The Tele-Medicine Trend

I was stunned by what I found. I’ve been delivering care by phone for 30 years. Before industrialized medicine, when one of my patients needed help after hours, they called me and I did my best. What’s old is new again. Except this time, it’s called “telemedicine” And you’re going to have to pay money for it—and the doctor on the other end of the line won’t know you. By 2023 one out of five...

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What’s the single most important clause in your employment contract?

What’s the single most important clause in your employment contract? It’s not your comp, or even your loan repayment. It’s your “exclusive rights” language. Carrie Fischer once said that her first Star Wars contract was so restrictive on the use of her image that she couldn’t look in the mirror without sending George Lucas a quarter. It took her thirty years to get out of that agreement, until then, she was cursed to looking at...

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Your Opportunity in the New VA Choice Bill

The VA Choice Bill was recently signed into law, and it represents yet another opportunity to strengthen your Medicare Advantage performance. Vets can now more easily get their care from physicians outside the VA system.  The bill is an expansion and improvement on a previous attempt to do just that. The bill is directed at vets without any other kind of insurance, not even Medicare. But with the educational campaign that’s funded by the measure,...

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Sunday Update

Links to enlighten—and make you look like a genius!   Medicare Advantage rankings hit underserved particularly hard To be fair, its much more difficult to have underserved patients hit their quality marks—still that’s why CMS is diverting revenue their way. It will take another 18-36 months for those changes in cashflow to show up on the Medicare Advantage Organization’s top line. Will the extra money change the rankings?  Stay tuned!     Whistleblower case can...

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Saturday Quiz

Coding Conundrum Questions that amaze and inform! Which of the following conditions DOES NOT increase the monthly capitation of a Medicare Advantage patient? A. Atherosclerosis of the Aorta B. Atherosclerosis of the Brachial artery C. Atherosclerosis of the Femoral Artery D. Atherosclerosis of the native arteries of the extremities—unspecified E. Atherosclerosis of the Carotid Arteries   Scroll down for the answer                           The...

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Wow, the student has surpassed the master.

Wow, the student has surpassed the master. A field report by Dr. Wanda regarding dual-eligibles, that is patients who have both Medicare and Medicaid and whose capitation can be as much as 30% higher than beneficiaries with only Medicare Advantage. “I took your advice to heart about recruiting dual-eligibles and tapped a great source, older and disabled patients coming out of prison. I make contact with a local state social worker and she started sending...

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Medicare Advantage Enrollment

Medicare Advantage Enrollment A recently released regional analysis of Medicare Advantage growth is giving an early look at what happens to Medicare Advantage enrollment when markets become saturated and mature. The western US was an early adopter of Medicare Advantage coverage and their enrollment rates have now consistently leveled out at around 40%. The other regions of the US aren’t at the 40% plateau yet and are still enjoying exponential growth, but if the west...

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An Enormous Change That Could Cost YOU

By law, beginning in 2019, even the best supplements to Medicare insurance will require beneficiaries to pay a little less than $100 each month out of their own pocket first before the insurance policies kick in. This is an ENORMOUS change, that could cost the average beneficiary $1,000 a year out of their own pocket that they’ve never had to pay before. Please pass this post around to everyone you know. Repost it. Retweet it....

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What to Do When Evaluating Employment Offers

What to Do When Evaluating Employment Offers When you’re evaluating employment offers, watch out for that “potential” number when evaluating the compensation. You’ve seen the advertisements: “…$250,000 guaranteed, $350,000 potential…” That “potential” number is being used to manipulate you on many levels, some obvious some not so much. And to make a good decision, you have to defeat them all. Do you ever pay sticker price for a car? Of course not. Nobody does. Then...

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2018 Medicare Handbook

The worm has most certainly turned. The 2018 Medicare Handbook just came out, and it’s the most favorable to Medicare Advantage that I’ve ever seen—and that’s a big opportunity for you. The handbook is delivered to all Medicare beneficiaries and those who will soon be eligible. It is the Federal Government’s official communication about the program and as such it is the single most influential marketing tool there is—bar none. When I first contracted with...

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