Boy does this look like a great conference. Thankfully, it's only a short train ride away for me.
The 17th Princeton Conference
Examining End of Life Care:
Creating Sensible Public Policies for
Patients, Providers, and Payers
May 19-20, 2010
WEDNESDAY, MAY 19, 2010
AUDITORIUM
The Robert Wood Johnson Foundation
Princeton, New Jersey
8:30 a.m. Continental Breakfast
9:15 a.m. Welcome
Stuart Altman, Ph.D.
Sol C. Chaikin Professor of National Health Policy
Brandeis University
Risa Lavizzo-Mourey, M.D., MBA
President and CEO
The Robert Wood Johnson Foundation
Session I: Chronic Disease in the 21st Century Requires a New Perspective on End of
Life Care
Many Medicare beneficiaries are living longer with chronic diseases blurring the
boundary between curative and end of life care. How has chronic disease and
dying changed? How has this affected the cost? What is the ethical framework
necessary to set the stage for reform?
9:35 a.m. John Lumpkin, M.D., MPH
Senior Vice President and Director, Health Care Group
Robert Wood Johnson Foundation
Moderator
2
9:40 a.m. Joanne Lynn, M.D.
Clinical Improvement Expert
Colorado Foundation for Medical Care
Senior Fellow
National Academy of Social Insurance
Presenter
9:55 a.m. Jim Lubitz, MPH
Consultant
Presenter
10:10 a.m. Norman Fost, M.D., MPH
Director, Program in Bioethics
University of Wisconsin - Madison
Presenter
10:25 a.m. General Discussion
10:50 a.m. Break
Session II: Differences in Approach, Cost, and Ethical Framework in the US and other
Countries
Many countries out perform the US with both higher quality and lower cost
healthcare. This session will examine what is occurring in other countries
compared to the US concerning intensive treatment at the end of life, knowing
and honoring a patient’s wishes, and the approach to balancing the desires of the
individual and the society.
11:00 a.m. Robin Osborn, MBA
Vice President and Director
International Program in Health Policy and Practice
The Commonwealth Fund
Moderator
11:05 a.m. Craig Earle, M.D., MSc
Director, Health Services Research Program
Cancer Care Ontario and the Ontario Institute for Cancer Research
Institute for Clinical Evaluative Sciences
Sunnybrook Health Sciences Centre
Presenter
11:20 a.m. Andrea Kabcenell, RN, MPH
Vice President
Institute for Healthcare Improvement
Discussant
3
11:35 a.m. General Discussion
12:15 p.m. Lunch
Session III: Variations in End of Life Services and Costs: What is the Role of Individual
and Provider Preferences and Resource Availability?
Evidence suggests that there are wide variations in both the types of services
used at end of life and the cost of these services both across regions and within
regions. These variations are not necessarily a reflection of patient preference.
Session III will examine factors that contribute to variation, patient preference,
and disparities while considering the role providers and patients have in end of
life decision making.
1:15 p.m. Judy Salerno, M.D., MS
Executive Officer
Institute of Medicine
Moderator
1:20 p.m. David Goodman, M.D., MS
Professor of Pediatrics and of Health Policy
Director, Center for Health Policy Research
The Dartmouth Institute of Health Policy and Clinical Practice
Dartmouth Medical School
Presenter
1:35 p.m. Amber E. Barnato, M.D., MPH. MS
Center for Research on Health Care
University of Pittsburgh Medical School
Presenter
1:50 p.m. Lisa R. Shugarman, Ph.D.
Director of Policy
The SCAN Foundation
Discussant
2:00 p.m. Kimberly Johnson, M.D.
Center for Palliative Care
Duke University School of Medicine
Discussant
2:10 p.m. General Discussion
2:40 p.m. Break
4
Session IV: Nursing Home Patient Readmissions to Acute Care Setting: What is the
Role of Medicaid and Medicare in Ensuring High Quality End of Life Care?
This session will examine the contributor to high utilization of acute care settings
for nursing home patients who are near the end of life, knowing and following the
patient’s wishes, hospice and curative care and potential use of outcome
measures. What is the role of the hospice for nursing home patients? How can
we prevent repeated transfers between the nursing home and acute care
settings?
2:55 p.m. Marie A. Bernard, M.D.
Deputy Director, National Institute on Aging
National Institutes of Health
Moderator
3:00 p.m. Thomedi G. Ventura, MS, MSPH
Health Data Analyst, Evaluation Specialist
Colorado Foundation for Medical Care
Presenter
3:15 p.m. Joseph G. Ouslander, M.D.,
Professor of Clinical Biomedical Science
Associate Dean for Geriatric Programs
Charles E. Schmidt College of Biomedical Science
Florida Atlantic University
Presenter
3:30 p.m. David G. Stevenson, SM, Ph.D.
Assistant Professor of Health Policy
Harvard Medical School
Discussant
3:40 p.m. Shari Ling, M.D.
Office of Standards and Quality
Center for Medicare and Medicaid Services
Discussant
3:50 p.m. General Discussion
4:15 p.m. Afternoon Session Ends
5
DINNER AND KEYNOTE SPEAKERS
WEDNESDAY EVENING
Prospect House, Princeton University
6:00 p.m. Cocktails and Hors D’oeuvres
Session V Ethical Issues Surrounding End of Life Healthcare: Informed Decision
Making, Spending, and Our Nation’s Inability to Discuss Mortality.
Many question the value of intensive treatment for individuals with progressive
and terminal disease. Do patients know the truth about their disease or the
potential of treatment options? Are patient preferences known, carried out, etc.?
As a society should we guarantee open access to every possible treatment or
should we set specific guidelines to ensure that limited national resources are
being used wisely? This session will examine the differing ideological and
ethical perspectives.
6:50 p.m. Stuart Altman, Ph.D.
Sol C. Chaikin Professor of National Health Policy
Brandeis University
Moderator
7:00 p.m. Thomas H. Murray, Ph.D
President and CEO
The Hastings Center
Presenter
7:15 p.m. Tom Rosenthal, M.D.
Professor of Urology
Chief Medical Officer
UCLA Medical Center
Associate Vice Chancellor
David Geffen School of Medicine at UCLA
Presenter
7:30 p.m. Discussion
8:00 p.m. Dinner
6
THURSDAY, MAY 20, 2010
AUDITORIUM
The Robert Wood Johnson Foundation
Princeton, New Jersey
7:45 a.m. Continental Breakfast
Session VI: Provider, Delivery System, Caregiver, and Insurer End of Life
Considerations and Innovations: What are the Promising Practices and
Current Challenges?
Throughout the country providers and delivery systems are attempting to improve
the quality of care at the end of life by establishing processes that examine
aggressive treatment and enable patients and physicians to address decisions
about intensive treatment. This session will provide an overview of what is
working and what challenges must be addressed. It will also address the role of
evidence based medicine and comparative effectiveness research as they
pertain to end of life care.
8:30 a.m. Karen Feinstein, Ph.D.
President & CEO
Jewish Healthcare Foundation
Moderator
8:35 a.m. Susan Tolle, M.D.
Cornelia Hayes Stevens Chair
Director, Center for Ethics in Health Care
Professor of Medicine
Oregon Health & Science University
Presenter
8:50 a.m. Randall S. Krakauer, M.D., FACP, FACR
Head of Medicare Medical Management
Aetna
Presenter
9:05 a.m. Tom Edes, M.D.
Director
Home and Community-Based Care
Veterans Health Administration
Presenter
9:20 a.m. James Brooks, M.Div.
Executive Director
Project Compassion
Discussant
7
9:30 a.m. Len Fishman
CEO
Hebrew SeniorLife
Discussant
9:40 a.m. General Discussion
10:15 a.m. Break
Session VII: Next Steps in Creating End of Life Policies
End of life is a difficult issue for Americans to discuss creating a formidable
barrier to policy reform. What public policy changes are necessary to create the
framework to ensure value based care at the end of life? What is currently being
considered and what are we not even discussing? What must happen on a
policy level to ensure patient, family, and provider support for a valued based
approach?
10:30 a.m. Charles N. Kahn III
President and Chief Executive Officer
Federation of American Hospitals
Moderator
10:35 a.m. Angie Truesdale
Director, Public Policy
NHPCO Hospice Action Network
Presenter
10:50 a.m. J. Brent Pawlecki, M.D.
Corporate Medical Director
Pitney Bowes
Presenter
11:05 a.m. Ira Byock, M.D.
Director, Palliative Medicine
Dartmouth-Hitchcock Medical Center
Presenter
11:20 a.m. General Discussion
12:00 p.m. Conclusion and Conference Summary
12:15 p.m. Lunch
1:15 p.m. Busses leave
The 17th Princeton Conference
Examining End of Life Care:
Creating Sensible Public Policies for
Patients, Providers, and Payers
May 19-20, 2010
WEDNESDAY, MAY 19, 2010
AUDITORIUM
The Robert Wood Johnson Foundation
Princeton, New Jersey
8:30 a.m. Continental Breakfast
9:15 a.m. Welcome
Stuart Altman, Ph.D.
Sol C. Chaikin Professor of National Health Policy
Brandeis University
Risa Lavizzo-Mourey, M.D., MBA
President and CEO
The Robert Wood Johnson Foundation
Session I: Chronic Disease in the 21st Century Requires a New Perspective on End of
Life Care
Many Medicare beneficiaries are living longer with chronic diseases blurring the
boundary between curative and end of life care. How has chronic disease and
dying changed? How has this affected the cost? What is the ethical framework
necessary to set the stage for reform?
9:35 a.m. John Lumpkin, M.D., MPH
Senior Vice President and Director, Health Care Group
Robert Wood Johnson Foundation
Moderator
2
9:40 a.m. Joanne Lynn, M.D.
Clinical Improvement Expert
Colorado Foundation for Medical Care
Senior Fellow
National Academy of Social Insurance
Presenter
9:55 a.m. Jim Lubitz, MPH
Consultant
Presenter
10:10 a.m. Norman Fost, M.D., MPH
Director, Program in Bioethics
University of Wisconsin - Madison
Presenter
10:25 a.m. General Discussion
10:50 a.m. Break
Session II: Differences in Approach, Cost, and Ethical Framework in the US and other
Countries
Many countries out perform the US with both higher quality and lower cost
healthcare. This session will examine what is occurring in other countries
compared to the US concerning intensive treatment at the end of life, knowing
and honoring a patient’s wishes, and the approach to balancing the desires of the
individual and the society.
11:00 a.m. Robin Osborn, MBA
Vice President and Director
International Program in Health Policy and Practice
The Commonwealth Fund
Moderator
11:05 a.m. Craig Earle, M.D., MSc
Director, Health Services Research Program
Cancer Care Ontario and the Ontario Institute for Cancer Research
Institute for Clinical Evaluative Sciences
Sunnybrook Health Sciences Centre
Presenter
11:20 a.m. Andrea Kabcenell, RN, MPH
Vice President
Institute for Healthcare Improvement
Discussant
3
11:35 a.m. General Discussion
12:15 p.m. Lunch
Session III: Variations in End of Life Services and Costs: What is the Role of Individual
and Provider Preferences and Resource Availability?
Evidence suggests that there are wide variations in both the types of services
used at end of life and the cost of these services both across regions and within
regions. These variations are not necessarily a reflection of patient preference.
Session III will examine factors that contribute to variation, patient preference,
and disparities while considering the role providers and patients have in end of
life decision making.
1:15 p.m. Judy Salerno, M.D., MS
Executive Officer
Institute of Medicine
Moderator
1:20 p.m. David Goodman, M.D., MS
Professor of Pediatrics and of Health Policy
Director, Center for Health Policy Research
The Dartmouth Institute of Health Policy and Clinical Practice
Dartmouth Medical School
Presenter
1:35 p.m. Amber E. Barnato, M.D., MPH. MS
Center for Research on Health Care
University of Pittsburgh Medical School
Presenter
1:50 p.m. Lisa R. Shugarman, Ph.D.
Director of Policy
The SCAN Foundation
Discussant
2:00 p.m. Kimberly Johnson, M.D.
Center for Palliative Care
Duke University School of Medicine
Discussant
2:10 p.m. General Discussion
2:40 p.m. Break
4
Session IV: Nursing Home Patient Readmissions to Acute Care Setting: What is the
Role of Medicaid and Medicare in Ensuring High Quality End of Life Care?
This session will examine the contributor to high utilization of acute care settings
for nursing home patients who are near the end of life, knowing and following the
patient’s wishes, hospice and curative care and potential use of outcome
measures. What is the role of the hospice for nursing home patients? How can
we prevent repeated transfers between the nursing home and acute care
settings?
2:55 p.m. Marie A. Bernard, M.D.
Deputy Director, National Institute on Aging
National Institutes of Health
Moderator
3:00 p.m. Thomedi G. Ventura, MS, MSPH
Health Data Analyst, Evaluation Specialist
Colorado Foundation for Medical Care
Presenter
3:15 p.m. Joseph G. Ouslander, M.D.,
Professor of Clinical Biomedical Science
Associate Dean for Geriatric Programs
Charles E. Schmidt College of Biomedical Science
Florida Atlantic University
Presenter
3:30 p.m. David G. Stevenson, SM, Ph.D.
Assistant Professor of Health Policy
Harvard Medical School
Discussant
3:40 p.m. Shari Ling, M.D.
Office of Standards and Quality
Center for Medicare and Medicaid Services
Discussant
3:50 p.m. General Discussion
4:15 p.m. Afternoon Session Ends
5
DINNER AND KEYNOTE SPEAKERS
WEDNESDAY EVENING
Prospect House, Princeton University
6:00 p.m. Cocktails and Hors D’oeuvres
Session V Ethical Issues Surrounding End of Life Healthcare: Informed Decision
Making, Spending, and Our Nation’s Inability to Discuss Mortality.
Many question the value of intensive treatment for individuals with progressive
and terminal disease. Do patients know the truth about their disease or the
potential of treatment options? Are patient preferences known, carried out, etc.?
As a society should we guarantee open access to every possible treatment or
should we set specific guidelines to ensure that limited national resources are
being used wisely? This session will examine the differing ideological and
ethical perspectives.
6:50 p.m. Stuart Altman, Ph.D.
Sol C. Chaikin Professor of National Health Policy
Brandeis University
Moderator
7:00 p.m. Thomas H. Murray, Ph.D
President and CEO
The Hastings Center
Presenter
7:15 p.m. Tom Rosenthal, M.D.
Professor of Urology
Chief Medical Officer
UCLA Medical Center
Associate Vice Chancellor
David Geffen School of Medicine at UCLA
Presenter
7:30 p.m. Discussion
8:00 p.m. Dinner
6
THURSDAY, MAY 20, 2010
AUDITORIUM
The Robert Wood Johnson Foundation
Princeton, New Jersey
7:45 a.m. Continental Breakfast
Session VI: Provider, Delivery System, Caregiver, and Insurer End of Life
Considerations and Innovations: What are the Promising Practices and
Current Challenges?
Throughout the country providers and delivery systems are attempting to improve
the quality of care at the end of life by establishing processes that examine
aggressive treatment and enable patients and physicians to address decisions
about intensive treatment. This session will provide an overview of what is
working and what challenges must be addressed. It will also address the role of
evidence based medicine and comparative effectiveness research as they
pertain to end of life care.
8:30 a.m. Karen Feinstein, Ph.D.
President & CEO
Jewish Healthcare Foundation
Moderator
8:35 a.m. Susan Tolle, M.D.
Cornelia Hayes Stevens Chair
Director, Center for Ethics in Health Care
Professor of Medicine
Oregon Health & Science University
Presenter
8:50 a.m. Randall S. Krakauer, M.D., FACP, FACR
Head of Medicare Medical Management
Aetna
Presenter
9:05 a.m. Tom Edes, M.D.
Director
Home and Community-Based Care
Veterans Health Administration
Presenter
9:20 a.m. James Brooks, M.Div.
Executive Director
Project Compassion
Discussant
7
9:30 a.m. Len Fishman
CEO
Hebrew SeniorLife
Discussant
9:40 a.m. General Discussion
10:15 a.m. Break
Session VII: Next Steps in Creating End of Life Policies
End of life is a difficult issue for Americans to discuss creating a formidable
barrier to policy reform. What public policy changes are necessary to create the
framework to ensure value based care at the end of life? What is currently being
considered and what are we not even discussing? What must happen on a
policy level to ensure patient, family, and provider support for a valued based
approach?
10:30 a.m. Charles N. Kahn III
President and Chief Executive Officer
Federation of American Hospitals
Moderator
10:35 a.m. Angie Truesdale
Director, Public Policy
NHPCO Hospice Action Network
Presenter
10:50 a.m. J. Brent Pawlecki, M.D.
Corporate Medical Director
Pitney Bowes
Presenter
11:05 a.m. Ira Byock, M.D.
Director, Palliative Medicine
Dartmouth-Hitchcock Medical Center
Presenter
11:20 a.m. General Discussion
12:00 p.m. Conclusion and Conference Summary
12:15 p.m. Lunch
1:15 p.m. Busses leave