WSJ: House Calls Make Comeback as Hospitals Face Readmission Pressure

Health care providers are bringing back the house call as a way to keep patients out of the hospital, while also avoiding Medicare reimbursement penalties.

The latest in the ongoing efforts to reduce re-hospitalizations, the Wall Street Journal (WSJ) reports that providers are sending teams of doctors, nurses, physician assistants and pharmacists to treat frail patients living at home.

The transfer of medical services to patients’ residences have some adopting programs called “Hospital at Home,” in which provides an array of tests such as ultrasounds, x-rays, and even electrocardiograms. 


Since last October, Medicare began issuing 1% reimbursement cuts to hospitals with higher-than-expected readmission rates.

Having much of the blame for patient re-hospitalization fall on their shoulders, hospitals have been accused by Medicare for inattentive care toward patients once they have been discharged, many of which end up back in the hospital for the same conditions within 30 days post-discharge.

By treating patients at home, providers are taking steps toward easing the transitional period for individuals as they move from institutions to home.


As for costs, WSJ reports that the payment models vary, with one method being private insurers can contract with Medicare to offer benefits through home-based care plans. 

The revamping of house calls has already scored well among patient satisfaction, writes WSJ, as many individuals are more comfortable receiving care in their own homes as opposed to institutional settings. 

A study published by Health Affairs in June also showed that costs for patients in the Hospital at Home program were 19% lower than similar patients in hospital settings. Reasons for which were attributed to fewer lab and test costs.

Transitional care programs like Hospital at Home have already started yielding improvements.

A not-for-profit health system in Cincinnati, Mercy Health was able to reduce its 30-day readmission rate from 16.9% in 2011 to 14.5% in November, using a transitional care program that assigned nurses to high-risk patients, according to WSJ. 

Positive results are also reverberating among insurers, like Aetna, who is currently contracting with home health agencies to expand transitional care programs for beneficiaries of its Medicare Advantage plan. 

Providing care to patients in the comfort of their own homes, while reducing the risk of re-hospitalization and increased Medicare penalization, transitional care models such as the Hospital at Home program might be the collaboration the industry has been waiting for between hospitals and providers.

Read the full Wall Street Journal article here.

Written by Jason Oliva