In Six Months, Telemedicine is Coming for You
Imagine your organization as a castle. Outside are all your patients demanding healthcare and within is the healthcare they want. Healthcare that, under your Medicare Advantage contract, you’ll be paying for. And your medical staff is on the walls judiciously allowing your patients to get the healthcare they need. Chances are, in […]
Sunday Links
We’re here for you! Lifespark homecare goes all in on Medicare Advantage It’s a podcast but it demonstrates that the homecare benefit is already creating its own constituency. That was fast. Medicare Advantage hasn’t paid out a single dollar yet. Clearly, the benefit will never be eliminated. And if experience is any guide, […]
Saturday Q. and A.
Dr. Greta asks: Do insurance companies allow nurse practitioners to be PCPs for their Medicare Advantage plans? Not yet. But it’s coming. Your best bet is to find an independent practice with a thriving MA population and speak to the physician about working with them. Make sure you check about […]
The Single Most Important Metric You Must Meet
Has the patient been seen this calendar year for an annual visit? Yes or No. You must hit 95% or more on this metric for the patients on your panel by December 31 of each calendar year. No other metric matters. Not colonoscopy rates. Not immunization percentage. Not even […]
Conversational Dyspnea
If the patient is conversationally dyspneic at the time of a telemedicine encounter, refer them on for immediate evaluation and treatment. Briefly check to see if they are having any other symptoms that would trigger a recommendation for a 9-1-1 call and then tell them they need to see a clinicians “right […]
Protect Yourself Against Slamming
Slamming is when someone fraudulently changes your Medicare Advantage coverage without your permission. It can create a real hassle for you if you find out this has happened at the time you need care. If you haven’t used your coverage in three months, call your PCP’s office and have them confirm your […]
“Downside Risk” in Your Compensation Formula is Coming
According to the most recent Kaiser Family Foundation survey, 20% of all healthcare organizations expect to take “downside risk” in the next two years. This is up from 3% who currently do. What does this mean? It means if they don’t perform, your employer will have to bear some of the costs […]
A Robust Nursing Home Presence is Essential for Your Organization’s Medicare Advantage Success
A robust nursing home presence is essential to your Medicare Advantage success. Even if you internalize that cost-center and have your own facilities, encourage the clinicians on your staff to consider serving as a medical director for a local nursing home or rehab facility. Match their medical director fee. Compensate them […]
Sunday Links
The latest links that you need to know Private insurers shouldn’t fear Medicare Advantage So says Forbes. Part of the full-court press for Medicare Advantage. And they’re right. The political influence that healthcare dollars will buy is limitless. When healthcare is paid for by the government, healthcare decisions […]
Saturday Q and A
Dr. Barbara asks: What’s the optimal patient panel size under a 50/50 risk-share split under a Medicare Advantage Contract? Fewer than 200 patients will leave you with a level of volatility in your performance that will be distracting and cause you unnecessary anxiety. The upper level is up to you. Once you reach it, you […]