History, Regulation, and the CRA


By Bruce Hammond, CRA, CFAAMA

Recent changes in law and accepted medical practices coupled with expectations of payers, patients, and physicians have made dramatic changes to our work environments, and the pace seems to be quickening. I had a professor years ago who broke down the history of modern man into three sections. First was the Bronze Age, where man began to understand the physical properties of organic matters and there was a quantum leap forward in many cultures. Next was the Industrial Revolution, when man harnessed the learnings from the Bronze Age to make leaps and bounds in efficiency and productivity, and the need for subsistence-only living was dramatically affected, changing cultures around the world. Then came what he described as the Regulatory Revolution, where man, with more spare time than ever in most developed countries, gave up rights and responsibilities to governments and agencies in exchange for what was perceived as the benefit of security and safety.

In healthcare we find ourselves at the focal point of that regulatory revolution. We have new Federal laws, new standards of participation, and grossly enlarged requirements from the private sector. In just the past week, we have seen the SGR “fix” not fixed, again. We have seen the further delay of ICD-10 implementation, announcements for and against the Affordable Care Act, new technologies announced, and more changing regulations dealing with all aspects of our profession. We can either see this as a burden or an opportunity; it is up to you to decide.

What does this have to do with the AHRA, the CRA, or the RACC? It makes them all the more valid and necessary organizations and credentials. As we face the onslaught of changes in technology, payment, personnel, registries, accreditation, licensure, MQSA, and a host of other areas, it is virtually impossible to keep up and represent yourself on all these fronts. Through the AHRA we now have a regulatory news resource that comes out regularly, Link, Radiology Management, and other resources for coding, law, employment practices, and more. We also have our corporate partners who provide continuing education, technology news, and sponsored activities and conferences for us to learn more.

As for the RACC, we are seeing numbers change, as we have passed the 1,000 CRA mark. We have also seen near record numbers of applicants for RACC Commissioner positions and to sit for the examination. There is a new test in the works (it is updated or at least reviewed every two years to determine the test validity and content), and we have seen a greater concentration of applicants exceeding the eligibility requirements.

The CRA is more valuable today than yesterday and will be more so tomorrow. However, the value is not dependent on the RACC Commissioners or the AHRA. The validity and ultimate value of the credential is dependent on you, the radiology administrator. The value is determined by you taking and passing the examination, and then placing the credential and facility certificate prominently in your office and department respectively. It is increased by bringing others in, by participating in elections, running for Commissioner, and working on item writing, test validation, and other activities.

One area where the radiology administrator can have a significant impact is communicating the standards for the credential to the “C Suite” and making it either preferred or required for your position. Other credentials are just letters until someone says, “you need this to be my new radiology administrator, director, manager, or supervisor.” The structure of the CRA process exceeds standards for most healthcare management credentials through psychometrically validated tests, testing processes, and near continual review. Most of all, holding the CRA credential shows that you are invested in yourself and your profession. It shows that you understand that skills must be learned, maintained, and validated. This is the true secret and value: it is YOU and your time and effort that will make the CRA work for you. There is plenty of work to do, let’s all get to it!


Bruce W. Hammond, CRA, CFAAMA is the CEO of The CailcoGroup in Fort Worth, TX. He can be reached at bruce.hammond@cailcogroup.com.

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