Driving Lesson

My kids got a hold of the 40-minute fireside chat I gave last month on the top 20 payer priorities and stories about how I try to rationalize my poor healthcare decisions (click here) – and perhaps as a bit of payback for all the times I call them out in this column, they let me have it. “Dad, first off, for God’s sake clean your glasses before you go on a zoom! And what’s with the 77 times you touch and fidget with your glasses?” My daughters are my favorite but even they gave it to me. “Nice work almost choking and nice that you made fun of your own doctor visit and not us for a change!” Welp, now that they mention it…I find it interesting that when your middle daughter fails her first driving test you buy her an ice cream cone but when she fails the second you give her a hug and tell her to hang in.  On Wednesday, after Sophie failed the third time, I headed for the shed and dusted off the 10-speed… It’s hard to raise kids amidst all the priorities we have. I’ve heard it said you’re only as happy as your least happy kid and sometimes, even when it isn’t easy, you acknowledge defeat and move on, as I did this week after her driving test.  A primary care clinic had to do that last month.  After a 3-year effort to try and raise its payments from one of the biggest insurers in Rhode Island, it had to go back to the standard rate.  “We tried 3 times to get these incentive payments but we fell short each year,” office manager Roy Sastain says.  He said the payments would have meant about a 20% increase in reimbursement rates per visit all in, paid out in installments, but “we never hit the quality thresholds.”  He blames a range of factors – patients are tough to manage, particularly Medicare and Medicaid, and he blames his own skills at getting the staff to screen and document issues and follow up with patients. “I didn’t appreciate how difficult it would be. We may just have to acknowledge we’re not cut out for this.” Sort of like our daughter, who had to look in the mirror last week and admit that she just isn’t ready to drive.  “I’m going to college in NYC in 4 months – I don’t need a license,” she said.  True sweetie, but pretty sure that’s called rationalization. Welcome to life…