title: Medicare Home Visit Program Associated With Fewer Hospital And Nursing Home Admissions, Increased Office Visits.
abstract: Clinical home visit programs for Medicare beneficiaries are a promising approach to supporting aging in place and avoiding high-cost institutional care. Such programs combine a comprehensive geriatric assessment by a clinician during a home visit with referrals to community providers and health plan resources to address uncovered issues. We evaluated UnitedHealth Group's HouseCalls program, which has been offered to Medicare Advantage plan members in Arkansas, Georgia, Missouri, South Carolina, and Texas since January 2008. We found that, compared to non-HouseCalls Medicare Advantage plan members and fee-for-service beneficiaries, HouseCalls participants had reductions in admissions to hospitals (1 percent and 14 percent, respectively) and lower risk of nursing home admission (0.67 percent and 1.3 percent, respectively). In addition, participants' numbers of office visits--chiefly to specialists--increased 2-6 percent (depending on the comparison group). The program's effects on emergency department use were mixed. These results indicate that a thorough home-based clinical assessment of a member's health and home environment combined with referral services can support aging in place, promote physician office visits, and preempt costly institutional care.
authors.affiliation: Soeren Mattke (mattke@rand.org) is a senior scientist at the RAND Corporation and managing director of RAND Health Advisory Services, both in Boston, Massachusetts.
authors.forename: Soeren
authors.initials: S
authors.lastname: Mattke
authors.affiliation: Dan Han is an assistant policy analyst at the RAND Corporation in Santa Monica, California.
authors.forename: Dan
authors.initials: D
authors.lastname: Han
authors.affiliation: Asa Wilks is a research programmer at the RAND Corporation in Santa Monica.
authors.forename: Asa
authors.initials: A
authors.lastname: Wilks
authors.affiliation: Elizabeth Sloss is a policy researcher at the RAND Corporation in Arlington, Virginia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sloss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006792:House Calls; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D009819:Office Visits / Q000706:statistics & numerical data*; D014481:United States
keywords: Ageing in place; Healthcare utilization; Home visit program; Medicare