Through implementation of their House Calls Program, Methodist Physician’s Clinic in Omaha, Nebraska set out to help patients access the right care in the right place at the right time — whether they are at home, at an assisted living or at a Skilled Nursing Facility (SNF). The House Call Program intensifies the medical home model to better manage high-cost patients through improved access and quality. The hospital- at-home concept was viewed as an alternative to the emergency department.
Dr. Rebecca Wester
Partners include Methodist Hospital in partnership with SNFs, home health providers, caregivers, pharmacists and individuals receiving care in the Omaha community. This initiative is led by Dr. Rebecca Wester.
The four main elements of Program are to:
- improve care transitions
- improve medication reconciliation
- identify early acute change of condition management, and
- foster proactive discussions about end-of-life decision making.
The House Call Program opened in March 2017. The first office visit was six weeks later; the first Emergency Room diversion was April 22, 2017.
Five percent of the population accounts for 50 percent of the healthcare spending with complex chronic debilitating illnesses. Those with advance illness, including congestive heart failure and chronic obstructive pulmonary disease and those with dementia and related disorders are the primary population targeted through the House Calls Program. These are some of the leading diagnoses for thirty-day hospital readmissions; therefore, offering the greatest potential for impact.
“In our efforts to provide care to all of our patients, a physician home visit program is critical. Without it, many of our home bound patient’s only access to a physician is calling 911 and being transported to the Emergency Room,” stated Todd D. Graves, President and CEO of Methodist Physicians Clinic.
Patients in the House Calls program receive coordinated care, similar to treatment and referrals they would receive from a primary care physician. Clinicians are available for urgent, same-day visits during the week. The House Calls team also is accessible 24/7 to answer clinical questions from patients and caregivers or to arrange urgent services.
“Working together is part of the solution. Our House Calls practice delivers patient-centered care, which improves outcomes, reduces the cost of care and alleviates pain and suffering. Through this effort, we will prevent unnecessary emergency department visits or hospitalizations, achieve better health outcomes and a higher overall satisfaction rate; while significantly reducing healthcare costs,” Dr. Wester stated.
The House Calls Program is only recently underway. Community partners better understand the benefits to stronger hospital/skilled nursing facility linkages, including a reduction in readmission rates. In addition, the community is benefiting from lower rates of immediate bounce backs (less than 72 hours). One of the biggest barriers at this time is a resistance to change and creating awareness within the community. We look forward to sharing future successes with the Program in the months to come.To learn more, visit their Web site.