House Calls Returning?

The Los Angeles Times reports on programs which are encouraging the use of house calls, particularly for patients who have chronic illnesses and those who have difficulty getting to a physician’s office.  (LA Times Article) The article focuses on a program in Richmond, Virginia which sends doctors and nurse practitioners to patients’ homes, hoping to avoid emergency room and hospital visits and costs by identifying and managing potential problems before they necessitate more expensive treatment.   A subset of the patients are those who have been recently discharged from a hospital, with the goal of avoiding readmissions.  Medicare does not pay enough to cover the extra cost of these residence visits, nor do many other payers.  A local hospital actually subsidizes about half the cost because avoiding hospitalizations saves the medical center money since it loses money on Medicare hospital payments.  Some health reform proposals have suggested encouraging these home visit programs by changing Medicare and other payer reimbursements.  That would appear to be a worthwhile idea and consistent with the recognized opportunity to improve health status and reduce costs by better managing patients with chronic diseases.