From Dr. Tom's Desk
Recruiting patients from underserved areas is a key strategy for your Medicare Advantage success.
The baseline capitation rates for Medicare Advantage beneficiaries can be as much as 20-30% higher in underserved counties compared to their better served counterparts.
Many of them are not covered by a Medicare Advantage plan. They simply don’t have the local healthcare infrastructure.
But CMS is highly motivated to broaden the geographic reach of Medicare Advantage throughout the country, so waivers can be had.
That’s what we did when we wanted to extend our practice into another county. We provided our insurance partner with the demographics of our patient population and asked them to expand. We set up a remote clinic, partnered with a physical therapy provider and created the required infrastructure to qualify under CMS’ rules.
We picked up 200 hundred patients our first day.
Eventually we picked up thousands.
Despite experiences like this, many organizations do little outreach into these areas, despite the economic incentives.
So, check the county rates for your catchment area.