Q&A with Dr. Tom
I've a number of seriously ill patients on my panel who are into their re-insurance coverage for the year. I've been working hard to restrict their care but the overall financial performance of my panel continues to be poor. What am I doing wrong?
Reinsurance coverage for your Medicare Advantage patient panel is one of your most powerful tools to limit your losses.
For example, if you have a $100,000 year-to-year re-insurance policy with a no limit 90/10 split, the reinsurer will pay you back for 90% of the money you spent on that patient's healthcare over the course of a year less the first $10,000.
Don't know your re-insurance levels? Ask your provider relations contact, they'll know
Reinsurance is a mighty tool. So powerful that I and my partners created our own reinsurance product to amplify the benefit.
If your patient's care costs have hit your cost limit, it's not the time to restrict their care.
It's the time not to worry about it.
Do whatever you have to do to get them better.
And hang how much it costs.
The reinsurer will eventually cover most of it.
Also, don't try to game the system by moving up healthcare costs into December just to get it covered by their reinsurance
Gaming the system is not how you succeed.
Being your patient's physician is.