Payers, Health Systems Should Look Beyond the ICU: CHEST 2026 Recap

The true cost of robotic surgery, the discharge process, early access to care, and planning for serious illness are among the issues health systems and payers should weigh, according to 4 clinicians interviewed at CHEST 2026. Speaking from surgery, internal medicine, critical care, and clinical ethics, each described where costs and patient outcomes are shaped before, during, and after a hospital stay, and where better planning could help patients.

Cost, Discharge, and Access

Robotic systems carry higher upfront costs, said Staci Beamer, MD, a thoracic surgeon at HonorHealth, but shorter stays, fewer complications, and avoided costs such as epidurals can offset them. “It’s really thinking about cost in a more broad sense, outside of what’s just the cost in the operating room,” Beamer said.

Reyleen Loreto, MD, an internal medicine resident at St. Joseph’s Hospital in Tampa, advised hospitals reducing COPD readmissions to first find their own gap. Her team targeted discharge, using checklists and COPD navigators. She noted the project supports, but does not prove, a link to fewer readmissions.

Adan Mora, MD, FCCP, a medical intensivist at UT Southwestern Medical Center and Parkland Hospital, said safety-net patients often arrive with lung, cancer, cardiac, or autoimmune disease that was not addressed early, leading to later-stage presentations, poorer outcomes, and longer stays that earlier access to care could reduce.

Planning Ahead for End-of-Life Care

Nneka Sederstrom, PhD, MPH, MA, FCCP, a clinical ethicist, said an ICU admission is rarely planned, so conversations about patients’ wishes should happen well before a crisis. When every care team knows those wishes, ICU care goes more smoothly for patients and their families, she explained. “I believe that payers and others should pay attention to who are those people out there trying to help increase those conversations and improve end-of-life care discussions,” she said.