When I’m retained to help a PCP improve their Medicare Advantage performance under a shared-risk contract, what’s my first piece of advice? Relax. If they’re working under a shared-risk contract, Medicare Advantage will reward them for doing what they do best—taking great care of their patients. Sure, they’ll be bombarded with metrics they have to meet and risk-codes they have to submit. I tell them to forget...
Read MoreSamantha was freaking out. Not only was she wearing a scratchy paper hospital gown, but she was anxiously awaiting the results of her mammogram, done earlier in the week. A double whammy. Her heart beat faster. She was sweating despite the flimsy hospital covering. Her mother had breast cancer, so she had a good chance of getting it too. A triple whammy. What would happen if she had a tumor? Would she have to have...
Read MoreTake it seriously. Telemedicine is serious business. A doctor whom you don’t know and who doesn’t know you is going to evaluate your medical problem and possibly prescribe a medication for treatment. She doesn’t know your history, your values, or your preferences except for what you tell her. And you’re doing it over the phone or on video. Your doctor can’t smell you or check out your body language. They can’t see many of the...
Read MoreI just got another recruitment pitch with a “30 minute lunchtime, guaranteed.” Here’s what I know: If a job offer includes a “guaranteed lunchtime,” then You won’t get it. You’re gonna need it. Hard Pass. On the positive side, it’s a pretty easy screener for a job you don’t want.
Read MoreStay away from single disease or treatment telemedicine services Things such as sites that only treat herpes or need you to prescribe poorly supported therapies such as beta HCG for weight loss. And DEFINITELY stay away from any service that sells durable medical equipment. They’re tempting. The services they offer are low-risk, simple, and can be highly lucrative. But they are also more likely...
Read MoreDr. Greta asks: Do insurance companies allow nurse practitioners to be PCPs for their Medicare Advantage plans? Not yet. But it’s coming. Your best bet is to find an independent practice with a thriving MA population and speak to the physician about working with them. Make sure you check about their non-competes. Most aren’t expecting you to compete with them, so it shouldn’t be a problem. Learn all you...
Read MoreOne of the nice things about working for yourself instead of working for an employer is that you quickly get a sense of who you’re working for and how much. How much time are you spending to pay your taxes, to pay for your personal upkeep, to pay to keep your licensure up to date? How much time are you spending to pay your “future self” in the form of savings? ...
Read MoreYep, I sure did get a lot of pushback about last week’s post from the organization leaders who read this blog You’re misleading your readers . . Retention bonus can be an effective tool in work force management. . . It is an industry standard to use them to retain top talent. . . Retention bonuses allow us the flexibility to keep ahead of a changing labor market. ....
Read MoreDr. Anna S. asks How do I keep my patients out of the emergency room? Make sure they have your home phone number. “The government pays me to be your personal clinician. Use me. Contact me before you consider any medical care outside this office.” Fortunately most ERs are paid by Medicare Advantage Organizations on a bundled basis—one payment for everything (though the payments are tiered somewhat based on the...
Read MoreTake note of your Medicare Advantage panel size. Call the three largest insurance agencies in your community Set up a meeting with their leader. They will love to see you. Tell them you’re interested in increasing your panel size. Ask them if they have any questions about the practical aspects of the program. Ask the about their challenges. Ask them how you can help. Tell them you’ll...
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