23 episodes

Co-presented by the American Case Management Association and the Association of Physician Leadership in Case Management, Care Transitions Today is a premier podcast for insightful discussions on case management and transitions of care. Our upcoming series, Case Conversations, delves deep into real-world medical cases, sharing experiences, best practices, and innovative approaches to patient care. Each episode, our panel of experts brings you a new case study, offering a unique learning opportunity for health care professionals at all levels of experience.

Care Transitions Today Co-presented by ACMA and APLCM

    • Health & Fitness

Co-presented by the American Case Management Association and the Association of Physician Leadership in Case Management, Care Transitions Today is a premier podcast for insightful discussions on case management and transitions of care. Our upcoming series, Case Conversations, delves deep into real-world medical cases, sharing experiences, best practices, and innovative approaches to patient care. Each episode, our panel of experts brings you a new case study, offering a unique learning opportunity for health care professionals at all levels of experience.

    Case Conversations: Aligning Clinical Needs with Reimbursement Realities

    Case Conversations: Aligning Clinical Needs with Reimbursement Realities

    This episode is co-presented by the Association of Physician Leadership in Care Management and the American Case Management Association. In this episode, we are joined by three physicians, Dr. Rebecca Severe, a Hospital Medicine-certified physician serving as Medical Director of Care Management for Advocate Aurora Health, Dr. Sweta Singh, Medical Director of Care Management at the University of Michigan Medical School, and Dr. Teresa Jacobs, Clinical Professor of Neurology at the University of Michigan Medical School



    In this conversation, the physicians focus on two patient cases. The first case covers a 42-year-old female who had a total knee replacement and developed a wound dehiscence and infection. The question arises whether the patient should be admitted as an inpatient or placed under observation. The second case is a riveting dialogue regarding a 75-year-old female with relapsed IgG lambda multiple myeloma who requires 48 hours of monitoring after each dose of a new immunotherapy medication. The dilemma is whether this patient should be admitted as an inpatient or placed under observation.



    The Association of Physician Leadership in Care Management, or APLCM, was created to provide support and education for physicians in this field. APLCM is unique because of its connection to the American Case Management Association, focusing on the partnership and collaborative model of nurse case managers, social workers, and physicians in care management. ACMA has a rich, 25-year history of supporting the case management field.



    APLCM is inclusive of all practice settings. Membership in APLCM also gives you access to all ACMA resources and benefits. Whether you're new to case management or have years of experience, APLCM membership is valuable. Gain access to professional networking opportunities and resources. Visit www.aplcm.org to learn more.



    Please visit www.acmaweb.org/podcast for more information about the podcast, or contact us directly at podcast@acmaweb.org with questions, topic requests, or other feedback.

    • 33 min
    Case Conversations: Effective Communication in Peer-to-Peer Reviews

    Case Conversations: Effective Communication in Peer-to-Peer Reviews

    This episode is co-presented by the Association of Physician Leadership in Care Management and the American Case Management Association. In this episode, we are joined by three physicians, Dr. Rebecca Severe, a Hospital Medicine-certified physician serving as Medical Director of Care Management for Advocate Aurora Health, Dr. Sweta Singh, Medical Director of Care Management at the University of Michigan Medical School, and Dr. Teresa Jacobs, Clinical Professor of Neurology at the University of Michigan Medical School



    In this conversation, the physicians focus on two patient cases. The first case is of a 66-year-old female with a history of COPD and ovarian cancer who presented with increased shortness of breath. The physician advisor had to argue for the medical necessity of the hospital stay, focusing on the treatment of pneumonia. The second case discusses a 74-year-old female with hyponatremia and dizziness. The physician advisor had to argue for the inpatient level of care based on the severity of illness, utilization of resources, and medical necessity.



    The Association of Physician Leadership in Care Management, or APLCM, was created to provide support and education for physicians in this field. APLCM is unique because of its connection to the American Case Management Association, focusing on the partnership and collaborative model of nurse case managers, social workers, and physicians in care management. ACMA has a rich, 25-year history of supporting the case management field.



    APLCM is inclusive of all practice settings. Membership in APLCM also gives you access to all ACMA resources and benefits. Whether you're new to case management or have years of experience, APLCM membership is valuable. Gain access to professional networking opportunities and resources. Visit www.aplcm.org to learn more.



    Please visit www.acmaweb.org/podcast for more information about the podcast, or contact us directly at podcast@acmaweb.org with questions, topic requests, or other feedback.

    • 27 min
    Case Conversations: Clinical Judgment in Care Classification

    Case Conversations: Clinical Judgment in Care Classification

    This episode is co-presented by the Association of Physician Leadership in Care Management and the American Case Management Association. In this episode, we are joined by two physicians, Dr. Rebecca Severe, a Hospital Medicine-certified physician serving as Medical Director of Care Management for Advocate Aurora Health and Dr. Sweta Singh, Medical Director of Care Management at the University of Michigan Medical School.

    In this conversation, Rebecca and Sweta discuss two patient cases and the determination of level of care. The first case is a 36-year-old male with a history of spinal cord injury and bilateral above knee amputation. The patient presented with weakness and flank pain and was found to have a high white blood cell count. The speakers discuss whether the patient should be classified as inpatient or observation status. The second case involves an 82-year-old male with a history of abdominal hernia repair. The patient presented with increased abdominal pain and respiratory distress after a CT scan. The speakers discuss whether the patient should be admitted as inpatient or observation status, considering the possibility of an allergic reaction to contrast.

    The Association of Physician Leadership in Care Management, or APLCM, was created to provide support and education for physicians in this field. APLCM is unique because of its connection to the American Case Management Association, focusing on the partnership and collaborative model of nurse case managers, social workers, and physicians in care management. ACMA has a rich, 25-year history of supporting the case management field.

    APLCM is inclusive of all practice settings. Membership in APLCM also gives you access to all ACMA resources and benefits. Whether you're new to case management or have years of experience, APLCM membership is valuable. Gain access to professional networking opportunities and resources. Visit www.aplcm.org to learn more.

    Please visit www.acmaweb.org/podcast for more information about the podcast, or contact us directly at podcast@acmaweb.org with questions, topic requests, or other feedback.

    • 28 min
    Case Conversations: Navigating Patient Status

    Case Conversations: Navigating Patient Status

    This episode is co-presented by the Association of Physician Leadership in Care Management and the American Case Management Association. In this episode, we are joined by two physicians, Dr. Rebecca Severe, a Hospital Medicine-certified physician serving as Medical Director of Care Management for Advocate Aurora Health and Dr. Sweta Singh, Medical Director of Care Management at the University of Michigan Medical School.



    In this conversation, Rebecca and Sweta discuss two
    different cases involving Medicare patients. The first case, a patient who underwent back surgery was initially downgraded to outpatient status, but later needed to be converted back to inpatient status. In the second case, an elderly patient with multiple medical conditions presented with lower abdominal pain after a hip replacement surgery. The decision to convert the patient to inpatient status is discussed, along with considerations for commercial payers. Overall, the conversation highlights the importance of proper documentation and timely decision-making in determining the appropriate status for patients.



    The Association of Physician Leadership in Care Management, or APLCM, was created to provide support and education for physicians in this field. APLCM is unique because of its connection to the American Case
    Management Association, focusing on the partnership and collaborative model of nurse case managers, social workers, and physicians in care management. ACMA
    has a rich, 25-year history of supporting the case management field.



    APLCM is inclusive of all practice settings. Membership in
    APLCM also gives you access to all ACMA resources and benefits. Whether you're new to case management or have years of experience, APLCM membership is
    valuable. Gain access to professional networking opportunities and resources. Visit www.aplcm.org to learn more.



     Please visit www.acmaweb.org/podcast for more information about the podcast, or contact us directly at podcast@acmaweb.org with questions, topic requests, or other feedback.

    • 29 min
    Case Conversations: A Deep Dive into Challenging Cases

    Case Conversations: A Deep Dive into Challenging Cases

    This episode is co-presented by the Association of Physician Leadership in Care Management and the American Case Management Association. In this episode, we are joined by two physicians, Dr. Rebecca Severe, a Hospital Medicine-certified physician serving as Medical Director of Care Management for Advocate Aurora Health, and Dr. Sweta Singh, Medical Director of Care
    Management at the University of Michigan Medical School.



    In this episode, our physicians discuss two intriguing cases. The first case involves a 67-year-old female with a history of COPD and aortic stenosis who presents with shortness of breath and fever. The doctors discuss whether the patient should be admitted as an inpatient or placed in observation
    status. The second case involves a 71-year-old female with a history of seizures who is undergoing long-term EEG monitoring. The doctors discuss the challenges of obtaining inpatient status for planned admissions and the importance of documentation in justifying the need for inpatient care.



    The Association of Physician Leadership in Care Management, or APLCM, was created to provide support and education for physicians in this field. APLCM is unique because of its connection to the American Case Management Association, focusing on the partnership and collaborative model of nurse case managers, social workers, and physicians in care management. ACMA has a rich, 25-year history of supporting the case management field.



    APLCM is inclusive of all practice settings. Membership in APLCM also gives you access to all ACMA resources and benefits. Whether you're new to case management or have years of experience, APLCM membership is valuable. Gain access to professional networking opportunities and resources. Visit www.aplcm.org to learn more.



    Please visit www.acmaweb.org/podcast for more information about the podcast, or contact us directly at podcast@acmaweb.org with questions, topic requests, or other feedback.

    • 25 min
    Innovation: Artificial Intelligence Supports a New Approach

    Innovation: Artificial Intelligence Supports a New Approach

    This episode is presented by the American Case Management Association and sponsored by Xsolis. Join our host, Deb McElroy, along with featured guest, Rikki Moye. Rikki is a registered nurse with 20 years of progressive leadership experience in the field of Case Management. She has been the Vice President of Case Management for the Oklahoma division of Ardent Healthcare, Hillcrest HealthCare System for the last 5 years. Her responsibilities include planning, managing, directing and evaluating the activities, functions and the personnel of the division Case Management program.  In this episode, the discussion focuses on innovative ways in which technology has been leveraged, leading to a redesigned care management model and improved outcomes. They also dive into implications for the future.

    Xsolis provides data-driven, analytics-fueled solutions to break down the silos that exist between providers and payers to create a better healthcare system for all. When you hear XSOLIS, think excellence in utilization management. Contact XSOLIS today to demo the CORTEX platform, learn more about our work connecting payers and providers, or just run ideas past us. Learn more today by visiting www.xsolis.com/acmapodcast

    Do you have topic requests or feedback about this episode? Reach out to us at podcast@acmaweb.org.

    • 42 min

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