The First Advice to Medicare Advantage Primes

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?






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 all that.




Let the administrators and insurers worry about the data collection and prompting the patients to meet the metrics—they’re better equipped to do it than the primes I work with.




And worrying about those things means spending less time on what the Primes do best and brings them joy—patient care.




If the primes simply take good care of their patients, they’ll earn a lot more than they will under Medicare Advantage.




They can spend the time and not worry about the treadmill—-Medicare Advantage truly is more about quality than quantity.




If they want to be true Medicare Advantage Masters, I direct them to all the content I’ve published over the years.




But only 1 in 20 primes actually want to achieve that level—most work to live rather than live to work.




When executed as the program was designed, Medicare Advantage allows any clinicians to do either one— and wind up just fine.