A Proven Model: National Demonstration Validates Treating Frail Elders in their Home Saves in Medicare Costs
The Medical House Call program at MedStar Washington Hospital Center announced positive and promising results in its first year as part of a national Independence at Home Demonstration, focusing on providing high-quality care to chronically ill elders in their home.
June 18, 2015
Medical House Call Program Improves Care and Lowers Costs in First Performance Year
Washington, D.C., June 18, 2015 – The Medical House Call program at MedStar Washington Hospital Center announced positive and promising results in its first year as part of a national Independence at Home Demonstration, focusing on providing high-quality care to chronically ill elders in their home. The program has proven that a home-based approach ensures not only better care and a better patient experience, but also reduces total Medicare costs. The results support what has been an effective model of elder care for 16 years in the nation’s capital.
“The Independence at Home Demonstration changes the way Medicare rewards providers,” said K. Eric De Jonge, MD, co-founder of the Medical House Call program at MedStar Washington Hospital Center. “CMS will now pay providers for good clinical and financial results, and allow these providers to share in the total cost savings.”
As part of a Mid-Atlantic Consortium (MAC), MedStar Washington Hospital Center will share in a $1.8 million payment from the Centers for Medicare & Medicaid Services (CMS). The government is rewarding participating practices that succeeded in reducing Medicare expenditures and met quality goals by allowing them to share in the savings. The MAC met all six quality measures and reduced per capita Medicare costs by 20 percent. The consortium also includes house call programs at Virginia Commonwealth University and the University of Pennsylvania.
More than 60 percent of the patients in the consortium were enrolled in the Hospital Center’s program. As an Independent at Home practice, beneficiaries of the Medical House Call program, on average:
- have fewer hospital readmissions within 30 days,
- have follow-up contact from their provider within 48 hours of a hospital admission,
- have their medications identified by their provider within 48 hours of discharge from the hospital,
- have their preferences documented by their provider, and
- use inpatient hospital and emergency department services less for conditions such as diabetes, high blood pressure, asthma, pneumonia and urinary tract infection.
“The results are gratifying as it underscores the value of our teams’ daily work,” said George Taler, MD, the other co-founder of the Medical House Call program. “The savings payments will help us expand our program and serve more patients across the region.”
Frail elders who need home-based primary care represent only 5 percent of the patient population, yet account for nearly 50 percent of Medicare’s budget, so savings in this group can have a large impact on the Medicare budget. At MedStar Washington Hospital Center, dedicated teams of geriatricians, nurse practitioners and social workers serve patients over time and across settings, are on-call 24 hours a day, seven days a week and travel to homes within a five-mile radius of the hospital. The Medical House Call program, in partnership with MedStar Institute for Innovation, has served as one of 15 national IAH sites since 2012.
MedStar Washington Hospital Center is a 926-bed, major teaching and research hospital. It is the largest private, not-for-profit hospital in the nation’s capital, among the 100 largest hospitals in the nation and a major referral center for treating the most complex cases. U.S.News & World Report consistently ranks the hospital’s cardiology and heart surgery program as one of the nation’s best. It also is a respected top facility in the areas of cancer, diabetes & endocrinology, Ear, Nose & Throat, gastroenterology & GI surgery, geriatrics, gynecology, nephrology, pulmonology and urology. It operates MedSTAR, a nationally-verified level I trauma center with a state-of-the-art fleet of helicopters and ambulances, and also operates the region’s only adult Burn Center.
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