From: "Ernie Leland" <Ernie@orchardsfamilymedicine

From: "Ernie Leland" <Ernie@orchardsfamilymedicine.com>
Sender: Practiceimprovement1@yahoogroups.com
Mailing-List: list Practiceimprovement1@yahoogroups.com; contact Practiceimprovement1-owner@yahoogroups.com
Date: Sun, 12 Mar 2006 20:09:27 -0800
Subject: RE: RE: [Practiceimprovement1] Who is Solo-Solo? (and quick update)
Reply-To: Practiceimprovement1@yahoogroups.com

Medicaid HMO pays the best of the government plans for us. It is also
the lowest hassle factor of the government plans. It pays less than the
commercial plans we closed to, but I would rather feel good about
supporting the lower income members of our community than helping the
lowest paying commercial companies pay significantly less than their
competitors.

Medicare visits were 12.71% of our billed fees last month. We closed to
Medicare after about three and a half months. We sent about 30 Medicare
pts letters from Elise's residency panel. Only about half of them
followed us because the residency/hospital has a medication patient
assistance program that they needed to be able to pay for their meds.
We now have a panel of about 40 Medicare pts. We were worried about the
number of hospital visits we would end up with. (We have had 5 Medicare
hospitalizations and 2 peds, no others.) At the time that we closed, we
were seeing a spike in Medicare visits where it represented more like
40% of our visits. Since then Elise has stabilized the Medicare pts and
we see them much less often. We could reopen, but most of the calls we
get are Medicare/Medicaid secondary which are at the top of my list for
hating to deal with, top of my list for most likely not to get
reimbursed for, and top of my list because the way our Medicaid works it
is the same as forgiving the deductible and co-pay for Medicare which
just ticks me off.

We have about 430 patients right now.

Ernie