The Client Challenge

From 2018 to 2021, the University of California Irvine (UCI) Medical Center made significant investments in its advanced practice provider (APP) workforce to drive ambulatory growth and support clinical coverage needs. During this time, the organization expanded its APP workforce by almost 70% and saw an associated increase in expenses but experienced significant inconsistency in APP practice models and utilization. Leadership sought strategic and operational support to fully unlock the potential of their expanded APP workforce.

up Expanded Capacity
up Improved coverage
down Reduced costs
up Increased revenue opportunities
up Improved provider statisfaction

Navigating to Next: The Solution

The Chartis Group partnered with UCI executive leadership and the Office of Advanced Practice to define a future-state vision and to identify “top of license” opportunities for the APP workforce. The team first assessed existing APP practice models, governance structure, and performance across three clinical areas. Current state information helped to inform refinement of an existing set of APP operating standards, which clarified clinical expectations.

Subsequently, the team worked with faculty, APPs, and front-line operational leaders to demo the new operating standards in select areas utilizing a detailed playbook designed for implementation rollout. A marketing and communication toolkit was used to elevate internal/external perception of APPs and further supported the modernization efforts. 

Navigating to Next: Key Components

APP Value


Confirm the current state care team roles and high-level APP performance.

APP Value


Reaffirm and enhance APP practice standards for inpatient and outpatient services.

APP Value


Establish implementation timeline and blueprint for departments and service areas.

APP Value


Implement practice standards across select department and service areas.

APP Value


Elevate the Office of Advanced Practice for advocacy and management of APP-related matters.

Client Impact

APP operating standards were initially implemented across three demonstration departments where practice model changes quickly produced  observable results.

  • Hematology-Oncology established independent APP visit types and associated templates resulting in expanded follow-up, supportive oncology, and survivorship offerings.
  • Neurology transitioned all APPs to an independent practice model resulting in expanded departmental capacity.
  • Trauma-Surgery established a census-driven staffing model that optimized APP coverage of daily inpatient and trauma service needs. The new model redistributed non-clinical, care coordination activities to other team members and included triggers for new APP hires and additional staffing needs.

Early success within these three areas helped to facilitate broad adoption and implementation of the new standards across the entire enterprise resulting in significant improvements in capacity, revenue, and broader care team performance.

Unlocked value of UCI's modernized APP workforce
115 %

YOY increase in wRVU

77 %

YOY increase in total APP payments

68 %

APP template utilization

How We Are Making Healthcare Better

Chartis helped our senior leaders rally around a new set of APP operating models and set in place an implementation roadmap that has helped us move toward top-of-license practice. ”

Deon Kidd

Next Intelligence

Modernizing an APP workforce is driven through a few key steps:
  • Confirm current productivity through high-level APP performance assessment.
  • Reaffirm APP practice standards covering inpatient and outpatient services.
  • Implement practice standards across select department and service areas. 
  • Define implementation timeline and blueprint for remaining department and service areas. 

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