In honor of the holidays, I’m going to share with you the secret to excellent net Medicare Advantage performance.
One of my clients just found out that her use of this knowledge generated more than $600k in net revenue for her this year—and I’m offering it here to you for free.
Spread it around. Use it to succeed. Look like a genius. You don’t even have to attribute it to me.
Grow your panel.
Partner with 2-3 of the most service-oriented insurance agencies in your town. Free up time for your docs to meet with the agents, Be available for the agent’s questions and concerns. Transform your relationship into a collaboration and watch the patients come your way.
Code your their illnesses
Get every patient in for their annual visit one time a year—no exceptions. Numbers count. You’ll do better if you code 95% of the patients on your panel with average skill than if you code 80% of your patients with exceptional skill. The best way to get them in? A personal call from their physician. Even if you don’t risk-share, offer your docs $25 a call and you’ll make it back many fold.
Take great care of your patients
This is easy. You have great docs, let ’em run. Don’t micromanage or guide their decisions based on cost. Give them the autonomy to ply their vocation with joy and all will win.
Notice that there’s nothing in here about care management or STAR ratings or many of the other extraneous tactics most organizations use to support their performance. That’s because, unless they’re done exceptionally well, the net return on them is low and, even worse, they divert resources from the core approach outlined above.
If you’re already a Medicare Advantage ninja, if all three of these key tactics are hitting on all cylinders then, by all means, look into care management or helping your insurer improve their STAR ratings.
But until you ace these big three, don’t bother wasting money or attention on anything else.
Focus on the key points of leverage in your contract and execute.
That’s the recipe for overwhelming success.
Happy Holidays.