More physicians performing house calls

The Washington Post on Tuesday examined how a "small but growing tribe of doctors, nurses, physician assistants and nurse practitioners ... are reviving [the] once-common practice" of performing house calls.

According to a recent article in the journal Clinics in Geriatric Medicine, advancements in technology, lack of financial incentives and lack of coverage by private insurers caused house calls to decline over the years. However, house calls have "been making somewhat of a comeback" after Medicare in 1998 modified its billing procedures to allow payment for home visits to the elderly and chronically ill and increased payments by 50%, the Post reports. The number of physicians performing house calls increased from 1.5 million in 2000 to nearly 2.2 million in 2007, but according to Constance Row, executive director of the American Academy of Home Care Physicians, house calls still account for fewer than 1% of all outpatient visits.

Advocates contend that house calls could help reduce costs and improve quality of care, particularly for home-bound seniors who comprise 5% of the Medicare population but account for more than 43% of the program's budget. An analysis by George Taler -- a physician at Washington, D.C.-based Washington Hospital Center, who performs house calls -- and colleagues found that house calls resulted in a 60% savings to the health care system in general, but that the reduction in emergency department visits and hospital admissions led to less money for the hospital and its programs (Mishori, Washington Post, 3/24).