Medicare Industry Insider

It’s easy to overlook the large number of hours that you work as your business grows and fail to realize you are getting increasingly frustrated. In this episode, we will dive into tracking, learning to value, and setting expectations with your time.

The Medicare Prescription Payment Plan will undoubtedly cause confusion in the industry. In this episode, we will help you expand your knowledge on the topic to help you gain value in your community and with your clients.
 
Medicare Prescription Payment Plan Fact Sheet

With this year's disruptions it's more important than ever to know how your clients are feeling about their coverage. We will go into a DEFT research study, break down the data, and turn it into useable pieces to help you organize and educate your clients.

Structuring your business with growth and goals in mind allows you to transition smoothly through each phase of your business while maintaining your culture and reputation. Listen in this week to learn what key metrics you should be tracking for growth.
 

Today’s episode will cover the top compliance violations we see and the process that a complaint goes through. Knowing what the top compliance violations are can help you prevent them, as well as help you understand the process if a complaint is filed against you.

It’s impossible to have all the resources you need to grow your business on your own. It’s helpful to use books to learn from others and find new ways to excel in different parts of your business. Today we will dive into a few of our favorites and share who they would be a good fit for. 
 
Book Titles:
- 10 Stories Great Leaders Tell (Paul Smith)
- Dare to Lead (Brene Brown)
- Atomic Habits (James Clear)
- Think Again: The Power of Knowing What you Don’t Know (Adam Grant)
- TalkingMEDICARE (Dan Mangus)

Agents are always looking for ways to share information with current clients and find new prospects. Hosting events can help you meet with a larger number of current clients, introduce you to new clients, and create a low-pressure environment for people to decide if they wish to work with you. Listen in to hear how you can make networking a breeze!

A presidential election can change who oversees different divisions and can shift priorities, causing regulations to dramatically change. Listen in on this week’s episode to know why this is important to know about when participating in voting!  
Informational Sources:
- https://www.kff.org/health-costs/poll-finding/kff-health-tracking-poll-economic-views-and-experiences-of-adults-who-struggle-financially/
- https://www.kff.org/from-drew-altman/its-not-a-health-care-election-but-health-issues-might-still-add-up/
 

Clients often do not factor the cost of transportation into their Medicare expenses. Listen in to hear why it’s important to know what is available in your local area, what the hospitals near you specialize in, and the cost to add the ambulance riders and other alternatives with ancillary products.
 
Informational Sources:
- https://www.medicare.gov/coverage/ambulance-services
- https://www.forbes.com/advisor/health-insurance/insurance-for-ambulance-rides/
- https://www.crainsgrandrapids.com/news/health-care/your-wait-for-an-ambulance-may-get-longer-and-thats-safer/
- https://www.aarp.org/health/medicare-qa-tool/does-medicare-cover-ambulances.html#:~:text=Medicare%20Advantage%20plans%20cover%20emergency,authorization%20for%20nonemergency%20ambulance%20services
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464671/
- https://www.ama-assn.org/system/files/2018-12/i18-cms-report2.pdf
- https://www.emergencyassistanceplus.com/resources/what-is-the-total-cost-of-a-life-flight/
- https://atstrans.org/uncategorized/non-emergency-medical-transportation-rates/
 
 

This is one of the most dramatically shifting years for our industry. Between policy changes, industry trends, and compliance regulations, it's important to be aware, make applicable changes, and prepare for a big transition. This year could be a once in a lifetime opportunity to increase growth if you are prepared.
 
Informational Sources: 
Peek boomer years: 11,200 people T65 a day until 2027: https://www.cnbc.com/2024/04/07/turning-65-what-to-know-when-planning-for-medicare-social-security.html#:~:text=More%20than%2011%2C200%20baby%20boomers,doesn't%20have%20it%20easy. 
AI revolution- Ask Integrity, carrier claims (https://www.forbes.com/sites/shashankagarwal/2024/03/28/the-ai-revolution-in-medical-claims-processing/?sh=7193829319e4) 
https://www.medicaldevice-network.com/analyst-comment/healthcare-sector-cyberattacks/
https://www.reuters.com/business/healthcare-pharmaceuticals/unitedhealth-warns-115-135share-hit-this-year-hack-2024-04-16/
https://kffhealthnews.org/news/article/rural-hospitals-half-operate-in-red-many-cut-services/
Nursing home groups file lawsuit to block CMS' staffing mandate - https://www.fiercehealthcare.com/providers/nursing-home-groups-file-lawsuit-block-cms-staffing-mandate
“Dead” diseases coming back- measles (MMR vaccine), syphilis (highest in 20 years) and chlamydia, Mumps, https://www.webmd.com/a-to-z-guides/ss/slideshow-diseases-coming-back  
We’ll see more restrictions in place from May-January when it closes unless the house bill passes: https://www.psychiatry.org/psychiatrists/practice/covid-19-coronavirus/covid-19-telehealth-policies-wind-down-timeline 
https://www.healthcaredive.com/news/telehealth-flexibility-extension-advances-house-ways-means/715592/  
https://www.pewtrusts.org/en/trend/archive/fall-2023/americas-mental-health-crisis
https://www.healthleadersmedia.com/clinical-care/77-us-docs-are-employees
U65 Changes https://www.healthinsurance.org/blog/short-term-health-insurance-limits/
https://www.beckerspayer.com/payer/cms-to-recalculate-medicare-advantage-star-ratings-report.html
23% of adults who lost Medicaid are still uninsured – 47% regained Medicaid and 28% picked it up through employers: https://www.cnn.com/2024/04/12/politics/medicaid-coverage-health-insurance/index.html   
Taking a toll on community health centers: https://www.fiercehealthcare.com/payers/one-year-after-unwinding-community-health-centers-struggle-medicaid-reenrollment 
High Generic Drug Costs https://www.wsj.com/livecoverage/stock-market-today-earnings-04-16-2024/card/u-s-probes-high-generic-drug-prices-7L04Lg6yABfMAwOXtQfW?mod=lctimeline_finance
https://www.statista.com/statistics/271501/us-email-usage-reach-by-age/#:~:text=Share%20of%20U.S.%20e%2Dmail%20users%202021%2C%20by%20age%20group&text=Email%20usage%20interested%20over%2093.4,reported%20using%20this%20communication%20method
https://www.statista.com/statistics/187549/facebook-distribution-of-users-age-group-usa/
Non-Compete Rule: July 2024 https://www.ftc.gov/system/files/ftc_gov/pdf/noncompete-rule.pdf
https://www.dol.gov/newsroom/releases/whd/whd20240423-0#:~:text=Effective%20July%201%2C%202024%2C%20the,the%202019%20overtime%20rule%20update