Homeopathic medications and refuses traditional therapies

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Question

The patient is a 75-year -old woman with rheumatoid arthritis for 30 years managed heavily on homeopathic medications and refuses most traditional therapies. Last year, she canceled her yearly physical exam. This year she was hospitalized for 6 days due to acute rheumatoid pericarditis. She is enrolled in a Medicare advantage plan.

1) The MAO is not responsible to reimburse all services during her hospital encounter for pericarditis 2) it is not important for MAO physicians to reach out to their patients who are under utilizing the healthcare system to capture any new and chronic conditions especially to compensate for risk-associated comorbidities 3) her capitated rate is the same as a healthy 75-year-old woman with no chronic condition 4) because she did not have contact with physicians during the previous year. No diagnosis of rheumatoid arthritis ( or any other comorbidity) is associated with her risk score this year.

Reference no: EM133751354

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