Practices must weigh pros and cons of adding house calls

Thanks to updates in reimbursement models as well as mobile health technologies, modern physician practices are becoming more amenable to providing house calls, according to an article from Medical Economics.

But while Affordable Care Act initiatives such as the Independence at Home demonstration help pave the way for a house-call comeback, practices need to consider many variables when deciding whether practicing outside the office makes sense. When drafting your pros and cons list, analyze the following:

  • Do you have enough elderly patients who would benefit from a house-call service?
  • Would the reimbursement you receive from house calls offset the costs of vehicle expenses, travel time, liability implications, potential for injury and lost revenue from being away from the practice?
  • Do you have the medical-management ability to help often-frail, elderly patients with multiple chronic conditions live safely and comfortably at home?

Physicians who spoke with Medical Economics described a number of ways they integrated house calls into their practices. For example, Samantha Pozner, M.D., a New Jersey primary care physician, visits patients at home only if they live near her route to and from work, and fits these visits in around her regular office schedule. On the other end of the spectrum, Andrea Brand, M.D., a family physician in Florida, transformed her traditional practice into a cash-only house-call practice serving 300 patients.

Regardless of the specific business models, Rebecca Conant, M.D., founding director of the University of California, San Francisco (UCSF), Housecalls program, predicts the house-call trend will continue its rise. "We're just seeing the cusp of this, with the focus on chronic care management and chronic illness, with medical homes pushing that back out into the community," she told Medical Economics. "If we go upstream to keep people out of hospitals and emergency [departments], they do better, have better outcomes, and it's less cost overall to the system."

To learn more:
- read the article from Medical Economics

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