Hospitals

Hospitals in the United States face many challenges in providing high-quality health care in a cost-effective manner. Compounding these challenges are many factors outside of their control. Medicare beneficiaries hospitalized for certain diagnoses can put a hospital’s reimbursement from Medicare at risk if they are readmitted within 30 days of discharge. Many of the risk factors for readmission are difficult for a hospital to influence. Physician Housecalls can help reduce the risk of readmission by visiting patients within a few days of hospital discharge.

Patients discharged from the hospital setting are often weak and less mobile than they were prior to the hospitalization. These factors make it difficult for them to make the trip to their primary care physician’s office; therefore they meet Medicare’s homebound criteria and qualify for home visits. 

Physician Housecalls can eliminate all of these rehospitalization risk factors by visiting patients in the safety and comfort of their own homes. Close coordination with the hospital discharge planner allows the patient to be seen within 2-3 days of hospital discharge. Physician Housecalls providers can continue to see the patient as often as necessary until the patient feels well enough to return to a regular physician. The patient may elect to keep Physician Housecalls as their primary care provider. Obviously, patients who enter the hospital and have not been previously followed by a primary care provider can elect to have Physician Housecalls assume this critical role on an ongoing basis.

Hospitals know it is essential patients have a primary care provider to write orders for home health and hospice services. These post-acute services are often necessary to help the patient return to their optimal state of health and to stay out of the hospital setting. Physician Housecalls works closely with the patient’s home health or hospice agency to assure all needs are met.

Insurance Companies

Homebound Medicare beneficiaries are typically frail and have multiple chronic disease comorbidities. Because it is difficult for them to visit their primary care physician’s office, they tend to not be seen as often as necessary to stabilize their disease processes. As a result, this small percentage of beneficiaries utilize a greatly disproportionate amount of the Medicare resources by being hospitalized several times a year. Medicare conducted its own study, Independence at Home, which showed that home-based primary care services, such as Physician Housecalls, can save an average of 35% of the annual health care costs for these individuals. As a result of that study, Medicare has continued to introduce new billing codes to encourage this type of care. Other types of insurance coverage for this population are also adding home-based primary care services to their coverage and enjoying the cost avoidance of repeatedly cycling into the acute care system.

Having a provider in the patient’s home allows for a much better assessment of environmental and caregiving factors that may greatly impact the patient’s health. The reality of a patient’s daily life is difficult to assess in a 15-minute clinic visit, and yet is often the most influential factor in their ability to comply with the treatment plan and to recover.