The Perfect Storm: Addressing Needs with Home-Based Primary Care

Virtual Event: The Perfect Storm: Addressing Needs with Home-Based Primary Care

Date: June 4, 2019
Time: 1-2 PM ET

In a health care climate of rising costs and resource strain, the aging population is particularly at risk for being medically underserved. In a 2018 white paper, Home Centered Care Institute (HCCI) founder and CEO Dr. Thomas Cornwell examines the potential for home-based primary care as a solution to this challenge.

HCCI is a non-profit organization dedicated to expanding access to home-based primary care (HBPC) by educating, training, and growing the home-based clinical care workforce. They’ve partnered with JourneyCare, Illinois’ largest non-profit provider of palliative and hospice care, on an HBPC pilot project to help improve access and quality of care through collaborative project management and oversight, rigorous process development and system monitoring, and alignment of evidenced-based care models.

This virtual event will feature a discussion of the opportunities and challenges inherent to this (and other) pilot projects in the context of the “Perfect Storm” identified by Dr. Cornwell.

Register now!

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Ascension’s Chief Community Impact Officer on Providing Care Outside the Hospital

Tamarah Duperval-Brownlee

Author: Samantha Liss  |  May 22, 2019  |  HealthcareDive

Tamarah Duperval-Brownlee is Ascension’s first chief community impact officer, which means she is in charge of helping guide the hospital operator’s new strategic vision to reimagine the best way to care for those in communities across the country. Duperval-Brownlee, a family physician, is responsible for helping Ascension pivot away from its focus on hospital campuses to better care for patients outside hospital settings.

The company’s new position comes as nonprofit healthcare organizations are under increasing scrutiny. Earlier this year, Senate Finance Committee Chairman Chuck Grassley, R-Iowa, wrote to the IRS requesting an investigation into whether nonprofit hospitals are living up to their charitable obligations and asking for more information on the agency’s oversight of the facilities.

Healthcare Dive asked Duperval-Brownlee a few questions about her new role.

HEALTHCARE DIVE: You’re in a very pivotal role in a very pivotal time in healthcare, especially for health systems as they transition away from traditional hospital campuses. How do you begin that transition?

TAMARAH DUPERVAL-BROWNLEE: My role isn’t necessarily to be the one to make the decision. Our markets are evaluating and doing their own discernment to understand what the right size needs of the population are, then I come in and provide the perspective to that. It’s about being able to leverage what we know from community health needs assessment, population trends, working with our strategy team and the like.

I’ve likened it to changing the solar system. The center of that has been the hospital and the ambulatory spaces and what we can do for people and to people. But what we’re entering now, and I think it’s articulated by our strategic direction, is that the center is the person that we’re serving and ensuring that we are the preferred health partner for them so when they need to come into a site of care, we’re there. Read more:

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Providers Applaud CMS’ Primary Care Initiative


The Primary Cares Initiative got a warm initial reception from key providers groups, but many still have questions about the details of the proposal.

By John Commins     April 23, 2019  |

Provider associations are praising the Centers for Medicare & Medicaid Services’ plans to launch five at-risk primary care models.

“Providing adequate financial support for high quality primary care must be an essential element of any strategy to improve the quality and affordability of our country’s healthcare system,” Gerald E. Harmon, MD, Immediate Past Chair of the American Medical Association Board of Trustees said in prepared remarks.

“Many primary care physicians have been struggling to deliver the care their patients need and to financially sustain their practices under current Medicare payments,” Harmon said. “The new primary care payment models will provide practices with more resources and more flexibility to deliver the highest-quality care to their patients.”

Health and Human Services Secretary Alex Azar unveiled the voluntary initiative on Monday, saying the CMS Primary Cares Initiative for Medicare and Medicaid beneficiaries would transform primary care to a value-based system that rewards physicians who keep patients healthy and out of the hospital. Read the full article

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Payment Reform Paves The Way For Expanding Home-Based Primary Care

house call doctor at door

May 2, 2019  |  Home Centered Care Institute

The field of home-based primary care (HBPC) received extraordinary news as the US Department of Health and Human Services (HHS), in collaboration with the Centers for Medicare and Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMMI), announced its groundbreaking CMS Primary Cares initiative in Washington, D.C.

CMS Primary Cares aims to improve quality, improve patient experience of care, and reduce expenditures by increasing patient access to advanced primary care services. This revolutionary payment model includes several elements specifically designed to support practices caring for patients with complex chronic needs or serious illness, the patient population that can benefit so dramatically from home-based primary care.

About 4 million vulnerable adults in the United States have difficulty obtaining or are completely unable to access office-based primary care because they are frail, chronically-ill, functionally-limited and/or homebound. In desperation, these individuals often use the emergency room as their primary care physician. Since many of these patients have multiple comorbidities, ED visits frequently spiral into a lengthy hospital admissions.

“With 10,000 baby boomers turning 65 every day and our population living longer with more chronic diseases, home-based primary care provides the optimal solution for a growing number of patients as part of a value-based healthcare system,” notes Dr Thomas Cornwell, a practicing home-based primary care physician and Founder and CEO of HCCI. “Beginning in 2020, the CMS Primary Cares initiative will reduce barriers to entry and create a financially stable model for hospital systems and practices to bring quality care to the patients who need it most.”

“Since 2017, HCCI has partnered with leading academic centers and health systems to provide high-quality two-day training programs using the nation’s first comprehensive curriculum for home-based primary care,” shares Melissa Singleton, HCCI’s Vice President of Education & Research. “We train the entire team – physicians, nurse practitioners, physician assistants, social workers, practice managers, and others. And they come to us from a diverse range of specialties, including internal medicine, family practice, geriatrics, and more.”

Dr. Cornwell adds, “With the new CMS Primary Cares initiative, we stand a real chance of attracting more providers to the field – creating universal access to best practice house call programs, making home-based primary care the national standard for treating medically complex patients who are better cared for in the home.”

HHS Secretary Alex Azar lauded the CMS Primary Cares initiative as a historic first step toward a much bigger vision, even broader than value-based care. That vision is a healthcare system where every American patient feels she’s being treated like a person, not a number; where your doctor has one focus: not what procedures to order or how to bill you for them, but how to keep you healthy and well.

HCCI applauds and supports the diligent efforts of HHS Secretary Alex Azar, CMS Administrator Seema Verma, CMMI Senior Advisor to the Secretary Adam Boehler, AAHCM (who has led the charge on advocacy for our field), USMM, Centene, Aspire, Landmark, John A. Hartford Foundation, and all the provider organizations around the U.S. who have helped make this possible.

If you are interested in learning more about HCCI or supporting the future of HBPC, visit

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Video Link:
Eric De Jonge, MD., President of the American Academy of Home Care Medicine shares insight about the new payment models:

About HCCI

The Home Centered Care Institute (HCCI) is a national non-profit organization focused on advancing home-based primary care (HBPC) to ensure that chronically ill, medically complex and homebound patients have access to high-quality care in their home. HCCI works with leading academic medical centers, health systems and industry experts to raise awareness of and advocate for expanding the HBPC model by growing the HBPC workforce through education and training and developing a research-based model for sustainable house call program implementation and growth.

Find out more at

Media Contact:

Julie Sacks
Home Centered Care Institute (HCCI)
[email protected]

Download a copy of the press release

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CMS’ new payment models aim to ease the transition to risk

Secretary of Health & Human Services Alex M. Azar Remarks American Medical Association

Written by Maria Castellucci  |  April 27, 2019  |  Modern Healthcare

Providers and analysts are calling new value-based physician payment models announced last week by the CMS game-changers, potentially signaling a new era in which many providers are taking on downside risk and responsibility for total cost of care.

The five new voluntary payment models, which are available under the Primary Care First heading through the CMS Center for Medicare and Medicaid Innovation, vary in levels of risk, but all involve providers receiving fixed payments based on their population of Medicare beneficiaries. They’re also designed to encourage improvement on quality metrics and lower costs through bonuses and penalties.

Two of the models are essentially riskier versions of existing primary-care experiments, while the remaining three are Direct Contracting models that are new to Medicare, with two requiring providers to take on full risk. Providers and analysts alike are touting the models as a significant moment in the movement to value-based payment, which has been talked about for years with little actual adoption.

“The shift won’t happen by tomorrow, but over the next two to four years you are going to see a drastically different marketplace, and I think looking back at what actually caused it to change, we are going to look back at this moment—I think it’s potentially that significant. We will have to see how providers respond and take advantage of the opportunity,” said Dennis Butts, managing director at consultancy Navigant. Read the full article

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House Calls Can Lead to Dramatically Better Health Outcomes Among the Elderly

Doctor making a house call on an elderly man

Written by Alieza Durana  |  Pacific Standard  |  May 1, 2019

Research shows that house calls are an excellent way to deliver care, providing better outcomes and lowering costs. So why aren’t we funding more of them?

Dr. Eric De Jonge, a geriatrician at Medstar Health in Washington, D.C., is on his way to work—but not at the hospital. After parking his car, he arrives at the front door of a small basement apartment, inside of which he greets his patient: an 82-year-old man bedridden after a stroke. He checks the man’s vitals, asks about his diet and medication, and recommends a regimen of physical therapy.

Yet as De Jonge speaks with the home health aide, who had been helping with cooking, cleaning, and monitoring the patient, and with the patient’s wife, who also serves as his primary caregiver, he learns that the wife is struggling to recover from a recent open-heart surgery. No longer able to drive, she’s been unable to get to the hospital for a post-surgery check-up and has experienced hemorrhaging and other complications.

After treating his patient, De Jonge turns to enroll the wife in the same house-call program that brought him to visit her husband, promising to return for another call in three weeks to make sure she’s recuperating and feels stable and supported.

“She would have lacked medical follow-up because she was ill and dedicated to her husband, and he could have deteriorated if she hadn’t gotten back home [post-surgery],” De Jonge recalls.

Historically, house calls were the only way most people had access to health care. In the early 1900s, doctors provided house calls to patients from the cradle to the grave. But during World War II, as hospitals and medical technology developed, hospitals became the only places where patients could get X-rays and antibiotics—two medical advances that, along with other factors, helped push the United States to the current model.

Now, even though seniors often receive various forms of care in their homes—most often provided by family, as with De Jonge’s patient and his wife—they usually still have to visit a doctor or hospital for primary care. Read the full article