One of the federal government’s top healthcare priorities is moving from a care delivery model that pays based on volume, or the number of services provided (fee-for-service), to one that pays according to health outcomes (value-based). As the Centers for Medicare & Medicaid Services (CMS) notes, value-based payment programs are part of a larger quality strategy to reform how healthcare is delivered and paid for in this country.

I am proud that the field of home-based primary care (HBPC) is helping lead the charge toward successfully implementing value-based care (VBC) on a large scale. We have ample evidence now that HBPC is one of the most effective means for achieving CMS’ three-part aim to provide better care of individuals and populations at a lower cost based on the quality of care. For example, the results of CMS’ Independence at Home Project (IAH) mirror what we are observing with the HBPC practices we advise: more consistent, quality primary care that saves money, particularly for patients with complex care needs or significant activities of daily living (ADL) deficiencies, by reducing ED visits and avoidable hospitalizations.

Services provided by an HBPC provider can include everything from bloodwork to immunizations and in-home X-rays, to medication checks and safety. In many ways, the HBPC provider is the “quarterback” of the care team coordinating additional specialized care as needed. The provider regularly interacts with the patient, caregiver and family, and by being anchored at home, is able to monitor first-hand everything from medication delivery to the amount of food (or lack of it) in the fridge, to tripping hazards and more. This means fewer acute medical situations are likely to develop. This model of care provides medically complex, often homebound or home-limited, patients with high-quality care in the comfort of their home tailored specifically to meet their needs and it is less expensive.

In order to succeed in VBC, payment arrangements practices must achieve quality targets and control costs. At the Home Centered Care Institute (HCCI), we provide the education, consulting and business intelligence providers and practices need to either enter VBC or expand their work in that arena. We teach the clinical approach to HBPC because a house call is not the same as an office visit. Patients typically have multiple chronic conditions which make diagnosis and treatment more complex, and with the medical visit taking place in an unpredictable environment, providers must learn to pay close attention to what they are seeing in the house … what the home is telling them. Yes, it is true: houses talk.

In addition, we teach practical back-office operations such as billing and coding, and geographic scheduling; we help practices understand the key metrics to track; and, most vital, how to monitor their outcomes to comply with specified quality metrics.

In all, HBPC is the solution to providing better, more affordable care for the 7 million homebound or home-limited individuals in this country who would benefit from this care by specially trained physicians, nurse practitioners and physician assistants. Unfortunately, 85% of those 7 million individuals, or about 5.9 million people, cannot access HBPC right now because there simply aren’t enough HBPC providers.

Imagine if 5.9 million people with cancer or another serious medical condition needed care and couldn’t get it. What would we do?

That’s where HCCI steps in. More than 12,000 full-time providers are required to meet this current need, a 75% increase from where we are at today. Given that 10,000 baby boomers are turning 65 every day in the United States, and that the number of people 85 and older is expected to quadruple by 2050, the need is growing exponentially.  The demand for HBPC is expected to grow at 10% annually for the next 10 to 20 years so immediate action is required.

We know that HBPC is not only better for the patient and family; it’s also better for the provider. Many providers say that HBPC aligns with the reasons they pursued medicine in the first place—because they had a desire to provide quality care and have a better and more holistic relationship with the patient.

It’s incumbent on the healthcare industry to help a broad range of providers make the transition to HBPC. It’s a win-win for all concerned: providers, payers, policymakers and, most importantly, patients.

Julie Sacks is president and COO of the Home Centered Care Institute.