How to Get the Best Compensation for Your Time.

The newly proposed change in Medicare payments has a profound impact on the strategy that I teach young clinicians for generating greater compensation for working the same amount of time.   It makes the strategy even more effective.   The strategy is based on the premise that most of the compensation in your job comes from actually seeing patients, the rest—the “bonuses,, the “value-based adjustments”—require significantly more work than the additional salary they generate.  ...

Read More

Hammering a Nail with a Ham Sandwich

CMS soon will require ACOs to take downside risk.   Forget participating in shared-savings. If your expenditures are less than your comparative benchmarks, you’re are going to have to pay—out of your own pocket.   And it will happen.   I sat across the table from a few of my partners as they had to write a check to our insurance partner. They spent more money than they took in. Being financially “at-risk” for their...

Read More

How to Help a Grieving Friend

This space is reserved for high-value tips to help patients get better healthcare safely.   Here is one of the highest-value tips I’ve ever offered.   How to help someone deal with their pain.   Not the most uplifting topic I know, but an essential one.   And after four minutes you’ll discover how to comfort those you care about when they suffer a loss.   It’s a life skill we should all know.

Read More

How to Avoid Failure in a Telemedicine Practice

Don’t quit.   Quitting is the greatest barrier to setting up your own telemedicine practice.   Telemedicine is so new and the providers still so much a work in progress that after a few challenging experience clinicians just give up.  Strong willed physicians—physicians who toughed their way through the most difficult rotations, who have delivered babies safely though the most horrific malpresentations and resuscitated those given up for dead—for some reason, after a couple of...

Read More

Getting Paid for Amputations Above the Waist

Amputations below the waist are associated with additional compensation under Medicare Advantage.   Amputations above the waist are not.   Don’t ask why, that’s just the way it is.   Prosthetic leg—you get additional payments to offset the cost.   Prosthetic arm—not so much.   However, phantom limb syndrome with pain (G54.6) or without pain (G54.7) carries significant additional compensation no matter where the limb is amputated.   Ask your patient about it.   They...

Read More

Sunday Links

The font of your expertise   A little different Sunday Links today. Here’s a listing of the greatest hits from my blog for the past 18 months, each one guaranteed to help you do better. Read every one of them? That’s how you become a Medicare Advantage Master.   Medicare Advantage Lessons Learned The last in a series. Read ’em all     You’re just as capable as a Radiologist. Words to live by  ...

Read More

Saturday Quiz

Designed to Amuse and Enlighten   With an equal disease burden, age and all residing in the same county, which of the following individuals would give you the greatest monthly capitation: A. Someone who became Medicare eligible because of reaching age 65 B. Someone who became Medicare eligible because of a disability. C. Someone who became Medicare eligible because of because of reaching age 65 and who is also eligible for Medicaid. D. Someone who...

Read More

The Day My Staff Revolted

One day I had had enough.  And boy did I learn something.   Something about the power of persuasion.   I should explain.  You have the second-best office staff in the nation.   How do I know that?   Because I had the first.   Top to bottom.   Compassionate, skilled, team-oriented.   Fun.   They were the best.   Then one day, I decided to stop seeing drug reps and attending their lunches.  ...

Read More

People Who Work With Me Succeed

I blog daily to give my “tribe” a single high-value tip every day that will help them do better for themselves—and by their patients.   A recent encounter with a new client led me to the tactic I’m going to share today.   I tried to always ask my new patients how they found me.   The answers were varied and often illuminating.  Online, a referral, one even told me I had the same name,...

Read More

The One Questions You MUST Ask When Selecting a Hospice for a Loved One

“How long has the average nurse been with your organization?’   Less than one year—run   One year to five years—ask some more questions.   More than five years—no more questions needed.   Hospice itself is a hard job. As you can imagine, burnout is common.   And given the fact that most are now corporate with a business model of sucking as much revenue off the Medicare hospice benefit as they can—burnout is even...

Read More