I just finished reading an interesting article written by Dr. Alan Dappen at Get Better Health. Dr. Dappen doesn’t take Medicare, but he does make house calls. The scenario he describes involves an elderly lady who is bedridden and needs a lesion removed from her arm. Dr. Dappen goes to her house to do the procedure, and the patient pays him $375. Both the patient and the doctor are happy with the arrangement.
Obviously this wouldn’t work for all seniors. People who are living on social security without any other income would be hard pressed to come up with $375 to be seen by a doctor who doesn’t take Medicare. And others might balk at the idea of seeing a doctor who doesn’t take Medicare, regardless of whether they could afford the care. But for those who are open to the idea and able to afford the services, Dr. Dappen does make it sound like a good deal. No hassle, no waiting, and the doctors will visit your home if you can’t go to them.
I’m curious what a procedure like this would have cost if the patient had opted to see an in-network Medicare provider in an office setting? As Dr. Dappen pointed out, an ambulance with a stretcher and paramedics might have been needed to transport her to the doctor depending on the severity of her osteoarthritis. That alone would have been more expensive than the procedure itself.
House calls are definitely still rare these days, but they are gaining in popularity as our population ages. The Independence At Home Act of 2009 created a test program to see if money can be saved and outcomes improved for 10,000 of the sickest Medicare patients – people with multiple medical conditions, who have needed high cost health care in the previous year. Time will tell how it works, but the idea is promising. Keeping people in their homes helps to make them comfortable, reduces stressful transportation issues, and also avoids possible infections that spread easily in medical offices and hospitals. Obviously for serious situations hospitalization would still be necessary, but for dealing with more minor illnesses and injuries, and especially preventive care, home visits make a lot of sense.
Private health insurance companies tend to take some of their cues from Medicare in terms of what they cover, so if Medicare eventually makes home visits more available, it stands to reason that people with private health insurance might also have access to house calls from doctors, even if they can’t afford to pay full price to a non-network provider.
Dr. Dappen’s article was included in Grand Rounds this week, hosted by Bongi at Other Things Amanzi.