Independence at Home Program Is Working, Study Shows

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)
Independence at Home Program Is Working, Study Shows

A new study shows the value of caring for patients in the lowest-cost setting – the patient’s home.

MedStar Washington Hospital Center recently published a study in the Journal of American Geriatrics Society (JAGS) that showed a 17% reduction in Medicare costs when care was extended to the home. The hospital participates in the Medicare Independence at Home demonstration program, an ongoing effort to study the effectiveness of delivering comprehensive home-based primary care services. The program is intended to determine whether such care helps Medicare beneficiaries with multiple chronic conditions and saves money at the same time.

The hospital’s Medical House Call program began in 1999, with an interdisciplinary team of physicians and nurse practitioners providing 24/7 telephone coverage. Team members visit patients at home and follow them during hospital admissions. Social workers coordinate psychosocial and supportive services.

The five-year study showed that home-based primary care saved an average of $8,477 per patient over two years. While the overall death rate between the house call and control groups was similar, participants in the program benefited by having:

  • 9% fewer hospitalizations
  • 20% fewer emergency department visits
  • 27% fewer skilled nursing home stays
  • 23% fewer specialty visits

In the study, Dr. K. Eric De Jonge, co-founder of the program, said that he believes payers and the Centers for Medicare and Medicaid Services should expand funding for such programs.

Although the program didn’t necessarily extend the lives of patients, it did improve the overall quality of life. Imagine if one out of every four of your clients could stay out of a nursing home or one in five could avoid an ED visit. How much better would their lives be?

Home health agencies are uniquely situated to create or participate in similar programs. Check with your local hospitals or regional health agencies. How can your agency help them keep patients where they want to be – at home?

For more information on the effectiveness of home-based primary care services, check out this study from the Johns Hopkins Hospital School of Nursing.

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