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Review
. 2018 Jul 16;3(3):41.
doi: 10.3390/geriatrics3030041.

The Resurgence of Home-Based Primary Care Models in the United States

Mattan Schuchman  1 , Mindy Fain  2 , Thomas Cornwell  3
Affiliations
Review

The Resurgence of Home-Based Primary Care Models in the United States

Mattan Schuchman et al. Geriatrics (Basel). .

Abstract

This article describes the forces behind the resurgence of home-based primary care (HBPC) in the United States and then details different HBPC models. Factors leading to the resurgence include an aging society, improved technology, an increased emphasis on home and community services, higher fee-for-service payments, and health care reform that rewards value over volume. The cost savings come principally from reduced institutional care in hospitals and skilled nursing facilities. HBPC targets the most complex and costliest patients in society. An interdisciplinary team best serves this high-need population. This remarkable care model provides immense provider satisfaction. HBPC models differ based on their mission, target population, geography, and revenue structure. Different missions include improved care, reduced costs, reduced readmissions, and teaching. Various payment structures include fee-for-service and value-based contracts such as Medicare Shared Savings Programs, Medicare capitation programs, or at-risk contracts. Future directions include home-based services such as hospital at home and the expansion of the home-based workforce. HBPC is an area that will continue to expand. In conclusion, HBPC has been shown to improve the quality of life of home-limited patients and their caregivers while reducing health care costs.

Keywords: home based medical care; home care medicine; home health; home-based primary care; house call.

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Conflict of interest statement

Mindy Fain serves on the Clinical Advisory Board of Landmark LLC. The authors declare no other conflicts of interest. The Home Centered Care Institute (Thomas Cornwell) receives funding from the John A. Hartford Foundation to produce home-based primary care educational resources.

References

    1. Starr P. The Social Transformation of American Medicine. Basic Books; New York, NY, USA: 1982.
    1. Driscoll C.E. Is there a doctor in the house? Am. Acad. Home Care Phys. Newslett. 1991;3:7–8.
    1. Meyer G.S., Gibbons R.V. House calls to the elderly—A vanishing practice among physicians. N. Engl. J. Med. 1997;337:1815–1820. doi: 10.1056/NEJM199712183372507. - DOI - PubMed
    1. The Moran Company . Data Accessed by the American Academy of Home Care Medicine. The Moran Company; Arlington, VA, USA: 2017.
    1. AAHCM Frontiers Newsletter. Summary of Lexis Search Executed by the Academy’s Legal Counsel on November 13, 2003. [(accessed on 23 June 2018)]; Available online: http://www.webcitation.org/70OZPqc26.

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