When I’m retained to help a PCP improve their Medicare Advantage performance under a shared-risk contract, what’s my first piece of advice? Relax. If they’re working under a shared-risk contract, Medicare Advantage will reward them for doing what they do best—taking great care of their patients. Sure, they’ll be bombarded with metrics they have to meet and risk-codes they have to submit. I tell them to forget...
Read MoreSamantha was freaking out. Not only was she wearing a scratchy paper hospital gown, but she was anxiously awaiting the results of her mammogram, done earlier in the week. A double whammy. Her heart beat faster. She was sweating despite the flimsy hospital covering. Her mother had breast cancer, so she had a good chance of getting it too. A triple whammy. What would happen if she had a tumor? Would she have to have...
Read MoreTake it seriously. Telemedicine is serious business. A doctor whom you don’t know and who doesn’t know you is going to evaluate your medical problem and possibly prescribe a medication for treatment. She doesn’t know your history, your values, or your preferences except for what you tell her. And you’re doing it over the phone or on video. Your doctor can’t smell you or check out your body language. They can’t see many of the...
Read MoreLooking for insights on how to succeed as a Medicare Advantage Prime? Everything you need to know is right here. How about succeeding as an organization with your Medicare Advantage contract? This is where you need to go. Are you patient looking for unbiased Medicare Advantage information? Here’s everything you need to know. Looking for deeper insights in real-time? Subscribe to Value-Based Transformations and get them sent to you in-box....
Read MoreIf you’re a single speciality primary care group or even a multi-speciality group without your own imaging center, consider buying your imaging studies in bulk from an outside vendor and then using them on the patients in your panel as the need arises. Check your Medicare Advantage contract, but many will allow you to service your patient outside your contract without charge. If yours does not, ask your...
Read MoreCome and get it! Most of the MA links across the web this week are consumer advocacy pieces written in local publications. They would all do better to simply refer patients here. –yet one more example of how Medicare Advantage has gone mainstream. The ACA was supposed to be funded by dramatic cuts to the program. If you made a bet in 2009 (as I did) that it would be the...
Read MoreDr. Cathy wrote me to ask: “Thank you for all your writings. My comp formula is being changed so that I can lose or gain up to 20% of my RBV revenue based on how much my money my Medicare Advantage patients cost. What should I do?” Cathy, You don’t say how many Medicare Advantage patients you have, but suddenly those folks have become very valuable too you. ...
Read MoreThe financial reports you get from your employer and your insurance partners are the key to your happiness. Understand them, and you’ll understand where your can capture the greatest value for your labor. Fail to do so, and you’ll simply push yourself to create more billable encounters as you seek to generate more revenue. That’s a recipe for burnout, depression, and worse. I’m a...
Read MorePoint your browser to YourTelemedicineCommunity.com and follow all my regular postings dedicated to your success in telemedicine. Industry insights. Actionable tactics. Business tips. The ONLY place on the net where you’ll find all this purely from a clinician’s perspective and 100% directed towards your success. YouTelemedicineCommunity.com Be there!
Read MoreOpen enrollment is here for Medicare Advantage—and here’s what you need to do to keep yourself safe: Don’t purchase a plan from someone who contacts you—either by mail, phone, or message. Use the Medicare plan finder tool to compare plans but be careful. There are many look-alike web pages which are actually sales tools in disguise. The real Medicare plan finder too ends in .gov. Once you find a plan, purchase it...
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