The Home Centered Care Institute (HCCI) is a microcosm of the larger trend that is home-based primary care.
This type of care is proliferating across the U.S., as is HCCI. The organization’s Illinois House Call Project launched in the spring of 2022 with a goal of serving 3,000 new patients in their homes over the next three years. Ten months later, it had already added 1,300 new patients.
That success has driven the start of new projects, but also additional excitement around bringing home-based primary care back in vogue across the whole country.
“There’s always going to be a subset of the older population that has mobility problems, that is either homebound or home-limited,” Julie Sacks, president and COO of HCCI, told Home Health Care News. “It’s a whole-day ordeal to go to the doctor’s office. And so in those situations, what we see happen is that people just forgo primary care altogether, because it’s just too hard. And when you start forgoing that primary care, you start to have complications, then you end up using the emergency room as your primary care physician.”
The Chicago-based HCCI’s goal is to spread the word about home-based primary care and increase provider and practice adoption of the model across the country. It gives providers the tools and knowledge to open up home-based primary care shops, or to grow them.
HCCI was originally founded by Dr. Thomas Cornwell, who is now the senior medical director of Village Medical at Home, which also conducts home-based primary care visits. Village Medical at Home is a part of VillageMD, a primary care organization that Walgreens Boots Alliance (Nasdaq: WBA) has invested over $6 billion into over the last few years.
Advocates often talk about the value of going “back to the future” with home-based primary care, returning to a model that used to be popular before brick-and-mortar facilities centralized care.
“A home-based primary care physician can come see a patient six, eight or 10 times per year,” Sacks said. “They can make sure the patient is stable and be the first call that the patient or family makes when there’s a potential flare up or problem. Many times, there can be an avoidable hospitalization if they are just cared for by somebody who knows them and they have a relationship with. So, we teach providers to do that.”
HCCI doesn’t just teach the clinical components of home-based primary care. It also teaches the operational components.
Right now, home-based primary care’s biggest hurdle is the fee-for-service model. HCCI ensures participating providers know how and when to bill for services, and helps them lean further into value-based care.
Sacks said that interest in home-based primary care has been significantly heightened since the onset of the pandemic. More medical professionals, family members and patients realized that going to a brick-and-mortar facility was not always the safest or best way to receive care or evaluation.
Better technology – for a long time – was one of the benefits of facility-based care. But that, too, has now changed.
“There’s so much technology that has moved into the space that allows providers to do so much at home that they couldn’t do 10 or 20 years ago,” Sacks said. “So, between the pandemic, the advances in technology, the cost savings, and overall better outcomes, we’re seeing more and more interest.”
That 3,000-patient goal will likely be adjusted upward in the near-term future. HCCI is also launching a second cohort project.
The second cohort is more likely going to be comprised of home health, hospice and palliative care organizations. While HCCI works with PE-backed practices, health systems and other types of primary care providers, they received serious interest from other providers as well, namely hospice and palliative care organizations.
“We want to find 10 or 12 hospice and palliative care programs that are committed to growth, that either want to start this or already have a small program that they want to grow,” Sacks said. “We can help them get on that growth trajectory and meet their goals, and also serve thousands of new patients through this model.”
As for home health care specifically, there are already some example of providers that have home-based primary care service lines. Take one of the largest nonprofit home health providers in the country, the Visiting Nurse Association Health Group, as an example.
Either way, home health care is an integral part of the care plan for home-based primary care patients.
“Home health becomes especially important as they move to value-based care,” Sacks said. “It’s not just about your internal team at your practice. If you don’t have social work, who are you partnering with to do behavioral health? Who are you partnering with to do hospice and palliative care? Home health?”
There can sometimes be disconnect between home health providers and home-based primary care providers.
But Sacks believes a valuable partnership can be formed between these types of organizations, with each referring to one another.
“There’s a lot of home health patients that could benefit from a home-based primary care provider that don’t have one,” Sacks said.