Passing the Costs Upwards


Your Medicare Advantage insurance partners are doing everything they can in their contracts to push care costs down to you.



You can be certain they’re altering your contracts, debiting you for expenses you’re not responsible for and hoping you won’t notice, they’re even taking kickbacks and giving exclusive rights to certain vendors to service your patients—and charging the higher-than-market rates to you.



This is all cynical, I know. but it’s happening.



Return the favor.



Let them spend their administrative bandwidth and ensuring that your patient population meets all their metrics.


Let them spend the money to ensure every last code is collected.


Let them invest in care management services.



If you’re risk-sharing, it’s in their interest to do a good job in all of these.



They’ll do such a good job in fact, that your organization need not bother.



You just invest in your medical staff. Create the systems that allow them to provide good care to their patients, care they can feel proud of.



Pushing the costs of all the “administrative” parts of Medicare Advantage back up the chain saves you money and improves your net performance.



As more services to address the “social determinants of health” get approved by CMS, their costs will inevitably be pushed down to you.



So you’ll need every last dime of savings you can get.