If you’re looking to bring more cash into your primary care practice, leading-edge technological services like telemedicine may seem to be appealing examples for garnering additional revenue. But since doctors are still working out the payment details for virtual encounters, “telehealth” may not be right for you just yet.
Perhaps your income booster doesn’t lie in the forward-thinking medical services of tomorrow. In fact, maybe you should look to the past for a revenue-enhancing care delivery model.
House calls may be the retro solution to some very current problems – low reimbursements for primary care services and poor access to care for the elderly.
Medicare provides a higher reimbursement for home visits than it does for in-office encounters. If your practice is hurting financially and you typically see a wealth of Medicare patients on a given day, consider setting aside one day per week in which you solely offer house calls.
Sure, many doctors argue that the incrementally increased payment rate for house calls isn’t high enough to motivate them to see patients outside the office. Since the differential depends on the services rendered, though, you may feel otherwise.
According to data reported in 2010, a new-patient visit performed in-office earns a doctor about $37 from Medicare. The same visit rendered at a home nets the doctor around $54 – just $17 more.
But while the highest-level Medicare visit typically reimburses a physician around $131, if it’s performed in a patient’s home it’s reimbursed for about $165 – $34 more.
As such, a well-planned day of house calls can certainly earn a physician more cash than a day of Medicare visits in the office. If that doc can additionally lower overhead expenses one-seventh of the week by paying fewer staffers to work in the office on “house call day,” the income impact can be even more significant.
Then again, seeing patients at their homes does require that you invest in portable medical equipment and pay the costs of transportation. But becoming comfortable with those expenses may now make you better prepared to earn significant house-call payments later.
A provision of the health reform law mandated the creation of the Independence at Home project, which was launched earlier this year.
Currently a demonstration project of the CMS Innovation Center, Independence at Home (IAH) is working “to test the effectiveness of delivering comprehensive primary care services at home” and determine if those efforts “improve care for Medicare beneficiaries with multiple chronic conditions.”
Not unimportantly, the IAH program offers incentives to participating healthcare providers who prove that they are providing quality care that reduces costs for Medicare. Practitioners involved who meet the CMS’ quality and patient satisfaction standards will be eligible to receive a portion of the money they help save Medicare through reduced numbers of hospitalizations, ER visits and tests.
By encouraging more physicians to offer house calls, the program will improve access to care for the homebound elderly, which is sorely lacking, and hopefully lower overall healthcare costs in the process.
The IAH estimates that Medicare spending could be reduced at least $15 billion a year – more than $150 billion over ten years – if the Independence at Home program were fully implemented across the country.
Believe it or not, the IAH may turn out to be a Medicare program that boosts payment, improves patient care and lowers costs. Even amidst the turmoil of the healthcare reform debates, the Independence at Home project has had full bipartisan support in Congress.
But even before the IAH leaves the demonstration phase, you may find that home visits are beneficial for your practice and your patients, thanks to those upped rates discussed above.
Map out your business plan and run some numbers to find out if house calls are right for you – you may discover that their higher Medicare reimbursements can boost your bottom line.
Does you practice perform home visits? Why or why not?