Forum Session

Medical Care for the Elderly Living at Home: Home-Based Primary Care (HBPC) and Hospital-at-Home Programs
July 22, 2011


Carol V. O'Shaughnessy, MA


Patient-centered care, care coordination, avoidable hospitalizations, and preventable use of emergency rooms: these are key watchwords among health care policymakers and practitioners as they look to control costs and improve patient care. One of the many approaches to address these issues is a throwback to an earlier era of medicine: home-based medical care, which includes home-based primary care (HBPC) programs and more intensive hospital-at-home programs. Various types of home-based medical programs exist, and sorting out the differences among them and the patient populations they target can be confusing. Some health care systems have adopted these approaches as a strategy to serve high-need and high-cost elderly patients who are not adequately served by the current medical system. A provision in the Patient Protection and Affordable Care Act of 2010 (PPACA) requires the Centers for Medicare & Medicaid Services (CMS) to conduct a demonstration program, known as Independence at Home, to test home-based primary care models; it is scheduled to begin in 2012. This Forum session reviewed the range and types of home-based medical care, evidence about their cost and care effectiveness, and barriers to wider adoption.


Bruce A. Leff, MD
Professor of Medicine
Division of Geriatric Medicine
Johns Hopkins University School of Medicine

Thomas Edes, MD, MS
Director, Geriatrics & Extended Care
Office of Clinical Operations
U.S. Department of Veterans Affairs

Bruce Kinosian, MD
Associate Professor of Medicine
Hospital of the University of Pennsylvania
Senior Fellow
Leonard Davis Institute of Health Economics

Slides from the presentations by Drs. Leff, Edes, and Kinosian are available for download.

↑ back to top

Browse Topics Side ArrowDown Arrow