Medical Care at Home Comes of Age

Christine Ritchie
Bruce Leff
Naomi Gallopyn
Charles Pu
Orla Sheehan
January 2021


This report provides an overview of home-based medical care models, the patients that they serve, and their robust evidence base.


Home-based medical care models — which support people with complex physical, behavioral health, functional, and social needs — have significantly expanded in the last 30 years due to an increased emphasis on person-centered care, value-based care approaches, and gaps in care. This report examines the history of home-based medical care models, the evidence behind them, and case studies on different models to help support health systems, policymakers, and health plans in implementing home-based care.


The continuum of home- and community-based models deliver varied services across primary, urgent, acute, and post-acute levels of care. The report details the following models, providing definitions, target populations, core components, staffing structure, evidence and outcomes, reimbursement type, and telehealth availability for each:

  • Home-based primary care;

  • Home-based medical co-management;

  • Home-based integrated medical/social care;

  • Home-based palliative care;

  • Hospital at home;

  • Mobile integrated health-community paramedicine;

  • Rehabilitation at home; and

  • Transitional care.

Notably, the effectiveness of most of these models has been proven through rigorous clinical trials. Different populations benefit from different home-based care models, and components of these models can be tailored the needs of each population. Additionally, the report features case studies on several hospital at home and home-based medical co-management models.


Home-based medical care models have been shown to improve patient experience and produce cost savings. Health care stakeholders can take this information to purposefully plan and implement home-based care programs and, with more widespread adoption, could create a comprehensive home- and community-based care delivery ecosystem for individuals with complex needs.  

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