For aging adults, having access to services that come into the home can be essential to aging well. While the concept of a doctor coming to a patient in his or her home is not new (in 1930 about 40% of doctor visits were held in the home) it is something that became less and less accessible over time. The reason for this is primarily financial, since physicians are predominantly paid for the number of patients they see and the number of procedures they perform. Doctors who travel to patients’ homes simply can’t pack in nearly as many visits as doctors who have patients come to them. And, while most insurance companies do reimburse for house calls, they’ll only do so if there’s a medical reason why the patient can’t or shouldn’t visit an office instead.
Thankfully, the pendulum seems to be swinging back the other way as physician house calls and other outpatient services such as home care and therapy are becoming more readily available. The primary reason for the return to this model is that the health care system is starting to notice the benefit. A 2014 study in the Journal of the American Geriatrics Society found that Medicare costs among 722 elderly patients in a house call program were $8,477 less on average per person than costs among a group that didn’t receive house calls over two years. The house call group also had 9 percent fewer hospitalizations, 10 percent fewer emergency department visits and saw specialists 23 percent less.
Furthermore, the Affordable Care Act penalizes hospitals for high readmission rates – something house calls can help avoid – and shifts Medicare from a volume-based, fee-for service system to one that also depends on quality of care.
From a patient’s perspective, accessing medical visits in the comfort of home has plenty of benefits. No need to arrange transportation, no waiting in waiting rooms with other sick individuals, no scheduling headaches or missed work for family members. In addition to that, patients enjoy a more personalized experience. The physician in their home is able to give more focused attention. It is also beneficial for the physician to see the patient in their normal environment. If they can see that the patient’s home is lacking cleanliness and organization, it might alert them that something more is going on. Patients can paint a picture of health and stability when they are in a physician office. But when the physician is in their home it is much more difficult to hide problems.
So What’s the Right Care for You? If you or a loved one are aging in place at home, you may want to consider an array of services that can be brought into the home. Regular home visits from a physician with a focus on preventative care could help keep you healthy and avoid medical issues that crop up from getting worse and putting you in the hospital. If you do end up in the hospital, setting up home care and rehabilitation services in the home following the stay could mean you can return home versus going into a rehabilitation center. Check out our previous blog that covers the differences between skilled nursing facilities and home care.
About the Author: Pam Reynolds, CMC is the President and co-owner of Allegiance Aging Care Services. Pam has spent almost fifteen years working in senior care including long term care facilities and home health care. Her higher education is in Social Work, and she has been credentialed as both a certified Geriatric Care Manager and Licensed Assisted Living Administrator. Read more about Pam and her team of Aging Care Professionals here.