House Calls Provide Unforeseen Benefits
House calls have been an important, though intermittent, part of my career. They often provide information and an understanding that are not only necessary, given the patient's circumstances, but also impossible to find out readily through an office visit. Home visits are a vital need, but they have also become a special point of concern by the Office of Inspector General (OIG) for 2017. In fact, the OIG 2017 Work Plan established a priority for audit of home visit claims.
Reimbursement updates in 1998 led to an increase in home visits from 1.4 million in 1999 to 2.3 million in 2009, a trend that has continued annually since 2009. Both the frequency of these services and the growth of dedicated companies who provide this service by physicians, and in the name of physicians with nonphysician providers, have led the OIG to question whether all of the visits are "medically necessary." This is, of course, a requirement for all covered services. Most importantly, the visits cannot be for the convenience of the patient, the patient's family, or the physician (or provider).
Indeed, home visits are more convenient for the patient, but the benefits of the visit for the patient are not always apparent until you get to the home, as I realized when I made a house call to an elderly woman when I was a member of a very large West coast medical group.
