VillageMD Continues Driving Home-Based Primary Care, A Trend That’s Not Going Away

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Dr. Thomas Cornwell, the senior medical director of Village Medical at Home, is living out his dream.

He thought at-home care visits were going to tick up significantly as far back as 15 years ago, but that never really came to fruition. Until Now.

Now, he’s one of the drivers of that growth, with the three founders of VillageMD – Dr. Clive Fields, Paul Martino and Tim Barry – giving him the autonomy and bandwidth to do so.


“In terms of spreading home-based primary care, this is just a dream.” Cornwell told Home Health Care News. “Part of my living that dream is because the leaders of the founders and leaders of village MD … just believe that the future of health care is at least in part in the home. They have this incredible vision of bringing more home-based primary care to the country.”

Collectively, these leaders have been doing just that. The most recent acquisition was of the Indiana-based Grace at Home, which is a provider of home-based primary care services.

Overall, VillageMD is a primary care provider. Its footprint spans across 22 markets and it is responsible for more than 1.6 million patients. Walgreens Boots Alliance (Nasdaq: WBA) has invested over $6 billion into the company, and the latter has brought the former more and more into the home-based care fold.


The companies set a goal together to open 1,000 new clinics within five years, and are well on their way.

Village Medical at Home specifically began in Houston, where there are now 16 different at-home primary care clinics. Now, it has also spread to Indiana, Chicago, Phoenix, Atlanta, Kentucky and Rhode Island.

It’s fair to say VillageMD is one of the drivers of primary care in the home in the U.S. But it has also increased in popularity across the country over the last decade.

Source: John A. Hartford Foundation

For context, the Medicare Advantage data is only up until 2019 because plan data is delayed.

The value of providing primary care in the home has been well documented, and that’s reflected by the amount of larger players – including Walgreens – that have invested in it. Both Humana Inc. (NYSE: HUM) and CVS Health (NYSE: CVS) were rumored to be exploring big deals in the primary care space as well over the past week.

“We can look at analytics to determine who our high-risk patients are, and then use Village Medical at Home to target those high-risk patients, in addition to seeing whether they’re homebound or not,” Cornwell said. “One of my favorite sayings, which is not new, is ‘the right care, at the right time, at the right place.’ And the right place for homebound people is not the ER just because they can’t get to the office – it’s in the home.”

Moving forward, Village Medical at Home will continue to look to expand, both to advance VillageMD’s mission and the mission of bringing more home-based primary care to people around the country.

“We just got Grace at Home, and even just bringing them into the fold obviously takes time,” Cornwell said. “But moving forward, we do plan to both organically grow, while also continuing to look at acquiring practices.”

One of the issues that home-based primary care practices typically face is that they have small censuses, and thus it’s hard to get to the attention of insurance companies.

But with VillageMD’s network becoming involved, that changes. In the meantime, the acquisitions help Village Medical at Home grow its footprint, so Cornwell calls those transactions a “win-win.”

“We can quickly make such a difference in these communities,” Cornwell said. “But they also have the ability to get into value-based contracts, because home-based primary care is really a value-based service and very difficult to do under fee for service.”

VillageMD is also planning and hoping to work with the federal government on direct-contracting initiatives in the future.

The company had already been involved in the Trump-era Global and Professional Direct-Contracting Models, and plans to apply to become a direct-contracting entity in the Biden-era ACO REACH model as well.

VillageMD has already said it is specifically looking to place clinics in underserved areas, which happens to be in line with the focus of the REACH model, which is an acronym for “Realizing Equity, Access and Community Health.”

“The world is starting to understand that … 5% of the Medicare population that consumes 50% of the costs,” Cornwell said. “And no other care reduces costs as much as home-based primary care, because they unintentionally focus on that 5%, because patients have to have multiple chronic diseases, they have to be functionally impaired and homebound. Nothing has been shown to reduce costs as much and now that there are financial engines behind reducing those costs and providing better care, I think this trend is going to continue.”

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