The Journal of the American Geriatrics Society published a study last week that found home based primary care (HBPC) improves care and lowers overall Medicare costs by appropriately substituting home health, hospice, and home physician visits for hospital and nursing home costs, especially for high cost Medicare beneficiaries.
The study, "Effects of Home-Based Primary Care on Medicare Costs in High-Risk Elders," looked at 909 Medicare beneficiaries with complex conditions and a Medicare SNF stay but were not eligible if they were in a nursing home for long-term care. The patients were served by MedStar Washington Hospital Center (MWHC)'s HBPC program, which delivers detailed care coordination at home with a team of geriatricians, NPs, social workers, licensed practical nurses, and office coordinators.
The authors concluded, "An HBPC model reduced total Medicare costs by 17% in an ill population and produced survival outcomes similar to those in a control population. The observed cost savings could make HBPC teams more financially viable if payers were to share savings, offer global budgeting to qualified providers, or simply pay more for HBPC for this ill subgroup of individuals. Such value-based payments could encourage scalability of this care model, promote the health and dignity of elders, and help stabilize Medicare's financial future."