When a health system says, “We don’t negotiate. We have a standard contract template that we offer all our clinicians,” you know exactly how you will be seen by your prospective employer. You will be a standard piece, a cog in a wheel asked to perform a standard set of tasks. In fact, you’ll be asked to perform as many standard tasks as they can manipulate you into doing. ...
Read MoreAvoid contracts that apply metrics to situations with high clinical acuities—such as ER, ICU, or Oncology. Your only way to win in metric-based contracts is to control the costs of the first two standard deviations of patients enough that you can afford the losses generated by the outliers. In high-acuity situations, EVERYONE is a potential outlier. And each is an outlier in their own individual way. No system will cover enough...
Read MoreYour Infinity Gauntlet of Knowlege. New Telehealth benefit regs finalized American Well already selling its telehealth services to plans “Value-Based Oncology” Coming to a cancer center near you. It’s actually “metric-based Oncology.” Spoiler alert: The metrics they measure mostly look at limiting costs—no surprise. Look at tomorrow’s blog posts for more information. Congress working on bill to further regulate prior-authorizations It’s hard to get information on the proposal,...
Read MoreDr. Ned writes: “What’s the most common diagnostic risk code that clinicians miss, i.e. what’s the lowest hanging fruit?” Atherosclerosis of the Aorta. I70.0—hands down. Take a couple of hours Go through their imaging Get it on their problem list Address it the next time they come in Congratulations, you just increased your monthly capitation by as much as 20%
Read MoreLots of organizations have programs promoting “healing in place” and burnout prevention. Be wary. If your leadership decides to dismiss you, your participation can be used against you—possibly in such a way that will follow you the rest of your professional life. I recommend to my clients that they avoid these programs altogether. Don’t help, don’t participate in their creation, don’t use them. I know...
Read MoreAlways end your encounters with a positive word or phrase. I use “get better.” It’s called anchoring. The positive word will suffuse your entire encounter with a positive feeling. Because I do this on a regular basis, my systems preferentially send more patients my way, my malpractice risk is lower and I get extra money through those services who pay for high patient satisfaction. It’s a simple...
Read MoreYour employment contract probably doesn’t have paid vacation. It includes the amount of time you don’t need to come in, during which you’ll be covered by your benefits and receive a check, but it’s not paid. Since you’re paid on productivity, the time you spend not-working will reduce your overall compensation. This is an unusual state of affairs. I guarantee that your administrator yearly salary isn’t docked for the...
Read More…so you better be careful what you decide to measure. Optimization carries costs. Financial costs, opportunity costs. And in healthcare, it also carries the cost of the burden it puts on your medical staff. If you’re risk-sharing under Medicare Advantage, consider what you measure. You really should only be measuring two things: What percentage of patients were seen for their annual visit in...
Read More“You’re so well-informed!” Medicare Advantage tele-health benefit seen as a “boon” for senior living. Medicare Advantage tele-health benefit seen as a “boon” for marketing senior living. There, fixed it for you. Selling senior living, yes…actually improving their care, not so much. Sutter Health settles over-coding action for $30m with no admission of wrongdoing Their real crime is not being big enough to buy their way out of trouble. Where’s the...
Read MoreDr. Salim asks What’s the most cost-effective way to scale your Medicare Advantage panel? Use your nurse practitioners Pay them well. Allow them to become their patient’s personal clinician. Be there to support them. Don’t overwork them. Your performance will astonish.
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