Medicare Project for Home Visits

October 15, 2010
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The idea of physicians making house calls may seem old-fashioned, but for frail seniors, bringing the medical practitioners to the home makes sense. A recent Los Angeles Timesarticle discusses a new Medicare demonstration project regarding home visits. The three-year project was included in healthcare reform and is called Independence at Home. Supporters of the project say it is further recognition of the importance of staying at home rather than going to an institution. “It will help expand these programs and acknowledge Medicare’s role in them,” says Elinor Ginzler, a senior vice president at AARP.
Approximately 10,000 Medicare enrollees will be eligible for the project; they must have multiple chronic conditions and be unable to perform the activities of daily living. Additionally, they must also have been hospitalized or in need of other high-cost care in the past year. The program is scheduled to begin by January 2012. Participating healthcare organizations will not receive up-front funding, but if they succeed in cutting treatment costs by 5%, improving health outcomes and getting positive patient reviews, then these groups will share in further savings. Medicare will pay the practitioners more for home visits as opposed to clinic visits, but Medicare will not pay for travel time or for coordinating care.
The Washington, D.C., area has benefitted from the Medical House Call Program at Washington Hospital Center. One patient, Karl Schwengel, has congestive heart failure and arthritis. He relied on neighbors and friends to transport him to a clinic or hospital for treatment. With the Medical House Call Program, a physician or nurse practitioner visits him every month to monitor his vital signs and medication and assist him in improving his health. Mr. Schwengel now has a physical therapist on his team who has helped him use a walker at home.
Washington Hospital Center’s program serves approximately 600 patients and has reduced expected hospitalizations among participating patients by almost two-thirds, according to George Taler, M.D., co-director of the program.
James Pyles, a Washington lawyer and a member of the board of directors of the American Academy of Home Care Physicians, says that home visits make financial sense. “We found that you could afford to treat a patient for a whole year at home by avoiding just one hospitalization.”
Chicago-based Home Physicians serves 12,000 patients in Chicago and Baltimore. Its clinicians see 10 or 11 patients a day, far fewer than the 30 patients a clinic-based physician may see. To make the visits pay, Chief Executive Craig Reiff says that he has to carefully schedule the clinicians’ visits. His clinicians also work in tight geographic areas, and he says, “It could be very difficult to make it work in rural areas.”
The Oast & Hook News will continue to monitor developments in this area.
The attorneys at Oast & Hook can assist clients with their estate, financial, insurance, life care, veterans benefits, fiduciary litigation and special needs planning issues.

Ask Allie

O&H: Allie, we understand you have been enjoying watching the wildlife in your neighborhood. Please tell us about it.
Allie: Sure!
I meant to write sooner, but I’ve been busy.
They are everywhere !!
I watch them from the front door;
I watch them from the kitchen door.
I watch them from my mom’s bedroom window.
I watch them from my window seat.
I watch them from my very special climber, which you guys gave me.
They’re scampering. They’re scurrying.
They’re dashing. They’re darting.
They’re racing. They’re chasing.
They’re jumping from tree to tree.
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They’re frolicking in the leaves.
They’re searching for seeds and nuts.
They’re stashing everything they find.
They’re digging in the ground.
They’re stockpiling; they’re storing.
They’re “squirreling away” !!!!!!
And me; I’m enjoying it all. But I must confess, squirrel-watching can tire a cat out.
As my squirrel friends continue their busy day, I think I’ll take a nap. Boy, am I tired.
I Love All Of You.


Oast & Hook attorney Sandra Smith will speak on the topic of estate planning from 10:00 a.m. to noon, Monday, October 18th at Army Community Service Building 206 located at 96 Stillwell Drive, Fort Monroe, Virginia 23651. For more information or to register for this presentation, please phone Jessica Ortiz Sanchez at 757-788-3878 or 757-788-3535.
Oast & Hook attorney Sandra Smith will speak on the topic of estate planning from 10:00 a.m. to 2:00 p.m., Saturday, October 23rd at Bethel African Methodist Episcopal Church located at 94 West Lincoln Street, Hampton, Virginia 23669. For more information on this church, please visit www.bethelhame.com. For more information on this presentation, please phone Jennie Dell at 757-399-7506.
Oast & Hook attorney Letha McDowell will speak on the topic of veterans benefits from 9:30 a.m. to 11:00 a.m., Saturday, November 6th at King’s Grant House located at 440 North Lynnhaven Road, Virginia Beach, Virginia 23452. For more information on this presentation, please phone Jennie Dell at 757-399-7506.

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