Saturday Quiz
Designed to amaze and enlighten Do you understand how your RAF score is calculated? Which of the following factors is NOT included in the calculation of your patient’s RAF score? A. Gender B. Patient’s home address C. Age D. Race E. The reason they qualify for Medicare in the first place F. All are included […]
Advocate for Your Patients: Use Your Prestige
Throw your weight around. Physicians still enjoy considerable prestige within the healthcare system—use it. No CT scan for two weeks? Call yourself and get that appointment tomorrow. Ortho can’t get them in for month. Talk to the clinic manager. Or the doctors themselves. Under fee-for-service you actually get penalized for taking the time out to […]
The Power of Curation
Does your organization need a game changing initiative to re-engage your medical staff? Embrace the power of curation. From a clinician standpoint, their greatest challenge is the growing amount of information they have to process—each piece requiring at least one decision. Research supports the conclusion that humans, even exceptional ones, can only make so many decisions […]
The Tele-Medicine Trend
I was stunned by what I found. I’ve been delivering care by phone for 30 years. Before industrialized medicine, when one of my patients needed help after hours, they called me and I did my best. What’s old is new again. Except this time, it’s called “telemedicine” And you’re going to have to pay money […]
What’s the single most important clause in your employment contract?
What’s the single most important clause in your employment contract? It’s not your comp, or even your loan repayment. It’s your “exclusive rights” language. Carrie Fischer once said that her first Star Wars contract was so restrictive on the use of her image that she couldn’t look in the mirror without sending George Lucas a […]
Your Opportunity in the New VA Choice Bill
The VA Choice Bill was recently signed into law, and it represents yet another opportunity to strengthen your Medicare Advantage performance. Vets can now more easily get their care from physicians outside the VA system. The bill is an expansion and improvement on a previous attempt to do just that. The bill is directed at […]
Sunday Update
Links to enlighten—and make you look like a genius! Medicare Advantage rankings hit underserved particularly hard To be fair, its much more difficult to have underserved patients hit their quality marks—still that’s why CMS is diverting revenue their way. It will take another 18-36 months for those changes in cashflow to show up on […]
Saturday Quiz
Coding Conundrum Questions that amaze and inform! Which of the following conditions DOES NOT increase the monthly capitation of a Medicare Advantage patient? A. Atherosclerosis of the Aorta B. Atherosclerosis of the Brachial artery C. Atherosclerosis of the Femoral Artery D. Atherosclerosis of the native arteries of the extremities—unspecified E. Atherosclerosis of the Carotid Arteries […]
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 […]
Medicare Advantage Enrollment
Medicare Advantage Enrollment A recently released regional analysis of Medicare Advantage growth is giving an early look at what happens to Medicare Advantage enrollment when markets become saturated and mature. The western US was an early adopter of Medicare Advantage coverage and their enrollment rates have now consistently leveled out at around 40%. The other […]