What Are the Models for Delivering Palliative Care in the Home?

As the population ages, the number of people living with multiple chronic conditions and serious illness continues to rise. These individuals have complex medical needs, high symptom burden, and cognitive and functional impairment. While short-term mortality rates in this population are high, many have unpredictable prognoses or may not wish to forgo curative treatment, rendering them ineligible for hospice care; for this population, home-based palliative care offers great benefit. This chapter outlines the current models of home-based palliative care in the United States, focusing on the different organizational homes, revenue streams, staffing mix, and relationship to other providers. Furthermore, it elaborates on the distinction between home-based palliative care and home-based primary care and summarizes data from studies examining the impact of home-based palliative care on clinical outcomes, utilization, and costs of care.