ElderLaw News — The Estate Planning & Elder Law Firm, P.C. — MD, VA, DC
ElderLaw News

ElderLaw News is a weekly e-newsletter that brings you reports of legal developments and other trends of vital interest to seniors and their advocates. This newsletter is brought to you by The Estate Planning & Elder Law Firm, P.C., William S. Fralin, Esq., President.

Medicare Project for Home Visits

The idea of physicians making house calls may seem old-fashioned, but for frail seniors, bringing the medical practitioners to the home makes sense.

A recent Los Angeles Times article discusses a new Medicare demonstration project regarding home visits.  The three-year project was included in healthcare reform and is called Independence at Home.  Supporters of the project say it is further recognition of the importance of staying at home rather than going to an institution.  “It will help expand these programs and acknowledge Medicare’s role in them,” says Elinor Ginzler, a senior vice president at AARP.

Approximately 10,000 Medicare enrollees will be eligible for the project; they must have multiple chronic conditions and be unable to perform the activities of daily living.  Additionally, they must also have been hospitalized or in need of other high-cost care in the past year.  The program is scheduled to begin by January 2012.  Participating healthcare organizations will not receive up-front funding, but if they succeed in cutting treatment costs by 5%, improving health outcomes and getting positive patient reviews, then these groups will share in further savings.  Medicare will pay the practitioners more for home visits as opposed to clinic visits, but Medicare will not pay for travel time or for coordinating care.

The Washington, D.C., area has benefitted from the Medical House Call Program at Washington Hospital Center.  One patient, Karl Schwengel, has congestive heart failure and arthritis.  He relied on neighbors and friends to transport him to a clinic or hospital for treatment.  With the Medical House Call Program, a physician or nurse practitioner visits him every month to monitor his vital signs and medication and assist him in improving his health.  Mr. Schwengel now has a physical therapist on his team who has helped him use a walker at home. 

Washington Hospital Center’s program serves approximately 600 patients and has reduced expected hospitalizations among participating patients by almost two-thirds, according to George Taler, M.D., co-director of the program.

James Pyles, a Washington lawyer and a member of the board of directors of the American Academy of Home Care Physicians, says that home visits make financial sense.  “We found that you could afford to treat a patient for a whole year at home by avoiding just one hospitalization.” 

Chicago-based Home Physicians serves 12,000 patients in Chicago and Baltimore.  Its clinicians see 10 or 11 patients a day, far fewer than the 30 patients a clinic-based physician may see.  To make the visits pay, Chief Executive Craig Reiff says that he has to carefully schedule the clinicians’ visits.  His clinicians also work in tight geographic areas, and he says, “It could be very difficult to make it work in rural areas.”

The Estate Planning & Elder Law Firm, P.C. News will continue to monitor developments in this area.


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