Improving Quality and Cutting Costs: The Value of Home-Based Primary Care

Recently, Dr. Thomas Cornwell, the president and CEO of the Home Centered Care Institute, spoke to Epic staff about the value of home-based primary care.

Dr. Cornwell explained that the Veterans Health Administration’s home-based primary care program for high healthcare utilizers reduced nursing home days by nearly 90% and hospital days by over 60%. The shift from high-cost care to lower-cost in-home care was projected to save over $103 million in one year. Now the VA has the largest home-based care program in the US, with nearly 30,000 patients enrolled.

“Home-based primary care improves quality and patient satisfaction, reducing hospitalization and cutting costs,” Dr. Cornwell said. “We need to continue to incentivize bringing patient-centered care into the home and scale these programs for the people who need it.”

Dr. Cornwell shared his experiences working with medically complex patients like Edith, a woman who was unable to walk due to fluid retention in her legs. During a visit to her home, he used Epic to determine the root cause.

“I tell residents that they can learn more about the patient’s social determinants of health in the first 15 seconds of a home visit than they ever could in a clinic visit,” Dr. Cornwell said. “I used Care Everywhere to see her recent CT scan and echocardiogram, and I was able to determine the diagnosis from her living room.”

After three weeks of exercise, diet, and aggressive medication changes, Edith lost 15 pounds of fluid and was able to walk. Now, at 93 years old, Edith continues to live on her own–an outcome that Dr. Cornwell describes as “miraculous.”

“Caring for patients like Edith in their homes is often better for patients and is far less costly than caring for them in hospitals and nursing homes,” Dr. Cornwell said. “Having their medical records at my fingertips in Epic makes these programs possible.”

Learn more from HCCI.