Another Reason to Risk-Share—More Competition for Your Laborers

Venture capital groups are flooding into the Medicare Advantage space—but not it the way you might think.   They are buying up practices and setting up primes with full-risk compensation structures.   With the incredible cash flow a well-executed Medicare Advantage practice can generate, these practices rapidly increase in value, not uncommonly five-fold in one or two revenue cycles—about 36 months. Such practices can then be sold into a consolidating market for breathtaking gains.  ...

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Sunday Links

Smart—Damn Smart   A set of 2020 Medicare Advantage rule changes were proposed last week. Full text here. Summary here. Insightful commentary here.         Some hospitals pushing back against low Medicare Advantage payments. Medicare Advantage turns inpatient days into a commodity, so you can’t blame insurers for pushing down prices just like Wal-Mart does to its suppliers in China. But learn the lesson—if you push prices too low what you’ll get in...

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Saturday Quiz

Designed to Amaze and Enlighten!   Which of the following conditions should you test all your Medicare Advantage patients for to pick up a risk code? A. Aortic Atherosclerosis B. Sickle Cell Trait C. Pathologic Vertebral Fractures D. Emphysema E. None of the above   The shocking answer below… x x x x x x x x x x x x x x x x The answer is E. None of the above. It’s never...

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Fortunately, You are Not a Horse

Horse blinders are a relatively recent invention.  They were created in the mid-1800s to protect the eyes of the second set of horses pulling a carriage from the reins attached to the first pair harnessed ahead. If you look at drawings from earlier times, you won’t see them.   Over time, blinders became standard in all tack, so the reins could be interchangeable between the front pair of horses and the back. They also became...

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One Quick Trick Toward Improving Your Medical Staff Morale and Retention (and it won’t cost you a thing).

Add a commitment to clinician well-being in your mission statement.   Do so and you’ll quickly find your organization will be virtually unique.   It’ll give you an enormous advantage in clinician recruitment.   You’ve already invested in your physician wellness program—why not advertise it to those for whom it really matters?   You wouldn’t open a new service line without marketing, why wouldn’t you do the same about how well you support your clinicians—especially...

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Dr. Tom

Dr. Tom   Am I trapped in the Medicare Advantage plan I pick for a whole year or can I switch plans outside of the yearly open enrollment period?   R.G.   R.G.   Great question.   In general, you may enroll into or change your Medicare Advantage plan during an open enrollment period that generally runs from the first week in October through the first week in December.   As you might expect, though,...

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The Mission Statement Tells All

Be wary of health systems that promote themselves to prospective clinicians as “physician-led.”   If you’re recruited by one, ask them if physician leadership or wellbeing is in their mission statement.   If it is, investigate further.   If it is not, walk away—and count your blessings that you didn’t waste your time.

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Persuasion

When you instituted an EHR, you sent your clinicians to training to learn the skills needed to work the thing.   Now, your revenue is increasingly dependent on how well your patients comply with your prime’s guidance.   Are you thinking how to train your clinicians to influence your patients more effectively?   Buy every clinician a copy of “The Science of Influence” by Robert Cialdini.   Pay them $500 once they state, in writing,...

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Sunday Links

A gold rush of information for your patient’s prosperity—and your own.       At least 40% of MA plans will offer home care assistance And at least 40% won’t be given enough supplemental funding by CMS to cover the costs. if you risk share, part of the expense of this service is coming out of your pocket—act accordingly.         Why Medicare Advantage is here to stay Venture capital firms are recruiting...

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Saturday Quiz

Designed to enlighten and amaze   A breast cancer patient 3 years s/p lumpectomy and radiation therapy who is in the middle of a 5 year course of Anastrozole can be diagnosed as if she has an active breast cancer. True or False   The shocking answer below: x x x x x x x x x x x x x x x x x x x The answer is True Unless your Medicare Advantage...

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