Home visits are not a new concept to healthcare providers; indeed just a generation ago house calls were a routine part of a provider’s schedule. As more and more effort is spent on strategies to keep patients out of high cost situations, i.e. hospital admissions.

Medicare and Medicaid patients make up over 2/3 of in-patients for non-surgical hospital admissions. About half of those could potentially stay at home and receive quality care from nurses and doctors and other home care personnel at half the cost. In this value over volume world we are entering, how to meet expectations, treat patients effectively and control costs are challenging us to re-think traditional roles of hospitals.

Home based care, nursing home care; home teams all become a vital part of that re-think.

Not surprisingly, hospital borne infections fall, and medical errors are contributing to the home solutions. There will be a growing segment of physicians who will only be home based physicians. This trend will become effective at about the same time that value based care begins to pay providers for hospital care visits at home.

“Mount Sinai’s “mobile acute care program,” which is funded by a nearly $10 million grant from the Centers for Medicare & Medicaid Services, is modeled after a concept that Bruce Leff, M.D., pioneered decades ago at the Johns Hopkins University School of Medicine. His Hospital at Home pilot program produced promising results of better outcomes and shorter “hospitalizations,” according to his findings published in the Annals of Internal Medicine in 2005.”

Dr. Leff and his colleagues had an idea. What if patients could be hospitalized in their own beds?

Some patients need the moment-to-moment monitoring that only a hospital can provide. The first task was to determine which common conditions required admission but could be treated with technologies placed in the home. These would be patients who clearly needed to be hospitalized, but who weren’t going to need the intensive care unit. Intravenous medications and X-rays can be readily adapted for the home; ventilators cannot.

Hospital at home may become the new buzz words of the next few years as more and more emphasis is placed on keeping hospital admissions and costly re-admissions low.

What is your specialty? Are there ways you could provide your specialty care at home? What would need to be in place to provide that care? Would you need 24 hr nursing care? How would your patients react to home care? Are there programs that exist today that you might benefit from? What would you need to do to start a home based hospitalization care program?

Start thinking about the future today!