"Right now the bottom line economically is for places like Sutter Health spending their own money and using grants to put teams to provide care, but the savings are going to the payers," he says. "We're saving Medicare a lot of money. The goal is to have much less hospital-based care and more home- and community-based. And then we can have care management reimbursed. The savings can be shared and the quality can be increased at the same time."
"We want to change the standard of care for advanced illness across the U.S., for the clinical and reimbursement structure, so this kind of care management is paid for, through any new mechanisms or bundled payments, or something else," he adds.
With the government's efforts to reduce readmissions and reduce costs, palliative and advanced life programs fit nicely into healthcare planning, Stuart says.
Stuart says he wants to spread the message about palliative care and advanced care planning. He is developing a strategies company around such programs and is a member of the board of the Coalition to Transform Advanced Care based in Washington, D.C.
"My personal aspiration is to develop a national initiative that can help change the game for this population," Stuart says of patients facing chronic and life threatening illnesses.
"I've gone from being a naïve medical student back in the day to having a platform to stand on, and some data to back it up," Stuart says of his mission. "It's taken 40 years, but I'm very grateful to the way it is turning out."