Home‐Based Primary Care in the Department of Veterans Affairs: Past, Present, and Future

Launched in 1970, the Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) Program is a unique, well-resourced model that has influenced the development of HBPC practice more broadly. VA HBPC delivers team-based, comprehensive care in the homes of medically complex Veterans. As the population ages, VA is committed to supporting a continuum of age-friendly care. Expanding and improving VA HBPC is one important strategy to address the high needs of medically complex Veterans in a patient-centered, yet cost-effective manner. In this paper, we draw on the existing literature and our institutional knowledge as HBPC researchers within the VA system to present a longitudinal perspective on VA HBPC. We describe VA HBPC's early history, identify key innovations, discuss challenges to expansion and care delivery, and propose future research and practice directions. Our goal is to inform the provision of high-quality, cost-effective, home-based care for medically complex patients within VA and beyond.