By Michael Wasserman

This ebook takes a clean examine how taking good care of Medicare beneficiaries can result in good fortune in today’s healthcare industry. utilizing examples from hugely winning perform versions, the publication will take the reader throughout the key parts essential to run a ecocnomic geriatric perform. the writer, who co-founded what grew to become one of many biggest geriatric deepest practices within the nation, discusses every one a part of the continuum of care from the viewpoint of the provider-client dating, highlighting the significance of commercial cultures during this setting. The textual content additionally positive aspects an outline of check versions, beginning with conventional fee-for-service, assurance (Medicare HMO’s), and completing with the concept that of bundled money types which have been heralded because the way forward for general practitioner compensation. ultimately, this ebook specializes in the sensible elements of commercial making plans, budgeting and hiring and concludes with chapters in regards to the key demanding situations confronted via a geriatric perform, concentrating on supplier productiveness, coding and billing, and working with strength pageant available to buy. The enterprise of Geriatrics is the final word enterprise advisor for basic care physicians, geriatricians, citizens, clinical scholars, healthcare directors, policymakers, enterprise and scientific administrative scholars, and perform managers.

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It turned out that they had acquired these clinics a couple of years earlier (their third owner over a short period of time) and had been losing a significant amount of money on their operations. These clinics had a past relationship with Humana and still cared for 3000 Humana Gold Medicare risk patients. Three thousand Medicare risk patients translated roughly to 14 million dollars in potential revenue. The AAPCC (average adjusted per capita cost) in Orlando was about $500 per member per month, and with a 5 % reduction by HCFA and approximately 20 % off the top for the HMO, we would be left with almost 14 million dollars per year in which to care for our patients.

I have seen numerous instances where a hospitalist fails in their attempt to work in a nursing facility. While this is not an absolute, it definitely represents a very strong trend. I would like to think that some of these observations have been changing but have trouble pointing to very many examples of such. Health systems and insurers continue to develop models of care that ultimately override the care delivered in hospitals and elsewhere, rather than actually changing the practice approach of the clinicians.

Admitted to us in SNF. Issues regarding admitting demented pts with NG tubes and no clear family discussion regarding long-term issues. 2 Hospital Rounds 12/9 B5. Still in hospital, hospitalist “couldn’t reach surgeon,” d/c today (1 day lost). C1. CP/syncope—EtOH 316, negative CK and troponin, binge drinker, negative persantine 4/97, h/o hiatal hernia and ulcers, smoker. CT scan and Doppler ordered for unclear reasons, ECG ok, patient to have stress test. 10 Hospital Days per Thousand 27 B3. Still sick.

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