Receipt of Home-Based Care Among Older Medicare Beneficiaries

A research article in HealthAffairs (August 2020) states that there is untapped potential to expand home-based medical care to homebound and non-homebound seniors, which can lower cost of care and improve clinical outcomes.

Estimates suggest there are about two million homebound seniors in the U.S. and about five million seniors who can only leave home with assistance or significant difficulty. Home-based primary care has been associated with decreased hospitalizations and emergency rooms visits. The CMS Innovation Center Independence at Home Demonstration, a home-based primary care program for high-risk seniors, saved an average of $2,700 per beneficiary per year over expected patient costs.

Non-homebound seniors who receive home-based medical care have more chronic illnesses, functional impairment, and higher healthcare utilization. They also tend to be more socially disadvantaged. Factors such as poverty, lack of transportation, and racial and ethnic disparities are barriers to more traditional healthcare delivery, making home-based care an important alternative for these individuals.

The researchers suggest that expanding availability of home-based medical care to homebound and medically complex non-homebound seniors is an important opportunity for the medical community because of the proven outcomes and cost benefits.