Personal Training for Your System’s Success

Keep a personal trainer on retainer so your primes can use them for their patients who are motivated to use the extra help.   What’s the most powerful predictor of healthcare costs?   It’s frailty.   How do you cure frailty?   Exercise. Resistance exercise.   Can you cure frailty in everyone?   No. You can only cure it in someone who’s motivated.   But with Medicare Advantage the ROI on a single frail person who’s...

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Sunday Links

All the news that fit to link   Private Medicare enrollment soars even as talk of Medicare For All increases From Forbes Every Medicare For All proposal consists of healthcare funded and executed by the government only. No private insurance of any kind. There are pros and cons, but Medicare Advantage is not part of any plan. Not one.     Medicare Advantage growth exploding not slowing Renown Healthcare Anthem Even Google   The narrative...

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Part-Time Work is the Way to Go

Lonette K. asks:   “I tried what you suggested but my boss won’t take “no” for an answer when it comes to limiting my workload. What (should I) do?”     Go part-time, either there or somewhere else, and make up the difference with a telemedicine practice, an expert witness practice, moonlighting, or some other sideline.     Part-time practice is a significant drag on the financial performance of your employer, that’s why they will...

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Is It Worth It? Yes!

Sara wrote to tell me about a Medicare Advantage patient with a lobar pneumonia seen on an x-ray at an outside Urgent Care.  The patient was diagnosed with an unspecified pneumonia.   Unspecified pneumonia has no additional compensation. Lobar pneumonia does.   She is being comped under a partial-risk contract. How can she make sure that the lobar pneumonia code gets submitted?   I advised her to get the patient in for a follow-up and do...

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What You Can Learn From Tribbles

Remember the episode of Star Trek where Captain Kirk met the tribbles.     Tribbles are soft, furry plushes who reproduced at an astonishing rate.     The bad-guy Klingon killed them with poison in their food—one that prevented them from absorbing nutrients. The more they consumed the poisoned food, the fewer nutrients they were able to absorb.     As Captain Kirk put it, “They starved to death. They were in a bin full...

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Malpractice Insurance and Telemedicine

There are two basic types of Malpractice Insurance   “Occurrence”—Covers you if the insurance was in force when the incident happened. “Claims Made”—Covers you if the insurance is in force when the lawsuit is filed, coverage can be extended with the one-time payment of a fee, a.k.a  “a tail.”     When evaluating an engagement with a telemedicine provider, “occurrence” coverage is the gold standard.  If your prospective employer offers occurrence coverage, that’s golden.  ...

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How To Translate The Stuff Your Insurance Company Sends You

In a recent survey, 86.6% of insurance companies admitted the stuff they write to you is not understandable.     Not just bills, but instructions on how to get the most out of your benefits, on how to get to see your doctor and just on how things work.     86.6%!!!!     This is a survey of the insurers themselves. They admit it.     Clearly making sure you understand what’s going on...

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Home visit only Practices—not Medicare Advantage.

Dr. Lorene L. writes Are home visit practices for regular Medicare viable too, or do you have to do one through a Medicare Advantage plan?”     Lorene   Home visit practices for Medicare are more viable now than ever before. Medicare Advantage is more lucrative, sure, but that’s not your only choice.     You can generate around $150 for every Medicare home visit you do. Your Medicare contract does not stipulate round the...

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Standing With Authority

Henry the VIII had a problem.     He was old, with a leg ulcer that wouldn’t heal and smelled like rotten meat.     He was enormously fat too, barely getting around and the the word was, he was unfit to be king.     What to do?     Instagram a selfie in which he projected the power and authority of a king.     What’s the best body language when you want...

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Continuity of Care

The health systems I work with who have the highest performing Medicare Advantage plans all have one thing in common.       When their PCP decides a specialist visit is needed the patient is able to make that appointment on the way out the door—with the PCP’s staff coordinating the service.       And if the specialist appointment can’t be had in a timely basis, there’s a system in place in the office...

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