House Calls Are Making a Comeback
Do you remember when doctors made house calls? While the practice generally has been abandoned for the past 40 years, it seems to be making a comeback in the 21st century, due to rising healthcare costs.
A new federal program called the Independence at Home Demonstration, created by the Affordable Care Act, will test the effectiveness of providing healthcare to thousands of chronically ill Medicare patients in their own homes, allowing them to remain there instead of potentially entering long-term care facilities. The three-year pilot program, launched January 1, 2012, was developed with the intent to keep medical costs down by helping high-risk patients with multiple illnesses avoid being hospitalized.
Under the program, medical care is available 24 hours a day, seven days a week and is administered in the patient’s home by a medical team that includes physicians, nurses, physician assistants, pharmacists and other health and social services staff. If a doctor can make regular house calls to monitor a senior’s health – checking blood pressure, improving diet, providing medication reminders – hopefully serious health issues can be prevented.
The Independence at Home Demonstration program could have many benefits besides reducing Medicare costs. The program will provide seniors the ability to maintain their independence and should improve their health because they will receive comprehensive, high-quality care in their own homes from a member of a dedicated medical team. It also is hoped that a senior patient and his or her family members will be happier with the care the patient receives.
Would you like to be a part of the Independence at Home Demonstration pilot program, either as a patient or healthcare provider? Why or why not?
My response is two fold; yes, as an RN I would like to be part of a team that would provide quality services to Medicare patients at home. I have worked in skilled nursing facilities and a state-run veteran's hospital and they do serve a good purpose, however, I believe in preserving the patient's desires and their dignity in the comfort of their own home. Providing in-home care provides the client and their family with the support they need while maintaining the family unit. I believe the pilot program will prove to be a success in more than keeping costs down. Now as a family member of a patient who needs 24-hour supervision and the family has chosen to keep our loved one in their own surroundings as long as possible, I am interested in retrieving additional information to evaluate if we qualify for the pilot program.
Thank you for your insights on the Independence at Home Demonstration program. According to question A24 of the "IAH Frequently Asked Questions" document, in order to be counted as part of this demonstration, patients must meet at least seven requirements. Click this link to access the document: https://www.cms.gov/DemoProjectsEvalRpts/downloads/IAH_FAQ.pdf. Thanks, again, for your comment!
Fantastic blog post Rita! Thank you for the link to the IAH frequently asked questions. Do you have any more information on this pilot program?
John: I suggest going to the following website to access more information about the Independence at Home Demonstration program: https://www.cms.gov/demoprojectsevalrpts/md/itemdetail.asp?itemid=CMS1240082. Thank you for submitting your comment!
Rita, thanks so much for this very valuable information!
I'm definitely interested ... It is one of my daily objectives to find alternatives for senior care. Is this pilot program nationwide?
Yes, CaBrina, the pilot program is nationwide, but there are eligibility requirements. The senior must have multiple chronic conditions; be covered by original, fee-for-service Medicare; require someone's assistance with two or more activities of daily living (for example, bathing, dressing, eating or walking); have had a medically necessary hospital admission within the past year; and have recieved rehabilitation services in the past year. Please click on the link in the blog (Independence at Home Demonstration) for more information. Thanks for your comment!