Monday, March 10, 2014

Do House Calls Help?

Depending on your age, you may remember when doctors made house calls, and your milk was left on your doorstep by the "milkman".  It's not unusual for elder law attorneys to make house calls, but do doctors still do this? The Commonwealth Fund February/March 2014 newsletter, Quality Matters, ran a story about an in-progress study on the impact of house calls by doctors on certain patients.

The summary for the article, In Focus: Making House Calls to Improve Care of Patients with Advanced Illnesses

A Centers for Medicare and Medicaid Services demonstration is testing whether treating frail, elderly patients with multiple chronic conditions in their homes improves outcomes and reduces health care spending. While the three-year demonstration is only halfway through, some participants have reduced hospitalizations and readmissions dramatically by providing more intensive services to this population of patients.

The focus of the study is the Independence at Home Initiative through the ACA which "targets Medicare patients with functional impairments and multiple chronic conditions such as heart failure and chronic obstructive pulmonary disease... [because this group] is increasingly worrisome to policymakers [since] ... they comprise about a quarter of beneficiaries but account for roughly two-thirds of the program's expenditures. And their numbers are expected to increase dramatically with the aging of the population."

The article reviews interim results of some of the projects, offers some graphs, discusses advantages of house calls and reviews issues with replication. FAQs about the demonstration project, including beneficiary eligibility to participate is available here

The newsletter also includes an article on House Calls for the Homebound and a Q&A [on] Closing Gaps in Care with At-Home Visits. To subscribe to the newsletter, click here.

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