The Only Metric You Need to Meet Under Medicare Advantage

 

 

Medicare Advantage can be very overwhelming.

 

 

Administrators and insurance companies are trying to leverage your position to extract the last dollar of revenue from your patient’s insurance.

 

 

They can overwhelm you and drive you nuts with their demands—making you feel “substandard” in the process.

 

 

Here’s a tactic.

 

 

Don’t worry about it.

 

 

Don’t worry about any metric, about any goal they want you to meet.

 

 

Only worry about this one:

 

 

Get at least 95% of the patients on your Medicare Advantage panel in to see you for a comprehensive evaluation every calendar year.

 

 

Do whatever you have to do to make that happen (short, of course, of paying them to do so).

 

 

Call them. Send them notes. Help them use their benefits to overcome logistical difficulties.

 

 

But get them in.

 

 

Once they’re in, then work your magic.

 

 

Bond with them, get them the care which together you both decide is needed.

 

 

Let all the colonoscopy, immunizations, and mammograms take care of themselves.

 

 

Your employer and insurer may not be happy with you approaching your panel in this fashion.

 

 

Tough.

 

 

You didn’t become a doctor to serve them, you became one to serve your patient.

 

 

You may not squeeze the last nickel out of their Medicare Advantage benefits, but you will have looked after your patients and generated more compensation for doing so than you would have under traditional fee-for-service.

 

 

 

And if you limit yourself to meeting this single metric, you won’t have driven yourself crazy doing something you love.