MedStar Washington Hospital Center - Medical House Call Team Program

What is it?

An interdisciplinary team of geriatricians, nurse practitioners, and social workers provides home-based primary care to frail elders. The team also follows patients across all settings, including urgent, hospital, post-acute and hospice care.

Since 1999, the Medical House Call program has depended on Medicare fees, philanthropy, and hospital support to break even. Going forward, the program will be more sustainable as Medicare demonstration programs, such as Independence at Home (IAH), begin to share savings with providers who meet quality benchmarks, prevent unneeded hospital admissions, and reduce total costs of care.

Who is it for?

Frail elders with serious and disabling chronic illness. The D.C. population served is more than 80 percent African American and more than 80 percent women, with a 40 percent rate of dual-eligibility for Medicare and Medicaid.

Why do they do it?

The program’s goal is to promote health and dignity of frail elders, and help them remain in their homes as long as possible.

Impact

By identifying and treating severe chronic illness before crises occur, the House Call team has increased patient and family satisfaction while reducing the use of emergency care and hospitalizations. They have also achieved shorter lengths of stay and less serious events when hospitalizations do occur. Hospital stays average two days shorter than before enrollment in the program, and fewer than 5 percent of hospitalized patients require ICU care. The 30-day readmission rate is 12 percent, which is about half the national average. At the end of life, a majority of participants are able to die in the comfort and dignity of their own homes (60 percent of program deaths occur at home).

Contact: Eric De Jonge, MD
Section Director, Department of Geriatrics
Telephone: 202-877-0576
E-mail: Karl.E.DeJonge@Medstar.net