A new program called Independence at Home, part of the Affordable Care Act, provides incentives for selected primary-care providers who are able to save money by making time-consuming home visits to medically complex patients.
These patients are often in such serious condition that they find it difficult, if not impossible, to get to scheduled appointments. As a result, they may put off needed treatment until an emergency lands them in an expensive hospital bed.
House calls were long the main point of contact between patients and doctors. But in recent decades, low reimbursement rates, among other things, have encouraged physicians to maintain high-volume offices, making house calls hard to squeeze in. In 2010, Medicare paid more than three times more for beneficiaries with six or more chronic conditions than for the average recipient. As a group, they made up 14 percent of the total Medicare population, but accounted for almost half the total spending. For its home-visit experiment, the Centers for Medicare and Medicaid Services contracted with 20 providers or groups nationwide with up to 10,000 of Medicare’s sickest patients. The idea is that encouraging providers to invest up front in house calls and other home services that don’t generate extra revenue will improve care and avert more expensive treatments down the road.
If the participating practices hit quality benchmarks and consistently save money, they share those savings with the government. That’s the incentive. In California, the practices and universities who are experimenting with this concept can be found at HTTP://innovation.cms.gov/initiatives/map.
Ms. MacDonald’s practice is limited to Estate Planning, Probate, Elder Law & Trust Administration. Ms. MacDonald maintains her practice in the Santa Clarita Valley at 25115 Avenue Stanford, Suite B-124 in Valencia, California. She can be reached at 661-294-6464.