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Editorials |

Who Will Care for Our Critically Ill?Who Will Care for Our Critically Ill?

Scott Manaker, MD, PhD, FCCP
Author and Funding Information

From the Department of Medicine, The University of Pennsylvania.

Correspondence to: Scott Manaker, MD, PhD, FCCP Department of Medicine, 8 Penn Tower, Ste 800, One Convention Ave, Hospital of the University of Pennsylvania, Philadelphia, PA 19104; e-mail: Scott.manaker@uphs.upenn.edu.


Financial/nonfinancial disclosures: The author has reported to CHEST the following conflicts of interest: Dr Manaker frequently speaks, consults, and serves as an expert on reimbursement issues. He received $5,400 from Aetna in 2011 for expert work on diagnosis coding. Dr Manaker serves on the Hospital Outpatient Panel, a federal advisory commission for the Center for Medicare/Medicaid Services.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(3):594-595. doi:10.1378/chest.12-2710
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Strong forces, including health-care payment reform, the changing composition of the health-care workforce, and telemedicine, are sculpting our delivery of critical care. Among the strongest of these forces is the emergence and continued evolution of a role for advanced practice providers (APPs)(including nurse practitioners and physicians’ assistants) in independent practice, as well as team-based intensive care.1 Begun 15 years ago with the Balanced Budget Act of 1997, reimbursement from Medicare for the independent practice of APPs has proliferated to similar reimbursement mechanisms from many other payers.2

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