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Rebuttal From Drs Courtright and ManakerRebuttal From Drs Courtright and Manaker

Katherine Courtright, MD; Scott Manaker, MD, PhD, FCCP
Author and Funding Information

From the Pulmonary, Allergy, and Critical Care Division (Drs Courtright and Manaker) and the Department of Medicine (Dr Manaker), University of Pennsylvania.

Correspondence to: Katherine Courtright, MD, Pulmonary, Allergy, and Critical Care Division, Gates Bldg, 806 W, 3400 Spruce St, Hospital of the University of Pennsylvania, Philadelphia, PA 19104; e-mail: katherine.courtright@uphs.upenn.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: From 2010 to 2013, Dr Courtright’s spouse worked for Connolly, LLC, a Center for Medicare & Medicaid Services Recover Audit Contractor. Dr Manaker has received fees as a Grand Rounds speaker, lecturer, consultant, and expert witness on documentation, coding, billing, and reimbursement from hospitals, physicians, departments, practice groups, professional societies, insurers, and various attorneys. In March 2011, he received $5,400 from Aetna Inc for consultation on diagnosis coding. Dr Manaker serves on the Hospital Outpatient Panel, a federal advisory commission to the Center for Medicare & Medicaid Services. Dr Manaker also serves on the Board of Directors of ACCP Enterprises, Inc, a wholly owned, for-profit subsidiary of the American College of Chest Physicians.

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


Chest. 2014;145(2):217-218. doi:10.1378/chest.13-2521
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Drs Fuhrman and Aranson1 eloquently describe the evolving role of respiratory therapists (RTs). We too acknowledge and applaud the tremendous contributions of RTs who effectively provide many inpatient and outpatient services and secure their role as essential members of the chest medicine team as health care in the United States shifts from independent physician practice toward multidisciplinary team-based care.2 In accord with this shift, reimbursement models are also shifting toward paradigms such as bundled payments and risk-adjusted global capitation, designed to incentize clinical teams to deliver high-quality yet cost-conscious care.

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