Aaron Yao, PhD
Research Director, Home Centered Care Institute
In this edition of Grand Rounds in Hematology and Oncology from December 2021, Patrick M. Dillon, MD, University of Virginia Hematology & Oncology, Charlottesville, Virginia, introduces Aaron Yao, PhD, Research Director, Home Centered Care Institute, Virginia at Home, Richmond, Virginia. In this 56-minute presentation, Dr. Yao explores the expanding role of home-based medical care in supporting frail or homebound cancer patients and survivors, a population often overlooked in traditional oncology models. The talk ends with a short Q&A discussion.
Dr. Yao highlights that approximately 2 million older adults in the US are permanently homebound, with cancer among the leading diagnoses, and many more experience frequent periods of functional decline or immobility. These patients face significant disparities in access to care, particularly racial and ethnic minorities who are more likely to die at home without adequate support.
He outlines key home-based models of care, including home-based primary care, home-based palliative care, and community paramedicine. These approaches are often team-based, longitudinal, and designed to deliver high-touch, coordinated services that can address both medical and psychosocial needs. Evidence shows that such models reduce emergency department visits, hospitalizations, and overall costs while improving quality of life and aligning care with patient preferences.
Dr. Yao discusses the role of family caregivers. He stresses better integrating caregiver assessment and services into clinical and policy frameworks. Moreover, he presents data suggesting that older cancer survivors have greater risks of functional decline and that many will require home-based services to maintain independence and quality of life.
Dr. Yao emphasizes the importance of identifying and reaching vulnerable patients who benefit from home-based care. He advocates for better data infrastructure, screening for functional status, and policies that support reimbursement and scaling of effective home-based care models, especially for underserved populations.