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Whitepaper | Home Based Primary Care: Key Themes and Sector Developments

In recent years, innovative care models have emerged that are bringing back house call providers. Multiple factors including the rapid aging of America, emergence of value-based care models, and new government payment initiatives are leading to a favorable environment for the expansion of Home Based Primary Care (HBPC). Additionally, COVID-19, which led to significant loosening of regulations around telehealth and the increased ability of providers to see patients outside their offices, will likely be a major impetus for regulation aiding house call providers.

This paper begins by addressing the market demand characteristics creating the need for (HBPC). Following this discussion of market drivers, we examine the successes and use cases of HBPC to date. Finally, we look at some of the key payment initiatives, from increased reimbursement potential under Medicare’s Fee for Service codes to recent demonstration projects such as Primary Care First. HBPC operators have pursued unique paths to profitability, with most recognizing the longer-term future is within value-based arrangements to create alignment among key constituents and garner additional financial upside through improved care.