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Brad Stuart, MD, C-TAC’s Chief Medical Officer, delivered remarks on advanced illness care and moving treatment from the hospital to the home during a briefing at the National Press Club in Washington, DC on Sept. 24.
Hosted by Health Affairs and The John A. Hartford Foundation, the briefing gathered experts who contributed articles for the journal’s Aging & Health series. Dr. Stuart co-authored “A Large-Scale Advanced Illness Intervention Informs Medicare’s New Serious Illness Payment Model,” published by Health Affairs in June.
Dr. Stuart addressed the Primary Care First set of models, announced in April by the Center for Medicare & Medicaid Services (CMS), which includes a track designed to support the serious illness population. This model was partially informed, Dr. Stuart noted, by the Advanced Illness Management (AIM) program led by Sutter Health during his tenure with the health system.
This team-based intervention provides coordinated, home-based care to more than 2,000 seriously ill patients daily across 19 counties in California. The program has led to reduced hospital days in the last month of life, fewer hospital deaths, as well as reductions to inpatient payments and the total cost of care.
Employing this team-based approach, Dr. Stuart said, can help to ease the shortage of doctors in palliative care. Teams led by nurses, he said, have proven particularly effective in delivering high-quality care.
“We just don’t need doctors doing everything,” said Dr. Stuart. “We can have teams that doctors work through to deliver care.”
These teams can provide care management, Dr. Stuart explained, and they can also lead advance care planning conversations with patients, families and caregivers.
“Many of these people need person-centered care so that they can express what they want as people,” said Dr. Stuart, “but they have no way of doing that unless they’re supported.”
The briefing also featured presentations from R. Tamara Konetzka, Professor of Health Services Research, Department of Public Health Sciences and Department of Medicine at the University of Chicago Biological Sciences, and Katherine A. Ornstein, Associate Professor of Geriatrics and Palliative Medicine and Research Director, Institute for Care Innovations at Home at the Icahn School of Medicine at Mount Sinai. Their remarks also focused on articles that they published in Health Affairs, addressing disparities in home- and community-based care and the impact of caregiving on spouses and need for support, respectively. Individual presentations were followed by a discussion of developments in advanced illness care policy. If you would like to watch a full recording of the event, you can register to do so by clicking here.