More cost effective than ER visits or hospital stays, house calls will become more common as the U.S. population lives longer with chronic health problems.
Within minutes of his arrival at Diana Maine’s West Kendall home, Dr. Patrick Kavanagh is sitting at his patient’s dining room table, an assortment of blue-topped prescription medicine bottles between them. He reviews a notebook of blood pressure readings Maine has kept since his last visit a month ago, then wraps an electronic blood pressure cuff on her arm. They discuss the results.
Every day Kavanagh, trusty iPad in tow, sees between five and 10 patients like 83-year-old Maine, seniors with multiple chronic conditions who need care in their homes. His car is a portable medical office, and he has the ability to do practically anything on the road — including EKGs and ultrasounds. He can even request a technician to visit a home with a portable X-ray machine.
Kavanagh, an internist, works for My Home Doctor, a group of Florida physicians who treat non-emergency medical conditions at home through various insurance companies. Many of their patients are elderly and on Medicare. If a doctor didn’t come to see them, they likely would end up in the emergency room — which typically costs more than a home visit.
“This is preventative medicine,” Kavanagh says. “We’re monitoring patients and keeping them out of urgent care and the ER.”
House calls, once thought to be too time-consuming and not very cost-effective, are making a comeback as healthcare providers recognize that they’re actually the answer to good care for patients who can’t make it to a doctor’s office. Medicare-paid house calls have been steadily increasing, according to government figures, and doctors report the same for non-Medicare patients, according to the American Academy for Home Care Physicians. What’s more, technology has made accessibility to patients’ records and other medical information available at any time and any place, a boon to physicians on the go.
Now a three-year federal government pilot program called Independence at Home is encouraging doctors to pick up those black medical bags of yore and pay a visit to their sickest patients. As part of the new healthcare reform law, the demonstration project will cover 10,000 Medicare patients described as medically fragile. It is set to begin in January in locations yet to be decided.
Why? House calls can make both financial and health sense. Experts say various hospital programs around the country, as well as pilot projects through insurance companies, show that treating patients at home improves outcomes and often prevents more expensive hospital involvement.
“Any primary care physician will tell you that as patients age, they find it harder and harder to come to the office,” says Constance Row, executive director of the American Academy of Home Physicians, a Maryland-based organization that promotes care at home. “As a result their conditions worsen and many end up in the hospital for conditions that could have been handled and controlled at home.”
In the past few years, the traditional practice of house calls received lots of attention — including the USA Network “Royal Pains” TV show — as doctors began to provide concierge services to patients who paid an annual membership fee for easy access. This kind of a medical practice usually involves wealthier patients who can afford to fork over the extra money.
Source http://www.miamiherald.com/
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