1. To increase volume.

2. Your area is changing and pt are changing to Medicare advantage.

3. By becoming the "Crazy Eddie" of the area, you feel that you will make up the 40 % loss with the volume.

4. You feel that you will lose your patient base.

5. You have a "bean counter" making the decisions.

6. You have to survive.

I did this in the beginning and was lured in initially at 105% of Medicare. But as this carrier became a major potion of the practice, they kept cutting the reimbursement and threatening to take "their patients" elsewhere. Today, I keep my Medicare advantage/HMO portion of the practice limited.

The "Crazy Eddie" reference was a bit worse than just volume.


Frank J. Paiano, DO, FACOI
Internal Medicine of Central Florida, PA
The Villages, FL