Wow, the student has surpassed the master.

Wow, the student has surpassed the master.

A field report by Dr. Wanda regarding dual-eligibles, that is patients who have both Medicare and Medicaid and whose capitation can be as much as 30% higher than beneficiaries with only Medicare Advantage.

“I took your advice to heart about recruiting dual-eligibles and tapped a great source, older and disabled patients coming out of prison. I make contact with a local state social worker and she started sending the patients my way.  They are mostly non-violent offenders, surprisingly little trouble and far more compliant with their treatment plans that you would think. They’re also very appreciative of my help and prison has made them very polite to the staff.  We just received our first financials since we started signing them up and you’re right, our gross capitation is already up just from their demographics, I can’t wait to see what happens when the disease adjustment kicks in. It’ll take a full year before that revenue flows all the way through the pipeline, but things are already looking good.  Thanks for your good advice and I will keep you updated.”

The prison population is aging just like the rest of us, and the system is dumping them on the streets and onto Medicare as soon as they safely can. In the highest standards of her calling, Wanda has leveraged the power of Medicare Advantage and has found a sustainable system to serve these patients who would otherwise be medically indigent.

And she’s done so in a way I never thought of.  I am humbled by her cleverness and wit.

Such is the power of this payment model.

Dr. Wanda is the first inductee into the Medicare Advantage Mastery Hall of Fame.

Will you be the next?