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

Division of Geriatric Medicine and Gerontology, The Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
Division of Geriatrics, General Internal Medicine and Palliative Medicine, Arizona Center on Aging, Arizona Geriatric Workforce Enhancement Program, University of Arizona College of Medicine, Tucson, AZ 85724, USA
Home Centered Care Institute, Schaumburg, IL 60173, USA
Author to whom correspondence should be addressed.
Geriatrics 2018, 3(3), 41;
Received: 24 June 2018 / Revised: 13 July 2018 / Accepted: 14 July 2018 / Published: 16 July 2018
(This article belongs to the Special Issue Geriatric Care Models)
PDF [184 KB, uploaded 16 July 2018]


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. View Full-Text
Keywords: home-based primary care; home health; house call; home care medicine; home based medical care home-based primary care; home health; house call; home care medicine; home based medical care
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Schuchman, M.; Fain, M.; Cornwell, T. The Resurgence of Home-Based Primary Care Models in the United States. Geriatrics 2018, 3, 41.

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