If If you want to succeed at Medicare Advantage you must think like both a clinician and insurer.
Like a clinician, you have to put your patient’s needs first. You must guide them through their healthcare journey without a thought for your personal interest.
But like an insurer, you must balance the cost and benefits of every recommendation you make. And once made, you must use your considerable prestige to ensure your treatment plans are executed with ruthless efficiency.
Clinician and insurer
A dichotomy to be sure but as a whole far more powerful than each taken individually.
After all, who would you want to be on the financial hook for your patient’s care?
A business executive? A venture capitalist?
Or you?
You’re the only one who’s close enough to the workflows to make things run smoothly.
You’re the only one with the prestige to break the logjams so your patient can get the care they need.
You’re the only one who understands the costs and benefits specific to your patient’s healthcare options.
You’re the only one who, by training, temperament, and intention, has sworn to put your patient’s interests first.
Being good at either patient care (“the clinician”) or healthcare delivery (“the insurer”) is not enough.
You might be great at providing care—but are you doing it in a way that generates value? Or do your care strategies simply mean saying, “yes” to services your patients may want?
You might be great at cutting costs—but are you doing it in a way that generates value? Or do your cost-cutting strategies simply mean you’re saying “no” to services your patients may need?
Clinician and insurer.
Skillfully finding comfort in a balance between the two is the keystone for Medicare Advantage success.
Hone those skills. Find that balance.
And succeed.
Need unbiased guidance finding your ideal medical practice, contact me, no obligation just help and value.