House calls used to be considered a thing of the past. But while still not that common, home-based care is gaining traction.

The reason? Frail and elderly patients can benefit from house calls, and the concept meshes with value-based payment programs, as Lola Butcher describes in our cover story starting on Page 8.

"There is a lot of movement right now to be able to pay for house calls," says Linda DeCherrie, M.D., of Mount Sinai Health System in New York City. "[Provider organizations] need to get ready because this is really better care for patients, ideally at less cost, and this is what patients want."

Organizations are trying to address the workforce issues linked to house calls, and home-based care has an increasing number of advocates. In fact, a number of house-call programs across the country are finding that they can ensure continuity of care and reduce readmission rates for an increasingly aging population.

Two other articles in the magazine discuss boundaries that can exist in health care — and how to cross them. In his piece on Page 12, Anthony J. Montagnolo outlines three emerging technologies that may create new approaches to care: digital therapeutics, genetic testing and acuity-adaptable rooms. "As health technology becomes boundaryless, health care delivery will adapt and become boundaryless, too," Montagnolo says. 

On Page 14, in an article by the Society for Healthcare Strategy & Market Development, a professional membership group of the American Hospital Association, we offer some thoughts on integrated care and how a focus on consumerism allows hospitals to develop models for partnerships and access that transcend traditional health care strategies. Trustees need to look beyond their health system's boundaries as health care continues to evolve.  

Also in this issue, our Workbook, starting on Page 22, takes on the question of trustee reappointment. It provides tips for boards to formalize the reappointment process — a practice that sometimes can be just an afterthought. When board reappointment procedures are disciplined and systematic, better governance results.