Why Hospices Are Pursuing Home-Based Primary Care

As health care stakeholders work to improve care coordination, more hospices are exploring home-based primary care.

Offering those services can help hospice and palliative care providers engage patients further upstream, as well as offer a more comprehensive suite of services to meet their needs, according to Melissa Singleton, chief learning officer at the Home Centered Care Institute (HCCI).

“Organizations that are delivering hospice and palliative care now are looking to the future and wanting to provide more of a full-service solution for seriously ill patients,” Singleton told Hospice News. “Being that full-service solution requires the incorporation of a lot of different kinds of care along the continuum, including longitudinal home-based primary care. And so there’s a natural synergy there.”


HCCI inn 2024 will be launching its second cohort of its Illinois House Call Project, designed to help health care providers develop home-based primary care programs — including hospice and palliative care operators.

For the second cohort, the organization is specifically seeking to engage more hospices. The project follows up on a similar HCCI program that began two years ago in Florida in which providers saw a collective 25% increase in home-based primary care patient volume, as well as reductions in facility utilization and readmissions.

The Illinois program’s first cohort launched in 2022 with the goal of enrolling at least 3,000 new patients into home-based primary care by 2024.


“It really strengthens both [hospice and home-based primary care] programs to be in sync and to be integrated. That’s really why we see it as valuable,” HCCI President and COO Julie Sacks told Hospice News. “It’s really valuable to the patients because they’re able to access home-based primary care. Patients are able to access palliative care when they need it and hospice generally sooner than they normally would.”

About 12% of the 2.1 million seniors who reside in Illinois are 85 or older, and 40% of Medicare beneficiaries in the state have four or more chronic conditions, according to HCCI. Close to 260,000 of those seniors are homebound, with only 26% receiving home-based primary care.

The gradual move of reimbursement systems to value-based care models is partly fueling a resurgence in home-based primary care, according to a 2018 study in the journal Geriatrics.

Patients in the United States received more than 2.2 million home-based primary care visits during 2016, up from less than 1 million in 1996, the study found. Patients in assisted living facilities, group homes, and other facilities received 3.2 million primary care visits in 2016.

A watchword for many value-based payment models is care coordination. By operating a home-based primary care program, hospices can gain an edge when it comes to coordinating services.

“For the hospice and palliative organization, it gives them an opportunity to serve a broader population, which means additional revenue opportunities. They can be providing chronic care management and billing for that, as well as transitional care management,” Singleton said. “They can more fully meet the needs of patients and their caregivers over time by coordinating all of those medical services, and they can focus on what matters most to the patients.”

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