One of the benefits of practicing under a shared or total-risk contract is that the fixed global cap you practice under generates clarity in your business systems. Things that generate real value become obvious, as do things which do not. Occam’s Razor. the simplest explanation is the most likely. So, if your employer asks you to do something that you can easily see generates no or negative value, it’s...
Read MoreThere’s clinical telemedicine and DME telemedicine. Clinical telemedicine consists of taking care of patients. DME telemedicine consists of using your license to sell stuff. DME telemedicine usually involves a third-party paying for the stuff you prescribe. As such it’s open to all sorts of regulatory risks. Avoid it.
Read MoreMedicare Advantage is all about collecting your data. It’s how your health system and insurer gets paid by the government. It’s also how they generate revenue from vendors looking to sell you something—especially things that the government, not you, has to pay for. Health systems and insurers sell your data to these vendors. That’s why, as soon as you sign up, you get drowned in marketing....
Read MoreYou, a physician or nurse practitioner, are not special. You’re being asked to stare 50 hours a week at a computer to do things that you didn’t sign up for, didn’t train for and don’t feel quite right about. So you’re burned out, disengaged and depressed. Look around. I just described pretty much every other job out there. Car mechanic. Civil engineer. Even my dog groomer....
Read MoreWhere your genius lives. More on the new Medicare Advantage telehealth benefit From Forbes—so it’s what your patients are reading. Pharma has been unable to stop the new step therapy requirements for meds, so now they’re war-gaming the results. Step therapy requirements will make in-office administration of meds less profitable and therefore less available. Like most things in life, it’s a mix of good and bad. CMS promises...
Read MoreDr. B writes “I’ve lost money on my Medicare Advantage panel three years in a row. When should I quit trying?” Troubleshooting docs like Dr. B is what I do. Make sure you know how your contract works. Make sure you’re getting more than 95% of your patients seen every calendar year. Make sure you understand the basics of how to code. Once you have the systems in place to...
Read MoreHow was I so successful under my Medicare Advantage contract? I checked my patient panel lists once a month. And if someone disenrolled, I considered calling them. First, I checked with the staff to make sure they weren’t someone I was better off without—then I made the call. No one likes to take a chance on rejection, but I found the...
Read MoreI recently took care of a woman with a classic exacerbation of chronic bronchitis. Smoker, productive cough with purulent sputum, temporal fever of 101.3, symptoms for 7 days. I was preparing my prescription for doxycycline as I ran through my standard set of questions—and it turned out she was breastfeeding her 2 month-old. She never volunteered the information until I asked her directly. ...
Read MoreMedicare Advantage has released more rules allowing your doctor to obtain more information from you without being seen in the office. The health systems which employs your doctor and your insurer have a lot of money riding on the collection of this information. Prepare for Pestering. You will be getting phone calls, texts and emails asking you to put on your remote sensor so they...
Read More“Paid Vacation.” The term refers to time off you can take while still getting paid. That’s not what most employment contracts offer. You get time off, but since you’re not working—and you’re not generating RBVs—you aren’t getting paid. It’s basically FMLA time, benefit coverage and not much off. Demand for physician labor is increasing, try this the next time you evaluate your employment...
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