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 episode, the conversation revolves around two complex medical cases, focusing on the challenges faced in patient care, particularly regarding insurance authorization and clinical decision-making. The first case discusses an elective arthroscopic knee procedure that led to complications and the subsequent management decisions regarding inpatient versus outpatient care. The second case highlights the struggles of a patient with severe cardiac issues seeking TAVR (transcatheter aortic valve replacement) and the hurdles faced in obtaining insurance approval for a medically necessary procedure. The discussion emphasizes the importance of collaboration among healthcare professionals to navigate these challenges effectively.

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.