May 17, 2023 – Clinics were built to optimize the productivity of clinicians in a fee-for-service healthcare world, says Patina CEO Jack Stoddard in a recent article in Forbes. But the model doesn’t always hold up, particularly for people who are unable to go to a doctor’s office due to age or disability. And there are a lot of them. According to the American Academy of Home Care Medicine (AAHCM), an estimated 2 million frail, seriously ill and vulnerable adults – many with two or more chronic conditions – are unable to visit physicians’ offices.
Launched in October 2021, Patina specializes in providing home-based care to people 65 years and older. “We decided to bypass the ‘drive-park-wait’ clinic model and use technology and people to bring care to them, on their terms,” says Stoddard.
Home-based primary care represents a different approach to care than traditional office-based visits, say proponents. By staying in close touch with patients, home-based primary-care professionals can monitor and manage many chronic conditions, such as heart and lung disease.
“We learn a great deal about people when we visit them in their homes,” says Stoddard. “Does the patient have enough social support? How do they manage their medicines? Their meals? Are they lonely? Often these factors determine outcomes even more than clinical interventions.”
But is home-based primary care sustainable in a fee-for-service environment? After all, the systems and logistics requirements are demanding. Proponents believe it might work only if value-based reimbursement takes hold.
“Home-based medicine, broadly speaking, which includes home-based primary care, is witnessing a cameo moment right now,” says Rebecca Ramsay, MPH, BSN, CEO of Housecall Providers, which has been providing home-based care in northwest Oregon since 1995. “There are still significant barriers to making this type of care accessible to all who need it, primarily around sustainable payment models and workforce education and capacity building,” she says. “It will take action at many levels to reach our access goals.” Ramsay is a board member of the Home Centered Care Institute (a national education and research organization) and a governing board member of Advanced Illness Partners, a nationwide accountable care organization, or ACO.
Read more in the latest issue of Repertoire Magazine.