Inpatient-Only List Continues to Roil Physicians

Summary highlights from the ACPA’s NPAC 2021 conference: “Advising in an Unconventional World.”

The Centers for Medicare & Medicaid Services (CMS) continues to create confusion regarding the proposal it made last year to phase out the Inpatient-Only List, only to reverse their decision months later, as noted by Dr. Ronald Hirsch at the National Physician Advisor Conference (NPAC).

This and many other topics were highlighted at the recent American College of Physician Advisors (ACPA) annual conference, titled Multifaceted: Advising in an Unconventional World. Held in a virtual format and attracting over 300 attendees, this year’s event was truly multifaceted, both in its content and the breadth of participants representing many roles and health systems.

The conference kicked off with a State of the Union address by Dr. Juliet Ugarte Hopkins, followed by the Vice President of Member Engagement, Dr. Clarissa Barnes, discussing the benefits of membership and Dr. Alvin Gore, Vice President of Operations, who reviewed the results of this year’s ACPA member survey. NPAC 2021 offered for the first time ever subspecialty tracks in professional leadership, clinical documentation integrity (CDI), revenue cycle, pediatrics, and COVID-19.

There were sessions on developing successful physician advisor programs, data presentation in healthcare, artificial intelligence, hospital metrics such as length of stay and mortality, and fighting Medicare Advantage denials. New conference highlights included networking lunchrooms organized by Medicare Administrative Contractor (MAC) region, virtual happy hours with the sessions led by expert physician advisors in the field, and APCA committee interest groups, meant to attract new members.

Each day concluded with a specialized session, including an observation panel discussion on Medicare Advantage plans, an inaugural quiz bowl testing attendee knowledge, and an Expert Physician Advisor panel. The expert panel was moderated by Dr. Hirsch and included current and past ACPA presidents answering provocative questions submitted by attendees.

Several key discussions were must-see sessions for participants. Dr. Brian Moore addressed how to use CMS regulations to force Medicare Advantage plans to provide timely authorization for post-acute care services. He shared a templated fax physician advisors can use to quickly get Medicare Advantage plans to reconsider initial denials for post-acute care, which has been used successfully, with overturn rates greater than 75 percent. These templates will be shared on the ACPA website, along with regulatory references, over the coming months. Dr. Timothy Brundage also provided an excellent update on COVID-19 documentation essentials and reminded us of the importance of accurately capturing and reporting the unique aspects of COVID-19 infection.

Dr. Edward Hu delivered an in-depth explanation of the ever-evolving sepsis criteria, while Dr. Andrew Fletcher demonstrated the value of clinical laboratory medicine in partnering with case management. Day three opened with a bang, as Dr. Mary McLaughlin Davis discussed strategies for physician advisors to further collaborate with case managers.

It goes without saying that these topics and networking moments will inspire innovations that will be brought back to organizations across the country. The ACPA is excited about the growing field the physician advisor role represents, and the excitement was palpable, even on a computer screen, during the three-day conference.

On behalf of the ACPA, we cannot wait to see you in Austin for NPAC 2022 – Exploring the Spectrum: Leadership through Collaboration & Diversification!



Carolyn Dutton is triple board-certified in Emergency Medicine, Internal Medicine, and Quality Assurance and Utilization Review, with a focus in Healthcare Quality Management. Dr. Dutton is also a Certified Wound Specialist Physician. Her interests include multi-disciplinary wound care and serving as a system-level senior physician advisor. She is also a Certified Healthcare Financial Professional. Dr. Dutton is the medical director at Atrium Health University City Wound Care Center, where she also serves as the physician advisor for Utilization Management and Physician Advisor Services.

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