Welcome
I'm thrilled to introduce the inaugural issue of Value-Based Transformations, a newsletter designed for healthcare professionals and executives who are committed to excellent value-based care.
For over 20 years as a family physician, I've worked to leverage value-based care systems for my patients, my partners, and my practice. This newsletter brings together my insights from those years of experience—plus a laser-like focus on the most pressing issues that face today's healthcare organizations.
Why Value-Based Transformations?
Because, to date, thousands of my patients have benefited greatly from total risk and value-based contracts such as Medicare Advantage. I've spent years developing and sharing best practices for physicians, managers, and healthcare partners to leverage value-based care systems for both profitability and patient health.
And now, I want to share my expertise with you.
The truth is, I see and hear a tremendous amount of cynicism and negativity around risk products like Medicare Advantage. But making the jump from fee-for-service to value-based care systems can be an transformational net-positive move for healthcare professionals and their organizations — if it's done the right way.
From Tom's Desk
It's begun.
The reality of MACRA and MIPS has started to hit clinicians across the care spectrum.
The result?
According to my survey of state medical societies: accelerating dis-enrollment of physicians and independent nurse practitioners from the Medicare program. It's not in anyone's interest to report this so you won't find it in print...yet. But the anecdotal evidence is all around. Just look.
The trend is not surprising, it always happens after Medicare payment changes. But this is different. This is now becoming access problem.
Where are the clinicians going?
Not fleeing to the protection of health systems—those with the predisposition to do so already have.
Not discontinuing taking new Medicare patients—p to a quarter of all primary care providers nationwide have already tried that. Caring for any Medicare patients is now a financial and personal loser with opportunity costs through the roof, plain and simple...a simple business analysis will tell you that.
Nope, these clinicians are going to the cash pay/concierge model and opting out of Medicare completely. And that's a damn shame. Understandable, but a damn shame all the same.
You see, the only way caring for Medicare patients makes any sense is to use it as a recruiting tool for your Medicare Advantage product. The difference between traditional Medicare and Medicare Advantage benefits will become so great that your patients will naturally migrate away from one and toward the other. And for primes, your Medicare Advantage contracts are now probably your only vehicle to generate an equitable return on your professional educational investment.
It you have Medicare Advantage contracts, now is the time to revisit them.
If you don't have access to them, now is the time to rethink your relationship with traditional Medicare. Your data now will be used to cut your pay in 2019. By then the last train out of Medicare town is likely to be pretty crowded.
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