Gary Tetz

Everyone’s talking about Alternative Payment Models (APMs) these days. Providers. Consultants. Cab drivers. Baristas. Everyone. 

Just now some children rode by on bikes, and one of them yelled, “They’re incredibly complex and intimidating.” 

“True!” shrieked another, holding a Red Bull in one hand and texting with the other, “but we’re just going to have to learn to adapt in this new environment.” 

It’s an unstable payment climate, and I feel especially bad for administrators. They already have to be motivators, psychologists, attorneys, nurses, recruiters, caregivers, HVAC mechanics, accountants, nebulizer repair specialists, bus drivers and priests.

But now with APMs, we’re demanding they become data analytics experts and evangelists — abandoning the bridge of their facility Starship to make the case for clinical excellence and network inclusion to boardrooms of dark-suited folks prone to misinterpreting moldy CMS data. 

As networks narrow, this is how animals felt walking onto Noah’s ark, or the sinner will feel on Judgment Day. How long until the door slams shut? Will my facility be left outside the Pearly Gates of Preferred Provider Paradise? Administrators with sudden-onset insomnia are asking, like John Milton in Paradise Lost, “What hath night to do with sleep?”

Unfortunately, as in human relationships, there’s really no alternative to just accepting reality. A friend of mine is narrowing a boyfriend out of her network, and I asked if she was okay. “I’m fine,” she said. “He’s the one going through a breakup.” 

Which is how it goes. One party cheerfully dictates life-altering change, the other one pleads for more status quo. In the end, though, protest is usually futile — it’s either acceptance of the new terms, or obsolescence. 

For paradise-seeking administrators, Milton is spot on:  “Awake, arise or be for ever fall’n.

Things I Think is written by Gary Tetz, a national Silver Medalist and regional Gold Medal winner in Humor Writing in the 2014 American Society of Business Publication Editors (ASBPE) awards program.