Optimizing the Physician Advisor in Case Management

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Optimizing the Physician Advisor in Case Management

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Foster effective relationships between case management and physicians with a strong physician advisor program.

As of June 20, 2014, contact hours for nurses are no longer available with this product.

With increasing federal compliance regulations, there has never been a greater need to have a physician advisor (PA) on staff to provide your case management team with more support to achieve your organizational goals.

Whether you’re building a new PA program or want to revitalize an existing one, the new HCPro book Optimizing the Physician Advisor in Case Management: A Guide to Creating and Sustaining Measurable Program Results delivers the guidance you need to improve the chain of communication across the continuum of care.

Written by Mark Michelman, MD, MBA, Sharon Mass, PhD, LCSW, ACM, and Donna Ukanowicz, MS, RN, ACM, the book combines the perspectives of a physician advisor, nursing case manager, and social work case manager. The book is the industry’s first resource that provides:

  • Easy-to-follow steps to create or revamp your program
  • Tips to recruit and train PAs
  • Strategies for defining measurable goals and effective PA responsibilities
  • Analysis methods for evaluating need and justifying resources
  • Metrics to measure your success
  • A CD-ROM loaded with adaptable tools and forms  

This book will teach you to define and shape a program that improves utilization management and compliance, and it provides solutions and strategies to help your organization:

  • Make correct admission decisions and streamline discharge planning
  • Understand observation status and maximize reimbursement
  • Prevent denials and effectively reverse decisions
  • Improve resource utilization
  • Focus on clinical documentation improvement
  • Target quality improvement efforts
  • Strengthen communication across the continuum of care
  • Educate physicians and case managers
  • Track, trend, and resolve outlier information


Table of Contents

Chapter One: Case Management and Physician Advisors
Chapter Two: Assessing the Need for Physician Advisors
Chapter Three: The Role of Physician Advisors
Chapter Four: Selecting a Physician Advisor Model
Chapter Five: How Physician Advisors and Case Managers Can Work Together
Chapter Six: Choosing and Hiring the Right Physician Advisor
Chapter Seven: Training and Orientation
Chapter Eight: Revitalizing Existing Programs
Chapter Nine: Outcomes

If you are contemplating a physician advisor for your hospital, ever wondered how a physician advisor would benefit your organization, or need guidance in establishing such a position, then this book is just what you need. Optimizing the physician advisor in case management: A guide to creating and sustaining measurable program results provides wealth of information on the possible roles, duties, and models of a physician advisor.  Full of practical tips and advice, Optimizing the physician advisor in case management: A guide to creating and sustaining measurable program results fills a visible void in the case management literature of the potential roles and benefits of dedicated physician involvement.
Gail P. Grant, MD, MPH, MBA

Meet the authors

Sharon Mass, PhD, LCSW, ACM, is the director of case management and palliative care services at Cedars-Sinai Medical Center in Los Angeles. She is a founding member of the American Case Management Association and an adjunct professor at the University of Southern California School of Social Work.

Donna Ukanowicz, MS, RN, ACM, is a registered nurse currently serving as director for case management at The University of Texas, M.D. Anderson Cancer Center in Houston. She is a founding member of the American Case Management Association (ACMA), is the immediate past-president of the ACMA Board of Directors, and the current chair of the National Board for Case Management.

Mark S. Michelman, MD, MBA, is a physician quality advisor, medical director of quality management, medical director of utilization management, medical director of case management, and physician coding advisor at the Morton Plant Mease Health Care System in Clearwater, FL.

Faculty Disclosure Statement: HCPro Inc. has confirmed that none of the faculty/presenters or contributors have any relevant financial relationships to disclose related to the content of this educational activity.

Learning objectives

Identify the types of case management models
Discuss the various roles and responsibilities of case managers
Describe why conflict can occur between physicians and case managers
Discuss how case management physician advisors can support case managers
Identify the types of case management models
Discuss where PAs can fit in different case management models
Assess the need for a PA
Discuss strategies to secure buy-in from medical staff, administration, case management, and nursing
Discuss the role played by PAs 
Examine how PA roles interact with case management
List the five main types of PAs
Determine ways to choose the best PA model for an organization
Explain how PAs and case management can work together
Determine ways case managers and PAs can influence organizational objectives
Understand potential sources of conflict with PAs
Explain criteria for choosing PA candidates
Identify whether the organization has a potential PA candidate
Evaluate the merits of internal PAs versus outsourced candidates
Discuss ways to determine whether the organization needs a full or part-time position
Explain training best practices for new PAs
Determine the director of case management’s role in orienting PAs
Discuss strategies for revitalizing an ineffective PA program
Identify how to set expectations for a PA program
Discuss ways to track and trend data
Evaluate data to determine outcomes of PA program

Published: November 2008