prevent it. That put the employee in the position where she could steal with impunity. If we had...
Read More“If they offer anything short of that—say, claims made without a tail—you might want to think long and hard about working with them.” I wrote that last Thursday, and since then I received hundreds of different variations on the question “Why?” Telemedicine is in its “wild-west” phase. Many telemedicine services seeking to recruit clinicians are poorly funded. Some are “fly-by-night.” Claims-made insurance is the cheapest, so offering that sort...
Read MoreAfter the first of the year, you can get a “do-over” on your Medicare Part D plan, too. This year, with all the new charges and prior authorizations and step edits required to get your meds, you’re more likely to find out that your drug benefit is not what you thought it was. You can change it with little to no hassle in the first three months of the year. ...
Read MoreYour thumbs are subtle indications of your power. In dealing with those in authority, make sure they’re exposed at all times. Don’t put your hands in your pockets. If you must, leave your thumbs exposed. Thumbs forward when you have your hands at your side. Shake hands with your thumbs up. Successful executives will try to establish authority during a handshake by turning their hands...
Read MoreKeep a personal trainer on retainer so your primes can use them for their patients who are motivated to use the extra help. What’s the most powerful predictor of healthcare costs? It’s frailty. How do you cure frailty? Exercise. Resistance exercise. Can you cure frailty in everyone? No. You can only cure it in someone who’s motivated. But with Medicare Advantage the ROI on a single frail person who’s...
Read MoreAll the news that fit to link Private Medicare enrollment soars even as talk of Medicare For All increases From Forbes Every Medicare For All proposal consists of healthcare funded and executed by the government only. No private insurance of any kind. There are pros and cons, but Medicare Advantage is not part of any plan. Not one. Medicare Advantage growth exploding not slowing Renown Healthcare Anthem Even Google The narrative...
Read MoreLonette K. asks: “I tried what you suggested but my boss won’t take “no” for an answer when it comes to limiting my workload. What (should I) do?” Go part-time, either there or somewhere else, and make up the difference with a telemedicine practice, an expert witness practice, moonlighting, or some other sideline. Part-time practice is a significant drag on the financial performance of your employer, that’s why they will...
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