Your Medicare Advantage revenue is at risk from another cost center.
In 2019, Medicare Advantage insurers will be allowed to pay for non-medical home care.
The details are still hazy, but the commercial home care providers are licking their lips at the chance to wet their beaks in your patient pool.
Read the linked article above. The commercial homecare companies and new venture-capital backed personal service providers can’t wait to begin seeing your patients.
The problem?
The money to pay them is not going to come from Medicare, it’s going to come from your pool. You’ve assumed the financial risk of your patient’s care costs. And in 2019, that financial risk is going to be stretched to include non-medical home care.
Is Medicare going to increase your capitation to offset these costs?
No.
They say they don’t have to.
They say that offering these services will increase the number of beneficiaries willing to sign up for Medicare Advantage—and choose a doctor in your organization as their prime.
Will these increased numbers offset your costs? Can you even service more patients sustainably?
These are open questions.
What’s not a question is whether or not your existing patients will avail themselves of these new services at your expense.
You can bet they will.
And you can also bet the companies providing them will be marketing these services to your patients directly. They aim to “sip from your milkshake.”
For the first time, you may find out what being at financial risk is all about.
If you have a strong connection with your patients, I suggest you begin the messaging now. “These services are for the frail elderly, that’s not you,” or “You can expect this service to be marketed at you, talk to me with any questions.”
If you don’t have strong connections with your patients, I suggest you work hard to create them.
You’re gonna need them.