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Posts Tagged ‘Tim Buckley’

A One-Day Diversion To Music

Posted by J. Paul Spencer, CPC, CPC-H in J. Paul Spencer, CPC CPC-H

The general state of the American health care system isn’t on my mind today.

Perhaps I am in the throws of an extended “information cool-down” from the Fi-Med RAC Summit that concluded on Tuesday. Maybe I am burned out on the hot topics of the day, which are the ICD-10 proposed rule and the Supreme Court deciding the fate of PPACA. It could be that I really didn’t want to get out of bed this morning on a cloudy, rainy day, as a day of sleep with my dog and cat nearby sounds better than writing about another study, opinion or semi-breakthrough in the world of medicine.

More than likely, it’s because I lost one of my musical heroes yesterday.

Those who have read my pieces in this space know that one of my bigger areas of interest is music, both listening and performing. Any musician with any value will look you right in the eye and tell you that they are only the sum total of musical heroes that have gone before. As a singer, I would be nothing without the previous vocal contributions of the likes of Tim Buckley, Van Morrison and Paul McCartney. As a songwriter, I wouldn’t have much to offer lyrically without the craft displayed by Richard Thompson, David Ackles, Graham Parker or Bob Dylan.

And then there was The Band.

When I was in high school, I was in an enviable position, as my high school had a functioning, licensed radio station. For two years in the early ’80s, I had the coveted Friday night on-air slot. While I have some regrets about not being on the air with my current music collection, it was a great laboratory for pointing me in the right direction in the realm of both listening and composing. I discovered the bulk of The Band’s catalog during those years, and as time has passed, I have come to consider them to be the greatest band that North America ever produced. They are also the centerpiece of The Last Waltz, the greatest musical documentary ever filmed.

In the middle of The Band’s music was drummer and singer Levon Helm, an Arkansas native tasked with keeping the beat behind four Canadians. On Tuesday, a notice was released to the world that Levon was in the final stages of his 14-year battle with cancer. Yesterday, that battle concluded. He was 71.  

I never had the chance to see him in concert. My friend Curtis did, as he states here. Yet having occupied a unique musical space for nearly 50 years, everyone who came across him had a story about his calming and welcoming presence that went along with his first rate musicianship.

My favorite story about Levon Helm has nothing to do with music at all. There used to be a morning DJ in Philadelphia by the name of John DeBella, who had previously been employed in New York. One morning, he told a story about having interviewed Levon Helm on-air during his days in New York. When the interview concluded and the microphones were turned off, Levon turned to him and in his gentlemanly Southern drawl said, “John, if you ever find yourself in Woodstock on a Sunday, just drop on by. We’ll have the game on”. Some time later, DeBella found himself around Woodstock, New York on a Sunday afternoon and thought to himself, “He probably doesn’t remember me, but what the hell? Let me try it”. He found Levon’s house in Woodstock, parked the car, walked up and knocked on the door. Levon answered the door, amazed and said “JOHN! HOW ARE YOU? COME ON IN! WE’VE GOT THE GAME ON!”.

There is a local band in Milwaukee called the Flood Brothers that do a mix of originals and covers. Sometimes, when I’m in the audience, they invite me up onstage to do a song, and invariably, the song we choose is “The Weight” by The Band. There are only a few songs in existence in this day and age that when played, the bulk of the audience feels compelled to sing along with the chorus. Mostly thanks to Levon’s vocal tone, mixing a storyteller’s care for narrative with a weariness of a traveler wanting only “some place where I could lay my head”, “The Weight” is a song that never gets old. The Flood Brothers play in town tomorrow night, and the urge is striking me to sing one more chorus.

Yet isn’t that the magic of all art, especially music? A song has a way of transporting you back in time to a moment when for a brief few minutes, it was the center of your existence. The listener never realizes that the song has just become a part of that person’s oral history until time passes. For me and my fan’s relationship with The Band, it is the vision of a 10-year-old kid, up late on a Saturday in 1976, watching the Band’s last television appearance on “Saturday Night Live” and listening as “The Night They Drove Old Dixie Down” spilled out of the television and into my mind for the first time, never to vacate since. At the center of the music was Levon Helm as drummer and one of three rotating lead and harmony vocals, presenting a story so seemingly real that I could picture him as a Confederate soldier. I remember buying The Band’s greatest hits on vinyl when my teenage years hit and being similarly ignited.

My childhood and high school days have disappeared with a combination of time, weight, acne medications and a pressing need to live in the moment. If the truth is told, all time prior to my introduction to my wife Leslie (half-Canadian; coincidence?) can be accurately described as my Dark Ages. Yet the music from as far back as AM radio in 1971 to the present day always resonates with a memory in tow in ways that my first encounter with a CPT book never can. Levon Helm has danced on the edges of my memory – consistently as a positive one – for over 35 years, and will continue to for many years to come thanks to his significant musical contributions. I am left with being able to only say “Thank you” to him from a distance.  

This space is supposed to be dedicated to medicine, so in order to satisfy that requirement, here’s a song by The Band about the early days of frontier medicine called “W. S. Walcott Medicine Show“. I bid Levon Helm a fond farewell with a special life-long thank you from my ears, and we’ll talk about things more closely related to health care next week. I thank the readers for their one-day exhibition of patience.

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April 20th, 2012 | 1 Comment »

ICD-10, Part C, Schizophrenia and Monkee Memories

Posted by J. Paul Spencer, CPC, CPC-H in Industry Updates

I have now reached the end of my first week back from vacation. Upon my return, my e-mail box was full of updates both inside and outside the world of medicine, so allow me to fill your heads with assorted wisdom.

It was the end of the day yesterday, and a client of mine from Georgia forwarded me the latest provider bulletin from Blue Cross Blue Shield of Georgia. I had only reached page 2 when my eyes and brain slowly began to fry. The bulletin began by addressing “myths” about ICD-10. This was followed by the following paragraph:

“Myth #1: Reimbursements will be lower under ICD-10 than ICD-9.

In considering ICD-10’s impact to reimbursement, certain assumptions should be made. First, that institutions and professional providers will bill accurately using ICD-10. Second, that health plans will pay accurately against the data submitted on a claim. To the extent that ICD-10 codes influence reimbursement methodologies, there may be a legitimate fluctuation in reimbursement. However, we have not seen evidence of material fluctuations. Organizations should focus on gaining predictability into what those fluctuations may be and how to address them.”

Allow me to translate all of that fancy evasive language for you into Spencerese:

“It’s up to you to know the code set, we are not going to assist you in doing that on claims and any drop in reimbursement is your own fault.”

I could go into a long, colorfully-worded dissertation about how this attitude is typical of the American insurance industry as a whole, but I write this blog under the umbrella of my employer and I don’t currently have a beer in my hand. Catch me at the next Happy Hour and I’ll be happy to share my opinion with you, provided that you’ve left your children out of earshot.

We tend to hear a long, steady, droning tone from both the Executive and Legislative branches of our government with regard to fraud and abuse in the Medicare and Medicaid programs. We are well aware of what is being done (mostly unsuccessfully) for Medicare Parts A & B. Last Friday, the OIG released a report about fraud and abuse efforts for Medicare Part C, commonly known as Medicare Advantage. To whom that advantage goes has yet to be determined. The review looked at 170 of the 188 organizations that offered Part C plans in 2009. The results of this review also captured Part D benefits, as most Part C plans also offer prescription drug benefits.  

The OIG found that 19% of all Part C plans reviewed did not identify a single instance of fraud and abuse. Further, 3 of the organizations offering plans accounted for 95% of all reported fraud and abuse incidents.

By any metric, this appears to be low. As part of reviewing this report, it is important to consider that CMS does not require Part C carriers to report on fraud and abuse efforts. With this information in tow, the fact that any cases were referred at all is something of a miracle. The OIG prefaces this report stating that Medicare Advantage is now a significant part of Medicare based on costs and enrollment. Based on Part C organizations doing very little in the way of fraud and abuse, I would say that the costs are higher than anyone currently imagines.

The next piece of news of interest has to do with a revolutionary treatment for schizophrenia taken directly from the modern age of electronic devices. One of the most common symptoms of schizophrenia is auditory hallucinations, commonly referred to as “hearing voices”. In many cases, the perceived voices can be louder than the voices of people in the room speaking to the afflicted party.

On the heels of studies at a Norwegian university of how the schizophrenic brain processes speech, a cell phone application has been developed specifically to train the schizophrenic brain to hear one voice over the other. The main goal is to give the afflicted patient the control over the voices, rather than the other way around. It is somewhat humbling to think that 50 years of semi-reliable pharmacology could possibly be set aside with a set of headphones plugged into a smart phone. I eagerly await further testing  of the application on more subjects.

I’d like to end today’s post on a personal note. We are all probably aware of the sudden death this week of Davy Jones, best known as a member of the ’60’s prefab band the Monkees. My wife Leslie is a huge Monkees fan, and saw them on what will more than likely be their final tour this past summer as it came to Milwaukee. Our home office is adorned with different photographs of Leslie standing with every Monkee save for Michael Nesmith.

The final episode of the television show The Monkees ended with an appearance by a single solitary figure with a 12-string guitar singing an original composition entitled “Song to the Siren”. The singer’s name was Tim Buckley, and he remains my biggest vocal influence whenever I open my mouth and hit a note. In fact, I have recorded a cover of this very song that will appear on a friend’s album release sometime this year.

On March 13, 2000, in a long-deleted Yahoo Music group dedicated to Tim Buckley, I met Leslie and began a conversation about music. Five years later to the day, we were married, an affliction that Leslie continues to suffer from to this very day.

To me, Davy Jones isn’t simply a teen idol of yesteryear who won’t be around any longer. Rather, he is one of the many musical catalysts who have surrounded either me or my wife over a period of years that provide a bond between us that solidifies with each passing day. No, I still don’t know what the chorus of “Daydream Believer” means, but yes, it does have meaning beyond words in my life. With that, I bid Mr. Jones a fond and peaceful farewell.

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March 2nd, 2012 | 1 Comment »