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Critical Care Research and Practice
Volume 2011, Article ID 170814, 7 pages
Review Article

Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act

Section of Critical Care Medicine, Department of Medicine, Drexel University College of Medicine, Philadelphia, PA 19102, USA

Received 28 July 2011; Accepted 4 September 2011

Academic Editor: Stephen M. Pastores

Copyright © 2011 Sachin Logani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The Affordable Care Act signed into law by President Obama, with its value-based purchasing program, is designed to link payment to quality processes and outcomes. Treatment of critically ill patients represents nearly 1% of the gross domestic product and 25% of a typical hospital budget. Data suggest that high-intensity staffing patterns in the intensive care unit (ICU) are associated with cost savings and improved outcomes. We evaluate the literature investigating the cost-effectiveness and clinical outcomes of high-intensity ICU physician staffing as recommended by The Leapfrog Group (a consortium of companies that purchase health care for their employees) and identify ways to overcome barriers to nationwide implementation of these standards. Hospitals that have implemented the Leapfrog initiative have demonstrated reductions in mortality and length of stay and increased cost savings. High-intensity staffing models appear to be an immediate cost-effective way for hospitals to meet the challenges of health care reform.