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Modern-day house calls could change future of medical care

Return of House Calls
Posted at 2:29 PM, Oct 14, 2021

CHICAGO — For millions of Americans, the luxury of being able to stay at home during the pandemic meant safety and peace of mind. The relaxation of telehealth restrictions made it easier to get medical advice. And now, in-home medical care is also on the rise.

In the 1930s, house calls by doctors were common practice, making up 40% of interactions between physicians and their patients.

But by 1980, it dropped to just 1% —replaced by hospital, office and urgent care systems.

“I think that there is a real craving for patients to try to achieve care and improve their health care outside of a hospital setting,” said Dr. Meeta Shah, an emergency physician at Rush University Medical Center in Chicago.

Part of improving that care appears to be emerging in the form of in-home care which has been making a comeback in recent years.

“It's a way for patients to really feel safe and they can heal in an environment that is their own. They can heal in their own beds,” said Jaclyn Henkhouse, vice president of clinical implementation at in-home care provider Dispatch Health.

This time there’s no doctor knocking at the door with a black medical case; instead, the bag has been replaced by high-tech mobile care units. These SUVs are equipped with a slew of medical treatment kits.

“An example of one of our cases stethoscope, otoscope ophthalmoscope syringes,” said Patrick Huynh a dispatch nurse practitioner.

Hyunh would be sent out with a medical technician. Together, they could treat even complex injuries and illnesses in the home.

“We don't treat life-threatening emergencies. Those definitely need to go to the emergency department. But, you know, we treat anywhere from an ear infection all the way to coughs to swelling,” said Hyunh.

Many health systems are banking on in-home care models that could reduce costs and help keep non-life-threatening emergencies out of the emergency department.

“Some folks just don't know any other option because the ED (emergency department) is the closest thing to their homes, and so, that's what they know to do when they become ill,” said Shah.

Colorado-based Dispatch Health, poised to become the world’s largest in-home care system, now has mobile medical units operating in 40 markets across 18 states and earlier this year announced plans to expand to 100 markets.

“We have the ability to provide point of care lab testing as well,” said Hyunh, who now operates through a partnership between Dispatch Health and Rush out of Chicago.

With the pandemic forcing many to stay at home, telehealth saw a surge in use, and Medicare waivers allowed dozens of states to bring acute medical care to seniors in their own homes.

“We kind of did a lot of that during COVID with telehealth,” said Shah. “We were coming into your homes virtually, and now, this is kind of an expansion beyond that to say, ‘Now, we can come into your homes actually with our team and our technology.’”

It’s something experts say can reduce hospitalizations and is a more affordable alternative to long-term care facilities.

“They'll call in and we ask for your insurance when you first call in and we'll run it through our system. And if it's not covered by your insurance, we'll let you know right up front. We do offer self-pay option,” said Henkhouse.

A Dispatch Health visit costs roughly the same as a walk-in urgent care visit. On average that’s between $5 and $50 depending on insurance coverage. Without insurance, they charge a flat fee of $275, which includes the entire cost of treatments, medication, procedures and lab tests.

The company says it’s already seen year-over-year growth between 100 and 200%.

The estimated $460 million house call market is expected to grow over the next decade, a return to an old model with a modern-day twist.