Medicare project: House calls for frail seniors cut costs

[Omaha Steve]

Source: AP

BY LAURAN NEERGAARD

WASHINGTON (AP) -- The humble house call is being put to the test to see if it can improve care and cut costs for some of Medicare's frailest patients - and new data suggests it can work.

Medicare announced Thursday that it saved more than $25 million in the first year of a three-year study to determine the value of home-based primary care for frail seniors with multiple chronic illnesses, by avoiding pricier hospital or emergency room care.

Dr. Patrick Conway, Medicare's chief medical officer, says the house call delivers "high-touch" coordinated care that allows doctors and nurses to spot brewing problems in a patient's everyday environment before he or she worsens.

"If we can keep people as healthy as possible and at home, so they only go to the hospital or emergency room when they really need to, that both improves quality and lowers cost," he said.

FULL story at link.


In this photo taken June 17, 2015, Dr. Pamela Miner, right, and nurse Mary Sayre pose for a photo at the Housecall Providers office in Portland, Ore. The humble house call is being put to the test to see if it can improve care and cut costs for some of Medicare's most frail patients, and new data suggests it can work. (AP Photo/Don Ryan)

Read more: http://hosted.ap.org/dynamic/stories/U/US_MED_MEDICARE_HOUSE_CALLS?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT

[Hoyt]

1. +1. House Visits by docs, advanced practice nurses, PAs, etc., would be enormous benefit.

Home health does some of that, but not to same degree. The payment rates for home visits hasbeenao low, few doctors do it unless patient can afford to pay more.

[brer cat]

2. It does make sense.

The cost savings are a major factor of course, but I also think about easing the wear and tear on the patients. There were so many times my parents simply could not face the trips to a doctor, waiting time, etc. and would delay going. For many patients, a delay in receiving care can have very costly and possibly fatal results.

[Dont call me Shirley]

3. This is great news. Now expand to people who are too sick to leave the house.

in

[justhanginon]

4. Certainly sounds like an idea worth exploring if they can

work out the economics regarding compensation for the providers. I would think if a person was in fragile shape from a chronic condition it could do more harm than good having to prepare them and then transport them to an office or hospital where they are among people with other myriad diseases which may or may not be contagious. Plus having to do it at sometimes close intervals. It sounds like they have most of what they need at hand for the visits plus the added advantage of seeing the home environment and taking that into consideration in the treatment.

[jwirr]

5. I thought every state in the US had this already. Here in MN we have had a senior waiver that

allows Medicare to keep patients in their own homes for more than a decade. Our nursing homes are intensive care wards. We use a screening team to determine the needs of clients.

And this is not just for seniors. The last part of the time I was taking care of my daughter in our home we had services that helped me take care of her. At first Medicaid waiver paid for them and then when she got on her dad's ssa Medicare paid for it.

Services that I know exist include home health aides who help with bathing, PT, respite and other health issues, RNs who both supervise the aid and give care when needed, homemakers who help with house work - shopping, drivers who help with transportation needs, meals on wheels, equipment and any other issues. The savings are made because these workers are in the home (usually) for a limited number of hours instead of full time and because family often are there to give extra assistance. The doctors came if I could not get my daughter to their office. But for her it was actually good for her to get out off the house.

This is an extremely good service.

[dembotoz]

6. care should be taken to see where costs are shifted. in walkers wisconsin state programs

increasingly bill back to the estate.

this included some of the home health care ones
form early in probate process lists various programs
as you check them off as to having used them, the state shows up at your door.

[blackhawk2415]

7. Opinion

Interesting read, although I think the scenario is highly circumstantial.