Article

The Doctor May Be Coming to You. Are We Seeing the Return of the House Call?

February 14, 2023
Doctor with patient at house call

Physician house calls have become less common over the last 100 years or so. Commonly cited figures state that in the 1930s, house calls comprised 40% of all patient visits. That number dropped to 10% by the 1950s and less than 1% by 1980.

Reasons for the decline include:

  • Doctors require more time when traveling to homes.
  • Doctors can see many more patients in the office versus at home during a typical day.
  • Low insurance reimbursement rates discouraged home visits.
  • Many essential medical equipment tests and equipment were not portable.
 

House calls are making a comeback, thanks in part to portable technology and better reimbursements. Granted, the shift toward house visits is small, but the non-acute healthcare industry would benefit from the return of house calls, which is why the market is predicted to experience continued growth.

INCREASING NEED FOR IN-HOME DOCTOR APPOINTMENTS

The U.S. house calls market was valued at $538 million in 2022, according to Grand View Research. The market is expected to reach $831 million in 2030. “Increasing demand for cost-efficient, accessible and convenient services for healthcare and wellness is expected to drive the industry growth,” the report states.
 
Another driving factor is the rapidly aging population. The fastest-growing age group in the U.S., 85 years of age and older, is projected to quadruple by 2050—with half of these individuals experiencing impaired mobility. In addition, 10,000 baby boomers become eligible to join Medicare every day between now and 2029. Elderly adults with dementia or other conditions can feel stress and anxiety when they go out in public alone for an appointment.
 
“With the coming demographic changes, it seems doctors may be making more home visits in the near future,” according to MD at Home.

THE EVOLUTION OF TECHNOLOGY LEADS TO PORTABLE DEVICES

The advancement of medical technologies that enable physicians to bring equipment on the road has made house calls easier. Doctors can now perform mobile electrocardiograms, some medical tests and other services remotely, with some equipment compact enough to be handheld.

Much of this medical equipment is the same or similar to the tools of the trade used by home healthcare professionals, who provide services such as changing bandages and wound dressings, administering medication, health monitoring and rehabilitation exercises. This type of care is often provided to manage an illness, injury or health condition.
 
Physicians who make house calls and home healthcare providers can benefit from devices like ultrasound machines that were once exclusive to office visits but are now smaller and therefore easily transportable. Some equipment is considered standard for all types of care, both in the home and inside facilities, such as a stethoscope, blood pressure cuff, wound care products and equipment to measure vital signs.
 
Like home healthcare visits, house calls can cover throat cultures, blood draws and other essential services. Common medical products for home healthcare and at-home doctor visits include medical gloves, alcohol pads, swaps, thermometers and similar items essential to providing care.

“Physicians now have more tools to help them make fast and accurate diagnoses in the home,” according to My Virtual Assistant. “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.”
 
Electronic health records provide significant benefits. Unlike previous generations of healthcare, providers can now see patients’ medical history outside of the office to help inform healthcare decisions during at-home visits.

“The population that most needs in-home care continues to grow exponentially and will do so for the foreseeable future, creating more demand for house calls.”

ORGANIZATIONS LEADING THE CHARGE FOR AT-HOME CARE

Several organizations are currently offering house calls and could serve as a model for others. For example, Doctors Making Housecalls provides primary care in more than 400 communities in North and South Carolina. Its 125 clinicians provide more than 160,000 house calls each year.
 
“Doctors Making Housecalls was created to serve patients in the comfort of their own environment,” says the company’s website. “Our special expertise is in improving the quality of care for high-risk patients, while simultaneously reducing costs and the unnecessary consumption of healthcare resources.”
 
Signify Health also provides care in the home, both in-person and virtually. The company’s clinicians were expected to connect with nearly 2.5 million patients in their homes in 2022.
 
“Signify Health is a leading healthcare platform that leverages advanced analytics, technology and nationwide provider networks to create and power value-based payment programs,” according to its website. The company, which has more than 10,000 licensed clinicians in its nationwide network, was purchased by CVS for $8 billion in September 2022.

IN-HOME CARE CORRESPONDS TO PATIENT NEEDS

Medicare and Medicaid seemingly realized the growing need for in-home care at the start of this century. In 2000, Medicare and Medicaid increased physician reimbursement for home visits. As a result, the number of physician house calls to Medicare beneficiaries doubled between 2000 and 2006.
 
There’s also evidence that home-based care can save money. In 2016, the Centers for Medicaid and Medicare Services (CMS) found that treating chronically ill Medicare beneficiaries in the home saved an average of $1,010 per beneficiary while also delivering high-quality care.
 
The drawback continues to be that during an eight-hour day, physicians see fewer patients for home visits than they would see while providing care in a facility. However, the population that most needs in-home care continues to grow exponentially and will do so for the foreseeable future, creating more demand for house calls.

Non-acute healthcare organizations that are considering adding house call services to their offerings should talk to their group purchasing organization. A GPO has the expertise to help members break into new markets and also has the products needed for in-home care at industry-best pricing to help members be competitive and successful.

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