Sunday Links

          What you need to know, when you need to know it.   In most states, medi-gap plans can charge higher premiums based on pre-existing conditions Those states have higher Medicare Advantage re-enrollment These findings suggest just how price-sensitive Medicare Advantage enrollees are. If out of pocket costs for Medicare Advantage beneficiaries go up, get ready for those beneficiaries to re-assess their choices.       The GAO predicts the new...

Read More

Saturday Q and A

Dr. Beth asks:   When is it appropriate to do testing to find risk codes? My boss is asking me to do routine Cxrs to find atherosclerosis of the Aorta.   Beth It’s never appropriate to do testing to find risk codes. Ever. If you can, find a new employer.  Yours is going to get you into trouble. No telling what other corners they’re going to cut.

Read More

The Most Important Clause in Your Employment Contract

It’s your non-compete.     Your employment contract is very one-sided.     It’s only as good as a judge will enforce.     And getting to a judge can be very expensive.     Your employer has far more legal resources to take you to court and enforce their interpretation of your contract.     They also have no scruples about manipulating the legal system to do get their way.     They will...

Read More

One Quick Trick to Dramatically Reduce Your Telemedicine Malpractice Risk

The most common causes of malpractice actions against telemedicine clinicians involve medication reactions.   So don’t prescribe any medication unless it’s indicated, and document why you did so.   So many clinicians prescribe comfort meds via telemedicine—lidocaine lozenges, benzonatate and the like.   Bad reactions are rare, but they happen. I’ve reviewed the cases.   Better to recommend OTC meds to be used as directed or naturopathic remedies like honey.   Telemedicine clinicians already practice at...

Read More

Beware! Changing From Medicare Advantage to Traditional Medicare is Fraught With Peril

For the first time, this year you could change your Medicare Advantage coverage outside of the open enrollment period.     But if you wanted to change back to Traditional Medicare, you wouldn’t be able to buy a Medicare supplement. You can only purchase those towards the end of the year.       Apparently, a large number of seniors didn’t realize this and they’re now stuck paying a significant part of their healthcare costs...

Read More

Change Your Story and You’ll Change Your World

We survive by telling ourselves stories. Stories of our lives, our missions, our motivations.     Change the story and you’ll change your world.     Change the story of you taking some of your compensation under a  “shared-risk” structure into a story of “shared-opportunity” instead.     They’re the same thing, but each story has a different plot and a different ending.     Under the “shared-risk” story, you work to avoid loss, to keep...

Read More

Specialists as Primes

With the advent of bundled payments for a growing number of procedures, your specialists will begin to feel the financial pinch of Medicare Advantage.     One solution.     Allow them to become risk-sharing primes.     Have them hire a PA or NP to provide front-line care and enjoy the financial benefit.     One of my partners was a cardiologist. He earned more from his MA contract than his specialty services.  ...

Read More

Sunday Links

You’re the Thanos of Medicare Advantage—But in a good way.     “Sticker Shock” for Sicker Patients Who Dump Medicare Advantage Plans For the life of me, I can’t decide if this is a pro or anti-Medicare Advantage article—that must mean it’s pretty balanced. It’s worth going through the paywall, it’s an interesting read.           Insurance agents report increased Medicare Supplement sales. Another sign of “Peak Medicare Advantage?”  Your job may...

Read More

Saturday Q and A

Dr. Dave inquires:   Should I be seeing my patient panel list every month? What do I do with it if I do?     Yes   Call every new patient personally and invite them in. Ask them why they signed up with you—send referral sources a personal thank you note.     Call every patient that disenrolls:   Make sure they disenrolled intentionally. Find out why. See if you can address the why.    ...

Read More

Here’s My Number

“Here’s my personal number. Call me before you use any healthcare. It’s what I’m here for.”     That’s what I told every one of my Medicare Advantage patients every year.     That’s what I advise my clients to tell their patient’s too.     A personal contact number for after-hours use is the single most effective tool to control costs.     It’s rarely abused, and when it is abused a little re-education...

Read More