The Doctor Is In. In Your House, That Is
Growing evidence has shown that comprehensive home medical care has the potential to be a viable alternative to the rising costs of care home facilities. The increasingly sophisticated nature of medical technology allows X-rays, EKGs, medical record notation and other medical care to be carried out at home. House calls to Medicare patients increased from 1.5m in 1995 to over 2.6m in 2014. 50% of total medical expenses are caused by the top 5% of care-intensive patients, with an average cost of $43,000 per patient. Under the current system, it costs more to treat patients at home; Dr. Cornwell of the non-profit House Call Project hopes to see a new payment model which would enable Medicare to provide savings from hospitalization for house call care. The proposed Independence at Home Act (S.3130) will support an extension of a Medicare home care demonstration program to provide severe chronic illness and disability patients with primary care at home. The home medical care program demonstrated savings of $35m, between $1,000 and $3,000 per patient. Before the proposed Act can be passed into law, there are still legal and medical issues that need to be resolved before home medical care can be introduced on a large scale.

REMEMBER when doctors made house calls?

While only a relative handful of doctors still offer them, there is growing evidence that comprehensive home medical care could be a viable alternative to the attendant woes and soaring expenses of institutional health services, particularly for those in late retirement.

It will take some important legislative changes before focused, less intrusive care in a dignified, comfortable setting can become more widely available. The polarizing politics surrounding the Affordable Care Act makes any reform to the health care system particularly challenging. Still, given the overall popularity of Medicare — Hillary Clinton and Donald Trump both say they support it — getting a new home medical care benefit through Congress looks more promising.

At the heart of the home care renaissance is a combination of high-tech, portable medical equipment and the age-old practice of doctors coming into the home to personally examine and treat their patients.

“We can do X-rays, EKGs, medical records and other applications in the home,” said Dr. Thomas Cornwell, who has made more than 32,000 house calls in his Chicago-based practice and wants to see Medicare support more home-based medical care.