Submitted as a kinda fun example of just how valuable a robust knowledge of Medicare Advantage can be.
Just when I thought I’d seen it all—I met Dr. Dan.
He’s a snowbird Family Physician from the Northeast
Every winter for the past few years, he’s been staying in the same spot. He’s made lots of friends from the same state. They stay down for the winter, too.
A couple of years ago, Dr. Dan had a great idea. He got for himself a local medical license and an off-the-shelf Medicare Advantage contract from a nationwide insurer. It was so easy, he got himself two more.
When his friends found out he was a doctor, they decided to change to him as a PCP for the winter. You can change PCPs monthly, no limit.
That way he could take care of them. He made no official “visits,” collected no codes, documented in Word on his laptop— and simply helped his friend’s out at need. A few times, when his friends had to go to the hospital, he supervised their care. The hospitalists welcomed his input even though he had no hospital privileges.
A couple of his friends even got sick enough to travel back to their home base. They just changed PCPs back.
Riding on past data submission from previous primes, Dan has averaged about $150 pmpm for the 4 months he usually takes care of his hundred or so friends. That’s about 60K over the winter. He keeps his own records, he already has malpractice insurance—to Dan, it’s found money.
Some of the PCPs his friends had back home are none too happy about the arrangement, but according to Dr. Dan’s friends, they just ignore the unhappiness—there’s been no serious pushback yet.
While I expressed admiration, I also expressed concern that he was violating some rules on practice location or the like.
Ever insightful, Dan replied he probably was—but the checks kept clearing and the insurers had more interest in keeping the patients enrolled than in enforcing the rules.
Great point.
It’s nothing I’d do on a full-time basis, but for Dr. Dan, it covers all his winter lodging expenses for what is really very little actual work.
He told me that he had to cap his enrollment otherwise it might actually become a job rather than a joy.
Once you start looking, you see these innovative practices everywhere—ones that serve both the physician’s and the patient’s wellbeing.
As I’m on the road consulting, I’m keeping an eye out and I’ll let you know when I find more.