Keeping You Ahead of the Curve Thinking of Starting a Medicare Advantage Plan in 2021? Start Now. I’ve been telling our faithful community that we’ve reached “peak” Medicare Advantage. A month ago in my newsletter, readers will remember about not one but two clients who pulled out of the business of Medicare Advantage plan consulting due to a saturated market. Now a high-quality outfit like Lumeris has to advertise for new business—telling. ...
Read MoreDr. Donna asks: “What’s the most effective method of getting a patient in for their yearly visit?” Ask them personally. Leverage your credibility. Make a connection. If a direct contact from me doesn’t work, like say through a phone a call or catching them at the store, then you have a decision to make. I was the only doctor in a small town, so I didn’t believe...
Read MoreRecently had a client who had signed an employment contract in the past with a hospital system sponsored by a religious organization. She was shocked to discover they treated her just like her previous employer—a for-profit system. That is, poorly. It doesn’t matter if your organization is for-profit, not-for-profit or sponsored by some sort of church. They’re all lead by businessmen (and they’re almost exclusively men) with the same...
Read MoreOne of my telemedicine service partners just announced that they no longer want clinicians to treat tick bites—all should be referred to urgent care. Don’t know if they lost a lawsuit, had a risk-review or if it was something else. But does bring up a good rule of thumb—If the telemedicine service partner you work with pushes you to be more conservative with your care, that’s ok. If they push...
Read MoreThe consumer advocate watchdog Medicare Web Watch has released its picks of the best Medicare Advantage websites in the 4 and 5-star categories. The picks are about the websites, not the overall product. But if the usability of your Medicare Advantage plan’s website is important to you, this may be one shopping site you don’t want to miss. It’s updated every year, so bookmark it for when it’s time...
Read MoreIf you’re a prime risk-sharing under Medicare Advantage, take your time. Make sure, when you see your patient for their yearly visit, you book lots of time to engage them fully. It may be the only time you have to bond, so you don’t want to be rushed. Answer their questions. Explain the justifications behind the health interventions you request. You’re being paid very well to...
Read MoreI freelance for a service that sends docs into the homes of Medicare Advantage patients to collect data for their yearly visit. They charge plans and organizations $500 or more to obtain the data of patients who would otherwise not be seen. Try paying that to your primes instead. Give them a substantial bonus if they get more than 95% of their patients in to be...
Read MoreKnowledge is Power! “We see the future of Medicare and Medicare Advantage as the same.” Thus spake HHS Deputy Secretary Eric Harden Saw the “mainstreaming” of Medicare Advantage coming 30 months ago when insiders starting jumping on the boards of Medicare Advantage Organizations—it was one of the things that inspired me to start writing. It’s an enormous sea change from just three years ago—as late as 2015, Medicare Advantage was hated and being defunded...
Read MoreDr. Hakim asks: What are the diagnostic risk codes my patient probably has and I’m missing? Atherosclerosis of the Aorta (review past imaging, it may be an incidental finding) Stage 1 diastolic CHF (review past echos) Renovascular hypertension (HTN + atherosclerosis of the renal artery on a past imaging study) Emphysema (review past chest x-rays) Peripheral Neuropathy (perform sensory testing on their feet) These are the most common. There are more—check...
Read MoreIf you get all your revenue from one source, say your employer, they own you. If you get your revenue from many different sources, you own yourself.
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