USA Today Examines Resurgence Of House Calls As Part Of Effort To Keep Older Patients Out Of EDs, Contain Costs

Main Category: Caregivers / Homecare
Also Included In: Primary Care / General Practice;  Medicare / Medicaid / SCHIP
Article Date: 06 Apr 2006 - 11:00 PDT


USA Today on Tuesday examined the "small but growing number of patients" across the U.S. who receive regular medical visits from doctors making house calls. According to USA Today, the number of Medicare beneficiaries receiving medical care at home has increased since Medicare raised payments for house calls in 1998. Last year, Medicare paid for about two million home visits, or about 1% of outpatient visits for medical care. In addition, Medicare has established a three-year pilot program in which 15,000 chronically ill elderly patients in California, Florida and Texas can receive in-home care from board-certified physicians 24 hours a day, seven days a week. Beneficiaries pay nothing beyond their traditional, fee-for-service Medicare premiums. Most of the patients have "limited mobility or failing minds and would otherwise never see a doctor unless taken by ambulance to the emergency room," which is "the most costly and traumatic venue for health care," according to USA Today. However, the supply of doctors willing to make house calls does not meet demand, Constance Row, executive directors of the American Academy of Home Care Physicians, said. She noted that there is a nationwide shortage of primary care doctors and geriatricians because most doctors prefer to specialize in more lucrative areas of medicine. Robert Shannon, a physician in Michigan whose practice is made up solely of people who use house calls, said he needs to make about five house calls a day to break even. He said, "We're not making a lot of money, but we're not going broke." David Phelps, a geriatrician in Kansas, said that by limiting one's practice to house calls, "you have fewer patients and more time to spend with them." Bonnie Kantor, a gerontologist at Ohio State University, added, "Technologically, we can do so many more things in the home than we were able to do" (Rubin, USA Today, 4/4).

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