Is Your Employer Actually “Risk-Sharing” With You?

If your organization claims they’re risk-sharing but you’re not seeing any real financial benefit, they may just be pretending to risk-share to gain your compliance while having no actual intention sharing the financial benefits of your mutual success.   This is a sadly common situation.     Red flags to look for:   Your employer devotes great resources in encouraging you to perform the specific tasks which advance the value of their Medicare Advantage contracts—such as...

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Specialists, Doubling as Primes Can Support Your Declining Income

If you’re boarded in internal medicine as well as your subspecialty, consider adding a Medicare Advantage contract to your revenue mix.     A modestly sized panel of a couple hundred patients, an off the shelf contract and you’ll quickly find the extra revenue rivals that of your primary service lines.     I was weaned on this model in my practice.     A cardiologist and a GI both followed this model—and did very,...

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Telemedicine Sucks My Will to Live

Actual quotes from physicians, shared to help understand what your peers are saying, NOT to set up a strawman.     “Answering calls about yeast infections and runny noses all day—no thank you.”   “Sounds dull.”   “I want to do something that actually helps people.”     I have an answer for all these statements, but for the docs that said them, they are valid concerns.   Frequent readers are also bored with reading...

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A Health System that Owns Real Estate or a Real Estate Company Whose Tenants Deliver Healthcare.

Since I started consulting, I’ve been contacted to interview with a number of large health systems that, in the end, declined to purchase my services.  Of course, I’ve been contacted by more who have.   What was the difference between the non-purchaser and purchaser—besides, of course, that the purchaser ended up doing fantastically well?   For months I’ve been trying to puzzle it out. The pitch was the same, the need the same, the potential...

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House Call Only Practice Live Blog

Readers will recall I took the challenge of commenters and started the process of creating my own house call only Medicare Advantage practice.  CMS has proposed changing the rules in 2019 so that any beneficiary can qualify for a Medicare Advantage house call, not just the infirm.   The idea is, with no office and little overhead beyond my malpractice insurance and a compliant cloud-based EHR, I could generate significant net revenue with a very...

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Telemedicine vs. Office Practice Smackdown

Looking for clarity about your work as a physician?   Telemedicine Office Practice Earn $25 to $39 per encounter—and your employer will cover the cost of your malpractice.     Earn $98-$102 per encounter—and your employer will cover the cost of your malpractice   Less the taxes.   Less the cost of benefits.   Less the taxes.   Less the cost of benefits.   The cost of your phone, your home office, your internet connection...

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Live Blogging My Medicare Advantage House Call Only Practice Challenge—Part 1

“Hey Dr. Davis, I wish you’ld quit writing about how “easy” it is to set up a practice.”   “You’re just writing to fill space.”   “It might have been easy to do once, but times have changed”   And that’s just the responses I can publish.  This is a family blog after all.   But you get the gist. Across the internet, on the discussion sites, on my social media, even on my email,...

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How to Get Paid 360K/year Taking Care of 300 Patients

Mrs. Smith was livid, I had given her sister bragging rights over her and she was greatly displeased.   Mrs. Smith had called the office requesting I come see her for a house call and then “went off” on my great staff when I refused.   I had done one for her sister days before. Her sister was homebound from a stroke and I, new in town, saw her at home for a visit in...

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I Know How Specialists Feel

I was speaking with an ACO executive last month about the challenges of bringing specialists on-board to the “value-based” manner of thinking.   “When we tell them they have to shave another $500 off of every episode of care, they get angry, then abusive and then they tune us out.”   I bet!   When I was first figuring out how our total-risk Medicare Advantage contract worked, more than twenty years ago, I tuned out...

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One Less Thing to Worry About

Great news!   You have one fewer non-clinical hoops to jump through just so you can care for your patients.   The government is no longer going to require annual compliance training for its Medicare Advantage clinicians   That’s right, no more of those patronizing video time-sucks with their annoying pre and post-tests so your insurer can attest that you were told stealing is wrong.   In fact, the government has removed their sample training...

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