I got a solid 88% on my first anatomy test.



My good friend got a 99.



Soon I found he could no longer meet for our early morning study sessions—nor could he tell me why.



Seems that one of the professors was under the impression that a high score on the first anatomy test correlated with clinical excellence—how he came to this conclusion is unclear, but it was the first of many times I learned to question the competence of my faculty.  The guy himself, I found out later, was a real putz.



He picked the top five scorers and gave them one year of personal mentoring in clinical medicine.



Did it make any difference?  Who knows, All graduated and have led great careers of service.



When some of my classmates (appropriately) complained that they themselves were paying the same tuition but getting less education, they were told that if they scored higher on tests, they might get the same treatment.



I’m certain they remember that now when they get hit up for donations.



Medicare Advantage contract underperforming?



Pull your five best performing primes out of your standard compensation pool and increase their risk share—and give them carte blanche to innovate.



See what they cook up.



STARK compliant? The law is unsettled. It may be a risk. Your STARK attorney will advise against it.



Whether you proceed depends on how poor your current performance is.



If something’s not difficult, it’s probably not worth doing



Other primes jealous?  Tell them they could be in the group if they began doing well.



When I was the customer, telling me to work harder so I could get a better product didn’t work.



When I was the laborer—it worked just fine.