Parents Could Teach Us A Thing Or Two About Attribution In Value Based Care

Figuring out who’s responsible for Allen Wilder’s 7-point drop in A1C and 10-point drop in BMI was not easy for the insurer – his endocrinologist, primary care doctor, cardiologist, and dietary specialist were all in versions of value based contracts and argued that the 42-year-old man’s improvements should have been solely attributed to them, but in the end none of them won the argument and the insurer gave credit to an exercise program. “There’s a ton of gray area around attribution made more interesting and problematic when you have drug treatments or exercise specialists in the mix – and sometimes it’s really just the patient’s behavior change,” Sadie Uston, NP, said of the challenges the industry is having with attribution in value-based contracting.  I would argue attribution is a whole lot easier at home as a parent – partly because my kids can be dummies, easily leaving a trail to who’s done what. This week I found a pair of dirty Spaulding socks in our fridge, two containers of OJ in the shower and an empty tank of gas in my Volkswagon – figuring out who was responsible amongst our kids was easier than a pillow fight with a 2-year-old — it took seconds, especially when I saw the stack of Celsius cans atop the trash bin – the trail of evidence almost as clear as Reagan National’s runway lights. They pointed to Jack in all 3 cases whose return home usually feels and looks like a Tsunami.  Perhaps the healthcare industry could take a cue from parental strategies – said one mom of 4, Maggie Lu of Buffalo, “I don’t divide up allowances – I don’t even give them – if you fix something, you get to keep eating my food and living in my house.” Touché Maggie Lu. Touché.