In the early 1900s, doctors made house calls as it was the only way most people had access to health care. However, this care delivery model became less popular with the advancement of technology and the growth of third-party payers and shifted from the home to clinics and hospitals. It is also important to note that the Fee-for-service (FFS), the traditional reimbursement structure of the Center for Medicare and Medicaid Services (CMS), and other third-party payers made house calls financially unsustainable. In a fee-for-service model, physicians and hospitals are paid based on the number of services provided or the number of patients seen. Logistically, it was much easier for doctors to see more patients or render more services in the office rather than travel to their patients’ homes.
TIME For A Change
In recent years, there has been an increased demand to shift from fee-for-service (FFS) to a value-based care model that reimburses the quality of care provided rather than the number of services (quantity) rendered. In addition to recent regulations and growing interest in policy changes that favor care in the home, technology once again is making the return to medical care in the home a possibility. Portable and wearable medical devices are being utilized to modernize home care. Patients can now be monitored and receive treatments in the comfort of their homes. During the COVID-19 pandemic, when many of us did not have access to doctors’ offices or avoided hospitals, telemedicine emerged as a significant care delivery component. House calls, supplemented with virtual visits (telemedicine), provide patients with improved access to doctors—a particularly meaningful solution for homebound patients who have difficulty getting themselves to the doctor.
DELIVERING VALUE
House calls do a lot more than provide convenience. Research has shown that they provide tremendous value by improving health outcomes and reducing overall medical costs. Patients build better rapport with their doctors, have fewer emergency room visits and avoid unnecessary hospitalization. With patients at the center of care, doctors spend more time with their patients, make holistic assessments and treatments based on medical, behavioral, and social factors. Recently, a number of providers, including hospital groups, have returned to providing house calls for their patients. With the center of Medicare and Medicaid Services (CMS) support and the increased interest in promoting care models that align with quality, house calls modernized by technology will undoubtedly deliver the value that patients deserve.
REFERENCES:
https://academic.oup.com/biomedgerontology/article/56/10/M603/584909