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Trends in House Calls to Medicare Beneficiaries
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To the Editor: A 1997 analysis declared house calls a "vanishing practice."1 Home nursing and rehabilitation services have increased in recent decades, but a concurrent decline in physician home care has been observed.2-3 However, a number of factors may lead to a comeback in house calls. These include the aging of the United States population4; advances in portable medical devices, information technology, point-of-service laboratory tests, and handheld computers5; and the 1998 Medicare increase of nearly 50% in allowable reimbursement for home visits. The 2004 allowed charge for a "comprehensive" visit to an established patient is approximately $110.6 We examined trends in annual house call volume and expenditures, as well as the types of clinicians making house calls to fee-for-service Medicare beneficiaries.
Methods
We analyzed aggregated fee-for-service Medicare physician/supplier data from 1998-2004, including all years for which free-of-charge public use files are available. The main outcome measures were annual . . . [Full Text of this Article]
Steven H. Landers, MD, MPH
steven.landers@uhhs.com
Paul W. Gunn, BS;
Susan A. Flocke, PhD;
Antonnette V. Graham, PhD;
George E. Kikano, MD
Department of Family Medicine
Case Western Reserve University School of Medicine
Shirley M. Moore, RN, PhD
Frances Payne Bolton School of Nursing
Case Western Reserve University
Kurt C. Stange, MD, PhD
Department of Family Medicine
Case Western Reserve University School of Medicine
Cleveland, Ohio
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