May 5, 2010

RACs: It’s No Longer the Same Old Tune

By

pdear120dsWhen CMS started the pilot RAC program several years ago, few providers outside of the demonstration states paid any attention, and some were ignorant of its very existence. A few more providers and organizations (very few) began to pay some attention when the first ”big notes” of CMS financial opportunity and recovery were sounded, but by the time the program was made permanent, the ability to influence or re-write the song was past. 


 

Jazz is a wonderful and uniquely American music form, as many contributing nationalities, ethnicities and generations have allowed it to grow into the amazing melting pot of sounds so many of us enjoy today. However, the path to growth and inclusion of this form of music has not been easy for many individual musicians, bands, clubs or communities. Places like Memphis, Nashville, Harlem, New Orleans and countless others have seen those pushing the bounds of musical genius harassed, ignored, shunned or taken advantaged of.

 

Change and interpretation of the “standard” way of approaching or enjoying musical expression has not been without resistance and controversy – or without outrage, in some instances.

 

RAC  “Music”

 

Since the 1960s, Medicare has been the songwriter, if you will, of overall payment for certain healthcare services to a defined beneficiary population here in the U.S. The song has been changed and re-written, with so many new writers. The goal all along has been to meet the growing needs of the population and to ”sing” in such a way that the participant providers who share the payment song will continue in the band.

 

And now another new refrain has been added: the RAC music. Depending on the “listener” the music may be dissonant, off-key, flat, loud, overwhelming or downright awful; however, other listeners may find the notes timely, relevant, “new age” or important.

 

Regardless of your perspective, exposure to various forms of music allows listeners to appreciate the facets of the current world; I was not a fan of rap music when it first appeared on the scene and still don’t find it a favorite of mine, however, it is expressive and relevant for many.

 

Providers all must listen to the RAC music being played today, understand the flow of its melody and the growth of new stanzas, and employ those who can appreciate the new music form.

 

Musical Conclusion

 

Most often the articles I have written here have been meant to convey some new information or perhaps a new way of seeing that which is widely known regarding the RAC program. It is a serious endeavor for CMS and should be taken very seriously by all providers, but deciding to “change the channel” or fail to listen to this form of payer music is not an option. You can dislike the music, but you best get the point of the lyrics.

 

In conclusion, I love jazz and the festival here in New Orleans; I love the city, the people, the food, and the sounds – all of it. An interesting note however: one of the closing acts this year is not known for their jazz music, but rather a form I do not know or enjoy much. It seems fitting to me, though, that they are included and that the crowds will be huge for them: Pearl Jam. Hmmm: not consistent with the original theme 41 years ago, I imagine, but nonetheless timely and worth listening to for many.

 

About the Author

 

Patricia Dear, RN, has more than 30 years of experience in the healthcare industry, working within corporate healthcare entities, for-profit and non-profit hospital systems, legal defense and plaintiff counsel. She is a recognized national speaker on reimbursement and compliance. She is the president and CEO of eduTrax®.

 

Contact the Author

pat@edutrax.net

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