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Resurgence of Physician House Calls

May 6, 2022

Soon healthcare may look more like the care your grandparents and their parents received.

A century ago, physicians went to the patient, not the other way around. In fact, during the 1930s, nearly half of all doctor visits took place in the patient’s home. So, what happened? And why are physician house calls making a comeback?

What Happened to Physician House Calls?

Nearly a century ago, it was standard practice for a doctor to visit a sick or injured patient. Sometimes patients couldn’t travel long distances because of the time and cost of traveling. As a result, physicians made house calls.

But following World War II, there was a decline in physician home visits. By the 1950s, house calls dropped to 10%. By 1996, house calls accounted for only 0.5% of doctor visits.

One of the main reasons for this change was that house calls were time-consuming. Traveling doctors spent valuable hours getting to and from patients rather than treating sick patients.

Another reason for the decline in house calls was financial. Around 1996, the standard insurance reimbursement for a physician house call was $87, even though home health skilled nurses ($97), physical therapists ($99), and occupational therapists ($102) received more per visit for in-home care.

Starting around 2000, Medicare and Medicaid increased physician reimbursement for home visits. As a result, between 2000 and 2006, the number of physician house calls to Medicare beneficiaries doubled. Still, the number of physicians making house calls continued to decline.

The Resurgence of Physician House Calls

Interestingly, a new generation in healthcare is again embracing the physician house call. Research has shown that house calls are invaluable to medical practice. They give doctors personal gratification while improving patient satisfaction. 

Here are a few more reasons that house calls are making a comeback:

  • increased demand by the rapidly aging population
  • advancements in mobile technologies
  • improved reimbursement

Home-based primary care, as it’s known, is becoming popular again. Fortunately, it’s just the right time.

The Need for Physician House Calls

One reason for the house call reprise is a growing need for in-home services.

It is estimated that 10,000 baby boomers will join Medicare every day until 2029. The fastest-growing age group in the US is those aged 85 and older, projected to quadruple by 2050.

Over half of this population has impaired mobility. The US homebound population is skyrocketing. Experts suggest it will double over the next 20 years.

There is a clear need for homebound services. But the elderly and infirmed are not the only ones that need physician house calls. Often, caregivers can’t find time to get to a doctor for their own health needs. Physician house calls are a solution for many.

 The Ability to Perform Expanded House Call Services

Another reason that house calls are making a comeback is better technology. Thanks to recent advancements, Doctors can now perform many diagnostic tests in the home. These include:

  • Mobile x-rays
  • Electrocardiograms
  • Blood tests
  • Mobile ultrasounds

Physicians now have more tools to help them make fast and accurate diagnoses in the home. 

Another benefit of technology is that doctors can view medical records virtually anywhere. Secure mobile apps and programs allow them to set up mobile offices. Providers can fax, scan, and retrieve documents in seconds. House calls are easier now than in days past.

Payment Changes for Physician House Calls

Payment reform is another reason for the rise in physician home visits. In 2000, payments for house calls were increased. And in 2006, Medicare added new billing codes, which further increased provider payments. Then, the COVID-19 Public Health Emergency (PHE) increased payments for telemedicine visits.

Today, doctors and other providers are starting or expanding house call practices to meet the need and growing demand in the healthcare system.

Physician House Calls Benefit Patients

Studies have shown that physician house calls benefit patients in many ways, including:

  • better identification of problems
  • more affordable
  • improved care quality
  • better patient experience

 Research also shows that patients appreciate the personal touch of a physician who meets them in their homes.

Virtual Physician House Calls

According to the Home Centered Care Institute, over 7 million people in the US need house calls, but only 15% can access services. Undoubtedly, telemedicine will continue to increase access to healthcare.

The best example of this is MVP’s Mobile Virtual Physician Visit. This innovative house call solution provides the benefits of a physician house call with added advantages of flexible scheduling and convenient appointments.

In the Mobile Virtual Physician Visit model, a certified medical assistant goes to the patient’s home and performs “hands-on” services, vital signs, and lab work. At the same time, they bring in a video device that allows the doctor to consult with the patient as if they were there. Patients get to ask questions. And doctors can view the home environment or even perform a home safety evaluation. Patients with chronic diseases can see their doctor weekly or every other week without the expense or trouble of leaving home.

Modern services are combining high-quality healthcare with new ideas. These innovations are the future of healthcare. And the resurgence of physician house calls will also play a role in these changes.

 

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Sources:

65+ in the United States: 2010”. census.gov. Accessed May 2, 2022.

Home Centered Care Institute”. hccinstitute.org. Accessed May 2, 2022.

House Calls Are Reaching the Tipping Point- Now We Need the Workforce”. ncbi.nlm.nih.gov. Accessed May 2, 2022.

Housecalls to the Elderly – A Vanishing Practice”. nejm.org. Accessed May 2, 2022.

“More House Calls by Fewer Physicians”. jabfm.org. Accessed May 2, 2022.

Rising Demand for Long-Term Services and Supports for Elderly People”. cbo.gov. Accessed May 2, 2022.

“The family physician and homecare”. pubmed.ncbi.nm.nih.gov. Accessed May 2, 2022.

Trends in Physician Housecalls to Medicare Beneficiaries”. jabfm.org. Accessed May 2, 2022.

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