Smart—Damn Smart
A set of 2020 Medicare Advantage rule changes were proposed last week.
Full text here. Summary here. Insightful commentary here.
Some hospitals pushing back against low Medicare Advantage payments.
Medicare Advantage turns inpatient days into a commodity, so you can’t blame insurers for pushing down prices just like Wal-Mart does to its suppliers in China.
But learn the lesson—if you push prices too low what you’ll get in return is crap.
Anthem using home services benefits to partner with senior living centers.
It’s almost like they read my newsletter six months ago about this very opportunity.
You’re welcome Anthem—no charge.
Medicare Advantage patients steered to specific nursing homes but with no improvement in outcome.
Outcomes would be improved if they read this book. It shows clinicians how it’s done.
A contra to the Medicare Advantage program
Always read critics closer than supporters—you learn far more.
How is prior authorization used in Medicare Advantage?
Spoiler: Not very often and not very well.
Experience teaches that docs use PAs as an excuse not to deliver needed care when they should be using it as an opportunity to bond with their patients through servant leadership.
What a damn stupid waste.
Tomism
Give your patient a reason to brag about their doctor and your panel numbers will explode.