According to a study by RAND Corporation, sending physicians or nurses to a Medicare recipient's home for a comprehensive health assessment can result in fewer admission to hospitals or nursing homes. The programme may result in patients visiting doctors more often but at the same time, it also reduces costs by trimming the amount of care provided. The findings are published in Health Affairs.
"We found that a home visiting programme can lead to meaningful cuts in the amount of in-patient care used by Medicare patients," said Soeren Mattke, the study's lead author and a senior scientist at RAND, a nonprofit research organization. "This is significant since many other strategies to reduce in-patient care among Medicare recipients generally have been unsuccessful."
Study researchers evaluated the experiences of patients enrolled in the HouseCalls program operated by Optum. They send physicians or nurse practitioners to a Medicare recipient's home for a comprehensive assessment with referrals to community providers and health plan resources for any issues that are not covered. Experiences of these patients were compared to other Medicare recipients enrolled in either the fee-for-service Medicare plans or the Medicare Advantage plans.
The findings show that patients who were enrolled in the HouseCalls programme had 14 percent fewer hospital admissions as well as a lower risk of admissions to nursing homes over the 12 months after they were evaluated as compared to those who were enrolled in the traditional fee-for-service health programmes. The decline in admissions was smaller when compared to patients enrolled in the Medicare Advantage plans.
Patients enrolled in the programme showed a 2 to 6 percent increase in visits to specialists in the year following the evaluation. The effects of the programme on emergency department visits was mixed.
Nearly 70 percent of Medicare recipients are elderly (65 or older) and suffer from multiple chronic conditions. Mattke points out that the results of the HouseCalls programme show that a combination of in-home assessment and follow-up on recommendations has the potential to help elderly patients age safely in place and avoid unnecessary institutional care.
Source: Rand Corporation
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