What were popular in the past but have recently begun to reemerge as healthcare providers strive to lower costs while simultaneously improve care, house calls continue to show their effectiveness in saving money for federal programs like Medicare, a recent study finds.
Researchers with MedStar Washington Hospital Center, a 926-bed teaching and research hospital in Washington, D.C., found that when medical care for frail seniors with advanced illness shifts to the home, total Medicare costs were reduced by 17% during a two-year period.
The results, which were published in the Journal of American Geriatrics Society, underscore the value of home-based primary care for aging seniors in the U.S.
Led by K. Eric De Jonge, MD, co-founder of the Medical House Call program at the MedStar Hospital Center, researchers compared Medicare costs and survival of 722 patients enrolled in the hospital Medical House Call practice to a control group of 2,161 patients selected from Medicare claims data.
After analyzing total costs, death rates, patterns of hospital admissions and types of doctor visits, the study concluded that home-based primary care saved an average of $8,477 per patient during two years.
Of notable findings included 9% fewer hospitalizations, 20% fewer emergency room visits, 27% fewer skilled nursing facility stays and 23% fewer specialist visits for those participating in the House Call program.
“Because this group of patients is the most expensive in the medical system, even fractional savings can make a significant dent in health care costs,” said Dr. De Jonge in a written statement. “This study confirms home-based medical care is an effective and lower-cost model of care for these high-risk elders.”
MedStar Washington created its House Call program in 1999 after recognizing the health challenges faced by seniors in its community.
An interdisciplinary team of physicians and nurse practitioners provide on-call telephone coverage 24/7, along with making frequent visits to patients at home and following them in the hospital. Social workers are also included into the mix, as they coordinate psychosocial and supportive services, while clinicians make same day urgent house calls to prevent avoidable hospitalizations and other costly complications.
More house call programs have regained popularity in recent years as healthcare providers grapple with penalties for having higher than average hospital readmission rates and the dilemma of providing higher quality care at lower costs.
“Promoting the health and dignity of elders by helping them remain in their home is hard work, but we can expand these services, if the payment system supports growth of such mobile care teams,” stated Dr. De Jonge.
View the JAGS study.
Written by Jason Oliva