Leveraging Payment Reforms to Transform and Expand Home-Based Care for People with Complex Health Needs

Leveraging Payment Reforms to Transform and Expand Home-Based Care for People with Complex Health Needs


Background

There is currently significant opportunity and demand to increase home-based care. However, while many home-based care models have been shown to better meet the needs of people with complex medical needs while simultaneously containing costs, traditional fee-for-service payment models limit payment for home-based services. Given this, payers and health systems are increasingly recognizing that value-based payment models have a unique ability to support the provision of home-based care for people with complex health and social needs.

Project Overview

This project explores how to transform and expand home-based care for people with complex health and social needs and aims to inform policy activities that may be leveraged at the federal and state level to advance home-based care initiatives. Through timely policy agenda briefs that synthesize Center research, this project will inform short-term policy reforms that can help simplify and align existing payment and care delivery models to achieve comprehensive, home-based care that addresses the needs of the whole person. The first policy agenda brief focused on opportunities to improve home-based care for Medicare beneficiaries and through pilots by the Center for Medicare and Medicaid Innovation; the second brief will focus on opportunities for Medicaid beneficiaries.

This project is supported by The Commonwealth Fund, a national, private foundation based in New York City that supports independent research on health care issues and makes grants to improve health care practice and policy. The views presented by the project are those of the project team and not necessarily those of The Commonwealth Fund, its directors, officers, or staff. This project is also supported by a grant from The SCAN Foundation. The SCAN Foundation is dedicated to advancing a coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence. For more information, please visit www.TheSCANFoundation.org. We are also proudly supported by The John A. Hartford Foundation, a private, nonpartisan, national philanthropy dedicated to improving the care of older adults. The leader in the field of aging and health, the Foundation has three priority areas: creating age-friendly health systems, supporting family caregivers, and improving serious illness and end-of-life care. Learn more at www.JohnAHartford.org.

 

First Policy Brief

Publications

Policy Agenda Brief on Opportunities for Expanding Home-Based Care for Medicare Beneficiaries and Increase Pilots Relevant to Home-Based Care

This policy agenda brief synthesizes research conducted by the Duke-Margolis Center to provide policy recommendations to increase access to home-based care for people with complex medical and social needs. This work was motivated by the significant policy opportunity right now to provide home-based care for millions of people in the United States, particularly individuals that are unable to receive health and health-related services in an office or facility setting due to health and functional limitations. Recommendations outline short-term policy reforms for Medicare beneficiaries that can help simplify and align existing payment and care delivery models to achieve comprehensive, home-based care that addresses the needs of the whole person.

Research Team

William K. Bleser - Margolis headhot

William K. Bleser, PhD, MSPH

Assistant Research Director, Payment Reform and Population Health
Senior Team Member
Anti-Racism and Equity Committee Member

Robert Saunders

Robert Saunders, PhD

Senior Research Director, Health Care Transformation
Adjunct Associate Professor
Senior Team Member
Margolis Core Faculty