How In-Home Primary Care Can Lower Costs, Boost Patient Satisfaction
In-home primary care can serve as the main source of primary care for homebound patients or in-home primary care providers can wrap around traditional home healthcare services.
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- In-home primary care differs from traditional home healthcare and it can play a unique role in ensuring quality of care and access to care at a low cost for patients, according to Chris Dodd, MD, chief medical officer at Emcara Health.
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Traditional home healthcare often takes place after a patient is discharged from a hospital and requires follow-up care at home or rehabilitation support after a stroke. In-home primary care, as the name suggests, carries out primary care services in the home. More specifically, Dodd’s organization, Emcara Health, implements advanced primary care in its in-home primary care model.
In-home primary care can be both the fundamental source of a patient’s primary care services or it can offer wrap-around services that complement the patient’s brick-and-mortar primary care provider.
Through a partnership with a large Medicare Advantage health plan in which the provider organization wrapped around the health plan’s established value-based primary care provider (PCP) services, Emcara Health found that in-home primary care had implications for patient satisfaction and patient experience as well as the total cost of care.
A case study on the five-year-long partnership between Emcara Health and the Medicare Advantage plan found that the in-home primary care services received a net promoter score in the 80 percent range. Additionally, the payer saw a 10 to 20 percent reduction in the total cost of care for the patients who received in-home primary care services over the course of a year.
“To me, the foundational partnership and what's most important is that we should enable primary care providers to bring under their umbrella as much of the continuum of care delivery as we can and let them be the true quarterbacks of care,” Dodd emphasized.
When providing in-home primary care as a wrap-around service, successful care coordination can promote that perspective of the primary care provider as the quarterback of care, but poor or nonexistent care coordination can lead to negative outcomes.
“We understand the sacredness of the relationship between the PCP and the patient, and there's nothing that we want more than to enhance that, not to hinder it,” Dodd said.
“So we spend a lot of time building trust with the provider groups that are in our local communities, getting to know them, making sure they know who we are, that we are here to really be their eyes and ears in the home.”
Dodd shared practical steps for enabling in-home primary care providers to coordinate smoothly with primary care providers.
Home healthcare grew during the coronavirus pandemic as the virus forced patients to stay home, but it can expand further through in-home primary care.
Looking to the future, Dodd envisioned an in-home primary care model that allows for fluid movement between hospital-at-home and primary care services. He argued that in-home primary care should continue to function both as a fundamental source of primary care and as a wrap-around service.
