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FAQs

Frequently Asked Questions

Home-based primary care (HBPC), also known as the “modern-day house call,” provides medical care to frail, medically complex patients who are either homebound or challenged to leave the home. These are patients for whom visiting a doctor in their office is either difficult or impossible. With house calls, physicians, nurse practitioners, physician assistants, and other providers, offer ongoing care to these patients in their homes – often through to the end of their lives. These providers also often function as part of an interdisciplinary team to manage both medical and non-medical needs (e.g., social factors, environmental needs).

HCCI’s Home-Based Primary Care brochure

By providing medically complex patients the same services they would receive in a primary care office, HBPC is markedly different from other types of in-home care, such as home health care. HBPC visits can include:

  • Routine medical care and management of chronic diseases
  • Annual wellness visits
  • Addressing urgent medical needs
  • Vaccinations
  • Management of cognitive and neurological disorders
  • Advance care planning (e.g., goals of care conversations, end-of-life preferences)
  • Wound care and other procedures
  • Care coordination with community services and other healthcare providers, including specialists in psychiatry, podiatry, optometry, dentistry, and more
  • Coordination of diagnostic testing (e.g., blood tests, EKGs, ultrasounds, x-rays)
  • Medical visits at assisted living facilities, group homes, foster care homes, and similar settings
  • Caregiver support and guidance on managing the patient’s complex medical and social needs

For Medicare beneficiaries, services delivered by the HBPC provider are covered under the same Medicare benefits that apply when seeing a provider for an office visit, e.g., Medicare covers 80% while the remaining 20%is subject to deductibles and copays.

Certain Managed Care or Health Maintenance Organization (HMO) health insurance plans may require a referral or for the HBPC provider to be selected as the primary care provider. As available, an HBPC practice in your area can answer specific questions regarding coverage.

It’s estimated that more than 7 million older adults in the U.S. are homebound or home-limited (nearly homebound), relying on in-home caregivers (usually family members) to assist with their day-to-day needs and general care. In these cases, it’s often extremely difficult – if not impossible – for these medically complex patients to access primary care services in a traditional office or clinic setting, which only adds to their caregiver’s burden.

HBPC has been proven to improve health outcomes, enhance the quality of life for patients and caregivers, and reduce the total cost of care by preventing unnecessary emergency room visits and hospitalizations, according to the Journal of the American Geriatrics Society.

HBPC can also help caregivers by eliminating the stress and time involved with transporting the patient for primary care visits while still receiving support and guidance on managing the patient’s complex medical and social needs.

Patients do not need to be formally considered “homebound” to qualify for HBPC.

Here are some examples of when HBPC might be in a patient’s best interests:

  • The patient has difficulty leaving the home due to medical conditions such as dementia or physical mobility limitations
  • The patient requires medical devices or special assistance/transportation accommodations to leave the home
  • Leaving the home can adversely affect the patient’s physical and/or mental health
  • Caregivers and/or other family members are not available or able to transport the patient
  • Patients transitioning from one healthcare setting to another need assistance with “bridging a primary care gap?

Many caregivers experience significant burden and face health issues of their own, such as depression. HBPC can help decrease the isolation, stress and anxiety experienced by many caregivers and family members by providing practical support. It also offers a way for loved ones who live remotely to remain engaged and informed about the patient’s care.

Many providers feel that home-based primary care brings compassion and meaning back to the practice of health care. They find the relationships developed in the homes of patients and their family members rich and rewarding. This may be particularly true for providers experiencing burnout. Some providers have indicated that HBPC allows them to return to “the reasons they went into medicine.”

Yes, patients who receive HBPC can also choose to continue seeing their regular doctor in an office.

If HBPC seems like a good fit for you or someone you care for, discuss it first with your primary healthcare provider or healthcare system. They may be able to refer you to an HBPC provider. You can also search the House Call Finder directory for providers in your area.

The following “conversation starters” may help during that discussion:

  • Leaving the home is very difficult for me/the person I care for and prevents me/them from coming to see you as often as needed. What are the options for receiving primary medical care at home?
  • My medication refills are out. It’s been more than a year since I last visited the clinic, and I am unable to get there due to my medical condition(s).
  • Can you recommend or refer me to a home-based primary care provider so that I can continue to receive the primary medical care I need at home?
  • Skilled home health services provide patients in-home nursing, physical therapy, occupational therapy, or other support services under the direction of a primary care provider. These services are covered by Medicare when the patient is deemed “homebound” and is certified to have a skilled need by a provider.
  • Concierge healthcare guarantees patient access to medical professionals 24/7. It is typically a private pay, subscription-based program.
  • Hospital at Home® provides hospital-level care to acutely ill older adults in their home.
  • Palliative care is team-based consultative care focused on symptom management and advance care planning.
  • Hospice care is non-curative support focused on providing comfort and end-of-life care when a patient is diagnosed with a terminal illness.
  • In addition to addressing your primary medical needs or those of the patient through HBPC, you or they may need community resources or social support. The resources below can be used to locate community programs and social services in your area:

    *If you or someone you care for is receiving skilled home health or hospice services, you can also ask your home health or hospice agency social worker about additional community resources.

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