Hospital Case Management Advisor

Most Recent Updates
by Phoenix Medical Management, Inc.

The rapidly evolving marketplace requires new competencies to effectively manage high-risk and at-risk patients as they navigate the acute and post-acute episodes of care. The models of the 1990s must be transformed to accomodate the expectations of new ACOs, risk based contracts, bundled services, patient centered care, and new delivery of care settings.  

We welcome your thoughts or your critique. Feel free to send an email to

gatekeeper, front-end- revenue cycle, case management, access management, utilization review

Gatekeepers of the ED

Examining your front end revenue cycle process by positioning CM and UR in the emergency department. Article published on RacMonitor, [...]

leadership, hospital unit based

How can unit-based leadership improve performance metrics?

On January 12, 2021, Taylor & Francis, published in the Journal of Hospital Practice, the Impact of a hospital unit-based leadership triad on key performance metrics. They discovered that having physician, nursing, and case management leadership empowered and aligned in the same metrics for performance they were able to achieve improvements in length of stay and progression of care metrics. [...]

Debating the Pros and Cons of Medicare for All

More than 27 million Americans currently do not have health insurance of any kind, and even more are underinsured. But those who do have adequate health insurance are hardly out of the woods. Many current health plans feature massive deductibles. In 2019, 82% of workers with health insurance through their employer had an annual deductible, up from 63% a decade ago, according to a report from the K [...]

Is LOS relevant any more

The Myth of Length of Stay, Revisited

Focus on length of stay has been ongoing since 1983. Yet we all know that If cost per case is less than the DRG reimbursement, the per diem rate, the bundled payment, or the value-based benchmark, the hospital achieves a margin no matter what the LOS might be. If quality patient outcomes and financial viability are the hospital's goals, then it's time to switch strategies. [...]

COVID-19 Patient Treated at Home

On April 30, 2020, CMS published an interim final rule (IFR) that made regulatory changes and clarified certain policies in response to the Coronavirus (COVID-19) public health emergency (PHE). The IFR’s changes include increased flexibilities for hospitals to provide and receive Medicare payment for hospital outpatient services to patients in their homes. IN DEPTH [...]

Glenn Krauss, CDI

Seeking A New Purpose for CDI in 2020

We're delighted to feature Glenn Krauss, noted subject matter expert on the practice of clinical documentation and a fearless fighter to help CDI specialists transform their task oriented focus to meet the demands of clear and concise medical documentation in today's marketplace. [...]