Insiders' Insights

House Call Resurgence

An aging population, advances in portable medical technology advances, and a change in Medicare's physician reimbursement sparked a 43 percent jump in the annual number of house calls between 1998 and 2004, according to the American Medical Association. However, recent reimbursement trends may threaten this growth.

Constance F. Row
Executive Director
American Academy of Home Care Physicians
Edgewood, MD

There are two major factors driving the increase in house calls: the aging of the population and, with it, the growth of people who have multiple chronic conditions and prefer to be cared for at home. From a hospital administrator standpoint, the biggest benefits are reduced unnecessary emergency room visits and inpatient hospitalizations. Many people are unable to access timely physician-office care and are left getting their primary care in the ER. The majority of physicians doing this are primary-care doctors who see the need for this kind of home care. On the other hand, reimbursement is a huge concern. Reimbursement was raised in 1998, but recently it has been going in the wrong direction, which could make it financially unfeasible for practices to see Medicare patients. Many patients cannot private pay, so house-call services would be discontinued.

Ben Olusola, MD
Family Physician
Medical Center at Lancaster
Lancaster, TX

When I go into the field, I see a lot of people with medical conditions who are in need of follow-up, if not intervention. Most of these people do not have a way to get to the doctor, clinic or hospital, which leads to complications resulting from delays in initiating treatment. When you see patients at home in their environment, it enables you to know them better. Maybe this person doesn't have a way to get to the bathroom from their bedroom, so you can give them some mobility devices or order physical therapy. I get more satisfaction doing house calls than seeing patients in a clinic, because they see me as their doctor, friend and member of the family. The reimbursement is reasonable, but it is not the only factor driving it. I think a lot has to do with the satisfaction that you get, the flexibility of schedule, and the fact that you are able to do more for the patient.

-Carrie Vaughan