The resurgence of home-based primary care models in the United States

Mattan Schuchman, Mindy Fain, Thomas Cornwell

Research output: Contribution to journalReview articlepeer-review

44 Scopus citations


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.

Original languageEnglish (US)
Article number41
JournalGeriatrics (Switzerland)
Issue number3
StatePublished - Sep 1 2018


  • Home based medical care
  • Home care medicine
  • Home health
  • Home-based primary care
  • House call

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology
  • Gerontology
  • Health(social science)


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