Extra Credit

Sometimes credit is misplaced, like my bride gave me credit for fixing the toilet leak when really it just self-resolved because if I ignore something long enough sometimes I get lucky. Or like in healthcare these days there are a lot of people complaining that they should get the credit for having lowered the patient’s health risk - a social service company tried to persuade a Medicaid plan that their 5 weekly visits to a community of refugees in Minnesota had a much greater impact on the 60% decline in so-called avoidable ER visits than any of the doctors who work inside a building.  “We basically helped these people understand that many times their symptoms could self-resolve or be fixed with changes at home, but we weren’t getting the bonus the doctors were getting,” Paula Kreeger said. A primary care group in the south used its data to convince a Medicare Advantage plan that 261 patients it treated in 2022 should be “attributed” lives, based on a detailed history of when they met the patient, A1C scores for diabetes at the point of care, the treatment plan notes, follow up call log, and follow up visit. “We asked the health plan to show us if these patients had seen another provider that could have indirectly impacted their health too – but they only could come up with that on 18 of them,” Molly Plant, a care coordination director says. Mark Swayne, an attribution specialist, admits that they are encountering attribution issues now with all the bundles and separate contracts with groups managing the same population – “it’s gotten messy assigning who gets credit for cost savings.”  My mom used to say not to worry about getting credit – “you can like it or lump it” she’d say. I didn’t really know what she meant until 6th grade when Miss Rosebrooks blamed me for killing the goldfish by dumping too much food in the bowl.  I was maybe 25% responsible since I was holding the food, but Lenny pushed Charlie who bumped into me, but she credited me with the fish mortality, which of course led to a detention.  But at 12 years old I had a metal Star Wars lunchbox, could ride my Huffy dirt bike to school and wore blue polyester bell bottoms 4 days a week, so I had it pretty good, obviously.  And so sometimes you just need to take your lumps, keep your chin up and be thankful for just being.