Care Transitions Today Podcast

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.