2011 National Summit on Critical Care Policy

Roundtable Hosts 3rd Annual National Summit on Critical Care Policy

Top U.S. critical care professionals, academic institutions, medical professional societies, and patient and public health advocacy groups gathered last Wednesday for the third annual National Summit on Critical Care Policy.  Delegates to the Roundtable’s Summit were briefed by top Administration officials from the Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), the National Institutes of Health (NIH) and others as they worked to identify policy priorities to bolster the delivery of U.S. critical care.

The critical care community has already begun to have a voice and impact in the current federal policy environment, and the Summit provided a timely forum for the select group of thought-leader Delegates to consider policy options relating to payment and delivery reforms, public health and medical preparedness initiatives, and challenges in advancing appropriate end-of-life care. 

The Summit kicked off with a panel of CMS officials, who briefed Delegates on new payment and delivery programs including the Medicare Shared Savings Program and Hospital Value-Based Purchasing Program.  Delegates agreed that policymakers have not yet addressed the way in which these new initiatives will relate to the delivery of critical care, despite the fact that care provided in the ICU will likely play a key role in the success of Accountable Care Organizations (ACOs). Delegates concluded that as delivery and payment reforms continue to be rolled out, the Roundtable should have a seat at the table in key deliberations and to help policymakers think through the integration of critical care delivery in payment reform approaches.

Dr. Tom Sizemore, HHS’s Office of Preparedness and Emergency Operations Principal Deputy Director and Dr. Lewis Rubinson, Deputy Chief Medical Officer of the National Disaster Management System (NDMS), provided Delegates with an overview of HHS’s current preparedness efforts and medical surge capabilities.  Dr. Rubinson highlighted the lack of intensivists, respiratory therapists and critical care nurses in disaster health teams and government response systems.  Dr. Rubinson also noted the need for focused attention on planning efforts for the evacuation of ICUs during emergencies, further underscoring key provisions of the Critical Care Assessment and Enhancement Act which call for the development of best practices for ICU evacuations during national emergencies or disasters, and reporting on the availability of critical care practitioners within the federal government’s medical response teams and addressing any existing shortages.

Two-time Pulitzer Prize finalist and National Journal Editorial Director Ron Brownstein joined Delegates for a luncheon keynote to discuss the findings of the Journal’s recent poll—done in conjunction with the Regence Foundation—on Americans’attitudes toward end-of-life called, “Living Well At the End of Life: A National Conversation.”  Mr. Brownstein provided his perspective on the political challenges to having a dialogue on this important issue, stating that most Americans believe enhancing the quality of life – not just extending life – should be a priority at the end of life, and that overwhelming majorities also want a more open public dialogue about the issues and options surrounding end-of-life care to effect more control during difficult care decision-making situations.

Mr. Brownstein’s remarks were followed by a panel discussion on initiatives and opportunities to advance end-of-life care policy from the perspective of the ICU, and how to address the rhetorical gaps in the greater end-of-life care conversation.

The Roundtable’s three working groups on Outcomes & Innovation, National Preparedness & Infrastructure and End-of-Life Care will continue to work on the consensus items drawn from the discussions at the National Summit.   If you are interested in joining one of these groups, please contact Sara Skubikowski at sskubikowski@criticalcareroundtable.org.

View the event program here.