Managing Care: The Crucial Nursing–Case Management Partnership

Readmissions, throughput, capacity, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores'laser-like focal points for every hospital. Enter Recovery Audit Contractor (RAC), Medicare Administrative Contractors (MAC), Comprehensive Error Rate Testing (CERT), Medicare Integrity Program (MIP), and other auditing entities, and the incentives grow larger while the penalties become more draconian. Medicare's Recovery Audit Contractor program provides an example. It retracted $828.3 million from acute care hospitals in California, Florida, and New York during a 3-year demonstration program.1 It has since expanded to include all hospitals and states.