Structured home care program reduced SNF stays 27%, hospital finds
Proposed Medicaid managed care rule could accelerate shift away from nursing home care, official sug
A hospital substantially reduced Medicare costs and skilled nursing facility stays by providing more primary care in frail elders' homes, according to study findings published in the Journal of the American Geriatrics Society.
The program at MedStar Washington Hospital Center in the District of Columbia achieved Medicare cost savings of 17% over a two-year period, researchers at the hospital determined. The roughly 720 patients enrolled in the program also experienced 27% fewer days in a SNF, 23% fewer specialist visits and 20% fewer emergency department visits than a control group of about 2,100 Medicare beneficiaries.
The hospital's Medical House Call program involves teams of physicians and nurse practitioners that provide around-the-clock telephone coverage, frequently do house calls and help manage the cases that do enter the hospital, according to information from MedStar.
“We can expand these services, if the payment system supports growth of such mobile care teams," stated K. Eric De Jonge, M.D., study co-author and co-founder of the house call program.
The D.C. hospital achieved the savings by shifting costs from inpatient stays and other expensive services to home-based care, the study authors explained. The most significant savings were achieved for the group with the highest frailty. Mortality was comparable for the participants and control group.
MedStar Washington Hospital Center is one of 18 sites participating in the Medicare demonstration project called Independence at Home, the hospital noted. The participants are studying costs and health outcomes associated with increased home care.