Can old-fashioned physician house-calls save money?

At least in one Virginia city, it's looking like an old-fashioned practice is offering the very modern benefit of providing quality care at lower costs. In Richmond, a program putting a team of doctors and nurse practitioners on the street, making house calls to homebound patients, seems to be doing a good job of helping them keep these patients health enough to avoid needless hospital visits.

The program is headed by Dr. Peter Boling, who leads a group of four doctors and five nurse practitioners. All told, the clinical team sees about 275 homebound patients who live within 15 miles of their hospital. Each patient gets a visit about once a month.

Because these patients have multiple chronic conditions, ranging from diabetes to heart disease to Alzheimer's, it's difficult for them to get to their doctor's office to get checked out when they have minor symptoms, so often they end up heading for the emergency department whenever there's a doubt as to their status.

While Medicare isn't paying enough to cover the program's $1 million annual budget, the remaining $500K is picked up by Virginia Commonwealth University Medical Center. Administrators at the hospital say it's worth spending the money, since the facility saves $1,500 for every day it can keep a Medicare patient out of the hospital. To date, it appears the program has saved VCU Medical Center about $2 million between 2003 and 2006.

To learn more about the program:
- read this Los Angeles Times piece

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