Poll: Can house calls provide better medical care at lower costs?

An article that appeared in the Los Angeles Times in late August looked at the idea that one of the keys to providing better medical care at lower costs may be house calls.

Should we bring house calls back?

There is some compelling data — like an in-home doctors’-visit program for Medicare patients at the Virginia Commonwealth University Medical Center that cut the length of hospital stays and saved the hospital millions of dollars. A similar program through the Department of Veterans Affairs cut hospital inpatient admissions by more than one-quarter, and total days in the hospital by more than two-thirds.

Elderly patients with multiple conditions who have trouble getting to their doctor’s office are often more likely to end up in the hospital. It’s worth noting that the sickest 10 percent of Medicare recipients account for two-thirds of total spending. In-home visits could take the place of unnecessary and costly hospital stays and help prevent equally expensive re-admissions to the hospital.

But home visit programs require an upfront financial commitment to achieve long-term savings, which Medicare has been reluctant to fund. Many doctors who want to incorporate home visits in their practice can’t afford to.

Politicians in the health reform discussion have proposed increasing funding to house call programs. For the sake of keeping our seniors healthy, let’s hope this funding survives the debate.

I encourage you to listen and vote in this week’s poll, located both below, and in the upper right column of the blog.

Please suggest future ReachMD Poll topics by emailing Poll@ReachMD.com.

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  • http://www.scienceandsensibility.org Amy Romano

    Home visitation is not just for seniors. There is ample evidence to support home visitation programs for newborns and their mothers as well. Studies have found a beneficial impact on child neglect, utilization of WIC services, breastfeeding, household safety, postpartum depression, interval to next pregnancy, and other outcomes.

  • Doc99

    What’s the cpt modifier for miles per gallon? At what level of payment does this become an attractive option? Quid pro quo, Clarice.

  • family practitioner

    We do house calls in our practice for appropriate patients.
    Medicare pays a little bit more, with emphasis on the little bit.
    So, why do we still do it?
    Because it is the right thing to do; the patient and family benefits, not to mention the money saved.
    Why do we do it for such little renumeration?
    Because we are fools.

  • Pingback: Bring Back the House Call « Off the Charts

  • HCPA

    the eternal question: as far as medicaid and/or medicare, how many visits are allowed (actually reimbursed) in a board and care/assisted living?

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