Home-based primary care (HBPC) brings the expertise of
physicians, nurse practitioners and physician assistants and advanced technology of a health care clinic directly to seniors and medically complex patients, providing comprehensive care in the comfort of their home.
HBPC has been shown to dramatically reduce both health care costs and nursing home placement. This focus on timely and appropriate care improves overall quality of life and care for patients and caregivers, while managing health care costs by limiting the need for institutional services.
There is no one type of patient that is right for HBPC, but those who most commonly benefit from HBPC are older and/or medically complex patients who either have difficulty leaving their homes or simply prefer to be cared for in the comfort of their own homes.
Not necessarily. Many HBPC patients are seniors in need of appropriate end-of-life care. HBPC is also appropriate for other medically complex patients, including people who struggle with activities of daily living, medically frail patients with limited mobility and high-cost Medicare and Medicaid patients in need of chronic disease management or advanced illness.
HBPC brings the technology and expertise of the health care clinic to the home. This offers exceptional convenience and comfort to those who have limited mobility or are uncomfortable with health care institutions. HBPC also connects patients and their families to needed services and support, helps avoid preventable hospitalizations, and focuses on patient health goals. Additionally, HBPC is increasingly being used to help home-limited patients regain some mobility.
Although HBPC is not hospice care, it also offers ongoing care, comfort and dignity to patients at end of life. The majority (70%) of patients say they would prefer to die at home, but only 33% of deaths take place at home. HBPC allows patients to live and die at home, surrounded by their loved ones.
Home-based primary care is focused on providing better overall care for patients in the home. It is not dependent on a particular diagnosis, as in the case of hospice where a patient has a terminal illness with a prognosis of less than six months. In the case of HBPC patients, a condition, circumstances or a combination of the two must make it medically necessary that the patient be seen in the home.
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.”
Existing evidence supports the role of HBPC in reducing the need for hospital and nursing home services, reducing health care costs and easing the financial burden on Medicare and Medicaid. See HCCI’s Perfect Storm for more details.
Yes, patients who receive HBPC can also choose to continue seeing their regular doctor in an office.
No. Home care is typically provided following a hospitalization (for example, post-surgery), and is most often provided by nurses and physical and occupational therapists. Most patients who receive HBPC are not receiving simultaneous home health services (e.g. wound care, blood draws). However, many HBPC patients do also receive hospice or palliative care.