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.

This conversation features a complex case involving a 56-year-old man with chronic pancreatitis and multiple comorbidities, admitted for intractable pain. The case highlights the challenges in obtaining inpatient designation and navigating insurance denials, even when clinical judgment suggests the need for hospitalization. The episode underscores the complexities of managing patients with chronic conditions, the challenges of working within insurance guidelines, and the importance of persistent advocacy for appropriate patient 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 [email protected] with questions, topic requests, or other feedback.