Innovation - Home Centered Care Networks

Home Centered Care Networks are strategic, integrated community care alliances that make true care coordination possible.

When Home-Centered Primary Care involves a coordinated constellation of home and community-based providers, patients receive better, more targeted and less costly care. These care networks provide a formalized structure for this integrated care. HCCI has developed best practices to help health systems build and implement their own Home-Based Primary Care Networks.

HCCI develops Home Centered Care Networks via a two-pronged approach:


Specific coordinated care teams will vary depending on the needs of each patient and family but often include behavioral health, home health, transitional care, end-of-life care and senior services. Hospitals, pharmacists, other clinicians and health experts may also contribute to home-based patient care.

Home Centered Care Networks solve some of the most challenging population health issues facing health systems today. A systematic network approach allows for:

  • Appropriate referrals for patients following hospital discharge.
  • Seamless transitional care as patients move from acute to post-acute care.
  • Prevention of unnecessary emergency department visits.
  • Decreased likelihood of re-admissions and re-admission penalties.
  • Enhanced communication and care planning between sites and providers.

Integrated Care & Communications Software Platform

The right house call tools and technology are critical for supporting the coordination of care across Home Centered Care Networks. To set the stage for truly integrated care, HCCI is developing a unique communication platform targeted to the needs of home-based medical care providers.

Home Centered Care requires a different approach to service delivery. Health systems must carefully consider every element, including organizational flow, practice policies, and even innovative payment structures such as Shared Savings Programs. However, stakeholders within health systems often work in silos, which may make it difficult to achieve full care coordination post-discharge.

HCCI is creating house call tools and technology that will facilitate collaboration across the Home Centered Care Network by:

  • Increasing communication among providers.
  • Increasing interaction between providers, patients and families.
  • Improving patient satisfaction ratings.
  • Providing quality care and better quality of life.
  • Notifying providers of patient hospitalizations.
  • Preventing unnecessary emergency department visits.
  • Decreasing re-admissions and associated penalties.
  • Expanding patient and family participation in the health care process.

In addition to HCCI’s own house call technology, our understanding of the existing and emerging technology market allows us to act as a trusted resource for evaluating home-based medical care innovations. Health systems trust HCCI to provide reliable, responsible guidance for their Home Centered Care providers and practices. Learn more about Home Centered Care tools and technology.

If your health system or practice is interested in developing a Home Centered Care Network in your community, contact us for more information or assistance. If you would like to learn more about Home Centered Care, please see our FAQ page.