As the need for home-based primary care (HBPriC) and home-based palliative care (HBPalC) continues to expand, providers of these separate but interrelated models of care are increasingly aware of the need to create a
continuum of care to provide a quality, seamless experience for patients, their families, and their caregivers.
This topic was the focus of a panel discussion during the Coalition to Transform Advanced Care (C-TAC)
National Leadership Summit held October 21 – 22, 2024, in Washington, D.C. One of many breakout sessions available to attendees, the panel discussion was led by four speakers, including Dana Crosby, VP, Education & Practice Development, for
Home Centered Care Institute (HCCI).
HCCInsights™ spoke with Crosby about her participation on the panel, as well as her past involvement with C-TAC and her insights into HCCI’s advocacy efforts, particularly with palliative- and hospice-care organizations.
Some excerpts from that interview:
HCCInsights™: Can you offer us some background on the relationship between HCCI and C-TAC?
When I joined HCCI about six years ago, we were focused on educating people in the home-based medical space on what home-based primary care (HBPC) is all about. Six years later, that’s still a focus — along with increasing understanding of how HCCI supports the HBPC providers and practices who deliver the care to ensure better patient outcomes.
That’s a commitment that both C-TAC and HCCI take very seriously and it’s really the heart of the relationship between our organizations. As HCCI began attending C-TAC conferences and networking with other attendees, we also began exploring opportunities to become more involved. We exhibited at some of the summits, gave presentations, and have served as speakers for panel discussions such as this most recent one.
HCCInsights™: What made HCCI a good fit for the Innovation in Home-Based Care Models panel discussion?
As HCCI expanded its advocacy efforts and resources, we realized how much HBPC fundamentally has in common with palliative- and hospice-care organizations who frequently provide services in patient homes. So, we began to develop resources and educational tools to support those organizations. We now have an online course entitled
The Intersection of Home-Based Primary and Palliative Care, for example, which highlights and defines the unique aspects of HBPriC and HBPalC, as well as the ways in which these two models of care are aligned.
HCCI is also committed to helping home-based practices successfully transition from fee-for-service to value-based care reimbursement. This is obviously important to everyone in the healthcare space, but it is especially important for those delivering healthcare services in patient homes. HCCI understands that creating a continuum of care that leads to better patient outcomes is the key to navigating this monumental shift – and we also understand that it will require an interdisciplinary approach to patient care for value-based care to be successful. Providers will have to work together, not in siloes. If a patient has an illness that requires medications, but might also benefit from a palliative care service, the provider needs to make sure they receive it — whether it’s music therapy, acupuncture, or a social service like home meal delivery. Because an integrated continuum of care is integral for helping patients to achieve better health care outcomes.
HCCInsights™: Was there one topic of discussion that you felt was especially relevant to everyone who attended the session?
I would say one of those areas of discussion was workforce development. It’s no secret the pool of talent in healthcare has been shrinking across the board – from doctors and nurses to operations executives and everyone in between. People are leaving healthcare. There’s a high burnout rate and we’ve probably all felt it as patients, and it’s even more prevalent in some rural and socioeconomic areas where people who need care simply do not have access to it.
Delivering care in the home or in a home setting is particularly challenging when it comes to the workforce. This field is not for everyone. So, you have to find and develop talent that is drawn to providing in-home care. There are unique factors that come into play – safety, the presence of other family members, unfavorable home conditions, etc. This is an area where HCCI is leading the way through education to help providers understand and feel comfortable delivering in-home care. We’re also working to increase exposure to home-based care as a potential career path for medical students by exploring new partnerships with residency programs to have HBPC included as a rotation option.
We still have some ground to catch up on, but whether a student is pursuing a degree in social work or planning to become a clinician or a healthcare administrator, they need to be exposed to the field – preferably as early as high school. We need to capture students’ interest early on in their educational path and educate them on the significant role home-based care will play in a future where value-based care will be the norm.
HCCInsights™: Were there any other areas of concern expressed by session attendees about creating a continuum of care for patients who receive home-based care?
There is a definite gap around reimbursement and policy reform. Whether we like it or not, there needs to be payment reform that allows the providers in this space to get paid for what they do. For example, sometimes caregivers provide services that don’t fit neatly into a specific category – like ensuring a patient is receiving the right medications at the right intervals which may involve educating a family member or caregiver on how to monitor that, or maybe it’s wound care. The point is providers need to be reimbursed for the extra time they spend talking with and educating caregivers, or providing them with the proper resources to ensure the patient receives proper care – it’s all part of the continuum of care. CMS has to continue to recognize the importance of home-based care and how it positively impacts value-based care, which is the reimbursement model everyone will be on in six years.
HCCInsights™: Last but not least, how would you describe the attendees for this session?
Inquisitive! There were a lot of questions and sidebar conversations which were interesting. The mix of individuals who attended was also interesting. We had some C-level folks, financial people, CFOs, but the majority were clinical providers who were either in the health system, had their own independent practice or worked for an independent practice, and we also had individuals who are involved with policy reform — so it was great that we were able to attract such a mix of, I’d say, 60-70 individuals to come together in one space. I was very pleased to be part of such an important and productive conversation.
