Dual-Eligible Success Through Self-Selection
Dual-Eligibles are patients who are covered under both Medicare and Medicaid. There are special programs to encourage them to enroll in Medicare Advantage. The government pays more for you to care for them then they do for beneficiaries who are eligible for Medicare for different reasons. They […]
No Non-Competes—Ever
Never sign a contract to provide telemedicine services as an independent contractor which contains any kind of non-compete. Ever. If you’re getting hired for a regular job with a regular paycheck then some sort of non-compete as part of that deal is a reasonable trade in exchange for the stability of […]
CMS Allow Your Medicare Advantage Plan to Pester You Even More
This time, it’s about the price of your medication. Starting next year, you’ll be receiving a monthly update regarding the least expensive alternatives to the medications you’re on. Will it help you lower you medication costs? Perhaps. But it will definitely take up a few minutes of […]
How To Tell Where Your Supervisor’s Heart Is.
Check the last degree they earned. If it’s an MD, they’re probably still doctors. If it’s an MBA, they’re a business person. One who’s been hired to use their MD as a smokescreen to manipulate your actions using the credibility of a peer. MDs who earn their MBAs are common—beware. […]
Trending Away From Opportunity
Increasingly, health systems are neglecting their clinician’s role in risk coding and relying on back office systems and their Medicare Advantage Organization’s to fill the gap. That is a capital error. Such systems are leaving an unbelievable amount of revenue on the table. As their partnering Insurers put the screws to them […]
Sunday Links
Your best source thus far. . . The ACA was supposed to kill off Medicare Advantage, now it’s one of the hottest investment trends around Requires Business Insider subscription. It’s hot because the government is paying insurers based on data and doing so with essentially no safeguards in place. It’s a very capital intensive […]
Saturday Q and A
Dr. William asks: What’s the best way to limit specialty care costs without denying my patients needed care? Efficient care is excellent care (and cost effective care). Make referrals to your specialists as seamless as possible. Don’t try to change your health system’s referral systems—that will take too of your […]
Medicare Advantage and Social Media—The Parallels and Your Success
When I first started in the consulting biz, I engaged a social medial company to raise my profile. It didn’t take long to figure out what they were doing wrong. The tried to promote me over multiple channels rather than establish connections over just one. I recognized it so quickly because […]
Trust Yourself
I’m credentialled with multiple telemedicine services. One does not want me to manage tick bites but will allow me to prescribe muscle relaxants. On the spectrum of risk, that makes no sense. Use each telemedicine services list of “don’ts” as the foundation of your care plans. […]
What Counts Toward a “Maximum Out-Of-Pocket?”
Under Medicare Advantage, the term “Maximum Out-Of-Pocket,” can be misleading. Not everything counts toward that amount. You’re still going to be expected to pay for certain services even after your “Maximum Out-Of-Pocket” is reached. What counts toward that total and what you’re still going to have to […]