A Simple Roadmap for Your Professional Success

For Clinicians and Clinicians-to-be.   As the compensation for your labor is reduced over the next three, revolutionary years, it’s time to take a simple test.   Are you . . . In a practice small enough to be excluded from MACRA/MIPS? Getting the majority of your revenue from direct patient payments? Getting the majority of your revenue through shared-risk from a managed care program such as Medicare advantage?   If the answer to any...

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Success Codes—Psych Edition

For Clinicians and Organizations   Time for another edition of my wildly popular “Success Codes” series. If you haven’t already, you may want to review my world class, yet humbly simple (yes, really) explanation of RAF scoring—it’ll help you understand some of the shorthand terminology below. It’s the only one on the web written by a PCP who’s been in the trenches blocking and tackling since Medicare Advantage first arrived on the scene 20+ years ago—and...

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Sunday Links

HOW TO MOST EFFECTIVELY DONATE IN SUPPORT OF THOSE AFFECTED BY HURRICANE HARVEY AND IRMA Will be evergreening this link for several weeks.     SELFIES DIAGNOSING CANCER Not skin cancer, but pancreatic cancer.  And not actually diagnosing cancer, but as a possible screening tool using subtle findings of jaundice in the whites of the eyes.  Sure to be lots o false positives, especially with one in eight Americans struggling with alcohol abuse.  The headline...

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Order Up

For Clinician and Clinicians-to-be As your EHR pushes you from task to task, patient after patient, day after day–keep one thing in mind: Short order cooks rarely change the world. Absolutely nothing wrong with short order cooking—nothing at all. If that is your dream.                   Have a question about getting the most out of your current training program, finding your ideal job or making your current one...

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The Illness-Adjustment Loop

For Clinicians and Organizations   Observe. Orient. Decide. Act.   OODA . The OODA loop is an essential tool for strategic analysis.   Twenty plus years ago, when I first looked over our first Medicare Advantage contract, it appeared to be a complex mess.   But with all the deferred revenue payments, the data-driven revenue adjustments and action/reaction format, it read uncannily like a form of an OODA loop.   So I applied that paradigm...

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During a Natural Disaster–A Patient’s Guide to Medicare Advantage

If you or someone you love has been displaced by one of the hurricanes and needs chronic medical care—-read on.   Folks covered by Medicare can seek any care they need by any medical provider that takes Medicare, they just have to present their card at the time of service.   Lost that card?  Call 1-800-Medicare for a replacement.   If you’re covered by Medicare Advantage it’ll take a bit more effort for you to...

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Mind the Costs–Don’t Underestimate That Red in the Ledger

For Clinicians and Clinicians-to-be.     I spoke to my son’s allergist the other day. He’s sixty-four, runs his own practice and was calling me back at 7pm at the end of a fifty patient day. Having collaborated with him for over 25 years, I asked him if MACRA was going to finally drive him out of his clinic. With strong emotion in his voice, he answered me. “I’m sixty-four,” he said “and I’ve been...

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Medicare Advantage and Disasters—A Clinician’s Guide

For Clinicians and Organizations. The last thing you should worry about in a disaster situation is what’s going to happen your Medicare Advantage pool.   But your patients have evacuated far out of the network area, getting their healthcare from who-knows-whom at who-knows-what cost—-and at least some is coming out of your pocket.   Should I really not worry about that?   How do they get their medication?   How do they prevent an interruption...

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Sunday Links

HOW TO EFFECTIVELY DONATE IN RESPONSE TO HURRICANE HARVEY Experience teaches it’s best to give to local charities; less overhead, more impact—but the choice is yours.     FDA WARNS OF POTENTIAL CONTAMINATION IN NUTRITIONAL SUPPLEMENTS This is a single case used to generate click-bait scare headlines, but in practice I’ve seen it as a real problem. I’ll be posting about this soon but be aware that the little statement in small type on the...

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