Medical Home Shows Promise With Right Support, Says Panel

After Carolyn, a patient in her late 60s who suffered from liver and heart failure, depression, and frequent falls, was admitted to the hospital six times in 2011, her daughter sought a way to secure more comprehensive care for her mother.

She found it in MedStar Washington Hospital Center's Medical House Call Program in Washington, D.C., an Independence at Home(innovation.cms.gov) demonstration project supported by CMS. After entering the program, Carolyn was admitted to the hospital only twice from 2011 to 2015, and she received urgent care and screenings via 150 house calls.

Eric De Jonge, M.D., director of geriatrics at MedStar Washington Hospital Center, told Carolyn's story during a recent National Coalition on Health Care forum focused on scaling up successful medical home programs. The house call program, he said, allowed an interdisciplinary team to monitor Carolyn more closely and visit her regardless of the time of day. According to Carolyn's daughter, the change saved both her mother's life and her own. De Jong said it also saved money, which funded higher salaries for physicians.

The house call program is designed to both keep patients out of the hospital and substantially reduce costs, De Jonge explained. To achieve these goals, teams of physicians, nurse practitioners, social workers and care coordinators provide care for patients who generally are too ill to visit a clinic. Initially approved as a three-year pilot program, it was extended for another two years in July.