More Doctors Making House Calls as Medicare Payments Have Increased

Enticed by increasing Medicare rates for house calls, some physicians are beginning to revive the practice of providing home health care, the Wall Street Journal reports. The number of house calls paid for by Medicare has increased almost eightfold, from 195,700 in 1996 to 1.5 million in 2001, according to CMS, the Journal reports. According to Dr. Peter Boiling, professor of geriatrics at Virginia Commonwealth University School of Medicine, at least two million Americans are chronically ill and confined to their homes. Medicare boosted payments for house calls by about 50% in 1998, following years negotiating with members of the American Academy of Home Care Physicians, who had argued that house calls were "just as complicated and time-consuming" as office visits, which Medicare reimbursed more generously. As a result of the increased payments, several urban hospitals are adding house-call physicians to their staffs, while doctors in less populated areas are "experiment[ing]" with home health as well. Many physicians maintain that house calls will be more cost efficient over time compared with repeat visits to emergency rooms, extended hospitalization or nursing home care. House-call proponents worry, however, that the increase in doctors making such visits "could grab Medicare's attention" and result in severe payment cuts (Greene, Wall Street Journal, 8/2).