Two million older adults in the U.S. rarely or never leave their homes and even more individuals face difficulty or need assistance to do so. Home-based care models are an important strategy for expanding access to high-quality care for adults with complex needs and reducing health disparities for homebound populations. Despite the opportunity for improving access to care, home-based care remains significantly underused and inequitably distributed.

To better understand Medicare and Medicaid policy options for expanding access to home-based care for people with complex health needs, the Better Care Playbook recently spoke with Robert Saunders, PhD, Senior Research Director of Health Care Transformation at the Duke-Margolis Center for Health Policy, and Jonathan Gonzalez-Smith, MPAff, Research Associate at the Duke-Margolis Center for Health Policy. Their recent research explores potential policy levers for supporting home-based care, with a focus on value-based payment.