Home care helps value-based PCPs manage care and improve outcomes

Greg Sheff, M.D.

Senior VP and Chief Medical Officer, Home Solutions


Dr. Sheff’s background includes two decades in healthcare as a practicing physician and healthcare executive. He is currently responsible for advancing Humana’s vision to transform the home into the center of care delivery. Prior to Humana, he served in leadership roles at multispecialty physician groups, health systems and home-based care companies.
The increasing emergence of in-home services satisfies two critical needs within value-based care: Providing care for patients where they want and need it most, and supporting physicians’ care plans when patients cannot—or will not, due to fear of COVID-19 transmission—visit their office.

Much of the recent focus in creating homecare opportunities has centered on primary care—the foundation of the value-based model—but has evolved recently to include advanced urgent care. The aim of the approaches is to drive improved access, experience, outcomes and quality of life.

Humana research has determined that 20% of its Medicare Advantage expenditures can be addressed via home-care services, and an even higher percentage in some areas such as prevention, care coordination, care management and assessments.

New partnerships with organizations focused on primary and urgent care home-based clinical visits provide complementary access points for care to members. These options are particularly suited for members where traditional primary care clinics are out-of reach because of an inability to find a local physician practice or home-bound status.

Heal, one option, provides primary care services by way of house calls, telehealth and remote monitoring to patients in eight states. The company also works with health plans to assist in closing gaps in care.

DispatchHealth offers advanced urgent care in 38 cities. The organization focuses on treating medical conditions—COPD, heart failure, cellulitis and others—that require urgent intervention, but not necessarily hospitalization.

That interaction and connection solidifies the patient-provider bond. That’s where the difference is being made.
Dr. Barron Taylor
practitioner with Heal

Why it matters:

Dispatching clinicians directly to a patient’s home overcomes many of the barriers that tend to prevent some from seeing their physicians, such as a lack of transportation and now, amid the pandemic, a desire to limit exposure to groups of other people. It also adds to the patient experience.

“Home-based care can be a partner and support system to help PCPs and other physicians take the best care of their patients,” said Andrew Lynch, vice president of Home Solutions for Humana. “Whether it’s Medicare home care, advanced urgent care, hospital at home, etc., we believe all of these can help value-based physicians better manage their patients and improve outcomes.”

The way forward:

Dr. Barron Taylor, a practitioner with Heal, says the ability to be present in a patient’s home gives valuable insight to an individual’s well-being he otherwise might never receive in a traditional physician’s office. He can use that information to pinpoint physical and mental health issues and develop care strategies.

“How can you truly make an evaluation if you’re not in the patient’s house?” Taylor asked. “That interaction and connection solidifies the patient-provider bond. That’s where the difference is being made.”