One House Call Has Big Aging-in-Place Payoff

When it comes to helping seniors age in their own home, an in-home assessment from a physician or nurse practitioner goes a long way.

Between 2008 and 2012, Medicare recipients enrolled in a house calls program had 14% fewer hospital admissions during the year after they initially were evaluated, compared with Medicare beneficiaries in a traditional fee-for-service structure, according to recently released findings from RAND Corporation. Those receiving house calls also were less likely to be admitted to a nursing home.

The study evaluated the HouseCalls program run by Optum, a health service business of major insurer UnitedHealthGroup. Patients in this program received in-home health assessments from physicians or nurse practitioners, as well as referrals to health plan resources and community providers to address issues, according to a RAND news release.

The HouseCalls visits were associated with an increase in participants’ visits to physicians, which increased 2% in the year following an evaluation.

Still, the reduction in costly inpatient care was notable, particularly because other efforts have not proven effective. These initiatives have included nurse-staffed call centers, which were meant to be a resource to help patients better manage multiple chronic conditions.

“Assuming that these results with the HouseCalls program can be replicated, this particular combination of an in-home assessment and follow-up on recommendations has the potential to help elderly patients safely age in place, access office-based care and avoid costly institutional care,” said lead author Soeren Mattke, managing director, RAND Health Advisory Services, the consulting practice of RAND Health.

The study involved participants in the HouseCalls program between 2008 and 2012, who were residing in Arkansas, Georgia, Missouri, South Carolina and Texas. Complete findings appear in the December journal Health Affairs.

Written by Tim Mullaney