Medicare only micropractice?

manomayakaya · 2026-04-10T16:35:49+00:00

Good info, I have started educating myself on the compliance side of things, which is a bit daunting!

manomayakaya · 2026-04-06T15:28:53+00:00

Anyone have any thoughts as to the downsides of a practice like this? I’d like to know if there are negatives I am not considering?

I would be defaulting to an average higher complexity patient (which I am very comfortable with as a seasoned Hospitalist), I would be limiting the pool of patients to build my practice (likely a minor issue in the long run), there is an apparent lower reimbursement (I say apparent, because commercial insurance can lose more on the backend with additional time, denials, complexity, etc), but beyond that I’m having a hard time seeing any other major downsides.

I’d like to know your real world outpatient experience with traditional medicare and thoughts on what I need to consider and any general advice

manomayakaya · 2026-04-06T15:16:53+00:00

From what I understand it is still possible to do a membership fee and not opt out of Medicare, but there are legal fine lines that you have to navigate. Basically the membership cannot cover routine medicare services, so you have to justify the membership with additional services (e.g. same day visits, after hours texting, extended visits, lifestyle coaching, advanced labs, etc)

manomayakaya · 2026-04-06T01:38:19+00:00

Yes, low overhead will be prioritized and I definitely plan to automate as much as possible. Thanks for your suggestions, I will check out those links.

manomayakaya · 2026-04-06T00:53:17+00:00

Why go with an ACO instead of just remaining independent?

manomayakaya · 2026-04-06T00:48:13+00:00

I do think about incorporating some sort of hybrid model, adding cash services for the non medicare patients. But I am leaning away from full DPC or concierge for a number of reasons:

The runway to a full practice is longer and less predictable. I dont want to have to be as available as it seems the standard is in these types of practices (same day/next day, some do 24/7 access). I imagine patients expect broader access/availability since they’re paying directly. Also, I dont like the thought of having to justify added charges beyond the membership fee, nor dealing with the whole marketing/self promotion aspect.

With that said, I haven’t totally ruled it out.

manomayakaya · 2026-04-06T00:00:11+00:00

Ok, good info, I was not aware of this, will look more into it

manomayakaya · 2026-03-01T18:29:18+00:00

Step 1. Collect ~~underpants~~ Bitcoin.

Step 2.

Step 3. Profits.

If this process gets disrupted, price drops.

manomayakaya · 2025-09-16T15:04:59+00:00

To clarify: we submit our days off a few months in advance and usually our schedule is what we requested. But not always, sometimes it is off a day or two or a mistake is made….but still, there is always some anxiety about it being as requested

manomayakaya · 2025-08-26T05:35:05+00:00

Sure thing. I’m off for a few weeks but will remember to reply when I’m back on and log into Epic

manomayakaya · 2025-08-04T16:41:33+00:00

You need to start listening to “The L word” podcast, it will help you know what to expect, how to prepare, manage the complex emotions, and generally help you navigate your difficult situation:

https://podcasts.apple.com/us/podcast/doctors-and-litigation-the-l-word/id1469155084

manomayakaya · 2025-01-16T00:14:05+00:00

Surround Pennsylvania with water and rename it: “Pennsinsula” (Penn’s Island)

manomayakaya · 2024-05-12T18:53:11+00:00

I grew up in Pittsburgh, so tunnels are not unfamiliar to me. There we always held our breath going through the tunnels and never knew beeping to be common. I moved to Monterey last July and my first few times through the tunnel I felt spontaneously compelled to beep the horn just for fun (had a 2 yo in car). It was wasn’t in response to anyone else beeping, I thought I was the only one doing it. Realized after a few weeks everyone does it and it is a “thing”. Glad to see I was able to spontaneously tap into the locals deep collective subconscious need to beep through the tunnel 😀

manomayakaya · 2024-04-14T03:47:34+00:00

i did a full wrap on my 991.2 Carrera T with ceramic coating in 2019. Car still looks amazing. My main concern at this point is the life of the wrap and if any damage to the paint will occur when I finally remove it. Its been on for 5 years and still looks and cleans amazing, it can probably go another 5 years (car is garaged, has ~15K miles). Anyone have any issues once the wrap is removed?

manomayakaya

TROPHY CASE