When Something Doesn’t Make Sense—It’s a Kickback

One of the benefits of practicing under a shared or total-risk contract is that the fixed global cap you practice under generates clarity in your business systems.     Things that generate real value become obvious, as do things which do not.     Occam’s Razor. the simplest explanation is the most likely.       So, if your employer asks you to do something that you can easily see generates no or negative value, it’s...

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Call the Patients Who Leave You

How was I so successful under my Medicare Advantage contract?       I checked my patient panel lists once a month.         And if someone disenrolled, I considered calling them.         First, I checked with the staff to make sure they weren’t someone I was better off without—then I made the call.         No one likes to take a chance on rejection, but I found the...

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Take Your Time

If you’re a prime risk-sharing under Medicare Advantage, take your time.       Make sure, when you see your patient for their yearly visit, you book lots of time to engage them fully.       It may be the only time you have to bond, so you don’t want to be rushed. Answer their questions.  Explain the justifications behind the health interventions you request.       You’re being paid very well to...

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Grow Your Panel With Personal Referrals

I once met the leading salesman for all of GM.     He was a short, fat, dumpy guy—the exact opposite of a slick car salesman.     But he personally had sold more cars for the company than anyone else—ever.     He was teaching the secret of sales and I wanted to know how much was applicable to growing the Medicare Advantage panels of myself and my partners.     Turned out, it...

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Mr. Biondo

Every few months I like to re-post my first blog entry and remind myself why we’re doing what we do. Mr. Biondo is a real person and a good man. He gave me permission to tell his story if I thought it might help someone. When I first met Mr. Biondo he was not at all well.  He had lost a leg through misfortune. The bed sores from his outdated mobility equipment had let infection...

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Get Rid of Your Dead Wood

“If you contact me again, I’m going to call the police.”   That’s what one patient on my panel once told me when I tried to get him in for his yearly visit.   I knew from my sources in the community that for some reason—probably a good one—he absolutely despised me, yet he stayed on my panel year and year. And when he did get sick it was me he wanted to see.  ...

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How Do You Get Dual Eligibles On Your Medicare Advantage Panel?

Go to them.     I struggled with this same problem when I started practice.     I needed the revenue dual-eligible would generate in support of my Medicare Advantage contract.     But they were hard to attract, hard to bond with and hard to retain.     But one day a bowling league buddy asked me if I was taking new patients. He was dual-eligible.     I said sure, and I asked...

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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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Residential Care Facilities Can Boost Your Panel’s Growth

If you’re sharing financial risk in a Medicare Advantage plan, consider contacting one of the large residential care facilities in your area and offering an on-site clinic once a week.     You don’t even have to go there yourself, send your NP or PA and just plan on attending one time a month.     Your new patients will have great access and you’ll generate significant growth in your panel.     I did...

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Looking to Grow Your Panel? Consider Veterans.

There was a bar and grill in the basement of the local VFW where I practiced—and I loved going there.   The stories, the atmosphere. It was a great way to get out of the office for a half-hour lunch and recharge.   Little did I know that it was also a great way to recruit patients for my Medicare Advantage panel.   Back then, veterans were the best Medicare Advantage patients to have. They...

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