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House call team at VCU Medical Center plays a pivotal role in the success of a national at-home primary care initiative

New payment model saves more than $25 million in first year, while improving care

This week the Centers for Medicare & Medicaid Services announced the initial year of results from the Independence at Home Demonstration, which is a CMS initiative designed to improve care while saving costs. The house call team at Virginia Commonwealth University Medical Center had a lead role in the creation and design of the initiative, working with MedStar Washington Hospital Center and University of Pennsylvania as the Mid-Atlantic Consortium.   

The program’s medical team provides home-based medical care, also known as house calls, and personalized care coordination to Medicare beneficiaries that have decreased mobility and high illness burden. House calls provide the opportunity for providers to spend more quality time with patients, gain a much better understanding of the care environment and the patient’s goals, then match the care plan to actual needs. Quick access when conditions change is another key feature of at-home care. Working this way, the Mid-Atlantic Consortium’s home-based medical care programs reduced the cost of health care for this population by 20 to 30 percent. Programs can then receive funds to support the team care model, but only if measures of care quality and patient satisfaction are met. 

“The VCU Medical Center House Calls program has been a pioneer in delivering team-based mobile medical care since the 1980s,” said Peter Boling, M.D., chair, Division of Geriatric Medicine, Department of Internal Medicine, VCU School of Medicine. “We are honored by the opportunity to contribute to the creation and success of Independence at Home. We met all the quality measures, we had very high patient satisfaction, and we substantially reduced total health care costs in a group of people with very serious health problems. These results are externally validated evidence that delivering the right care -- in the right place, at the right time, and with the right team -- makes a difference.” 

Seventeen practices participated in the demonstration, which began in June 2012 and can serve up to 10,000 Medicare beneficiaries. The Independence at Home Demonstration is scheduled for three years. Congress is currently considering legislation to extend it.   

The VCU Medical Center House Calls program celebrated its 30th anniversary last year, making it the oldest of the clinical programs in the VCU Division of Geriatrics, which falls under the Department of Internal Medicine. The program has been accredited by the Joint Commission since 1997.

About VCU and VCU Medical Center

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 226 degree and certificate programs in the arts, sciences and humanities. Sixty-seven of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University comprise VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.

Peter A. Boling, M.D.
Peter A. Boling, M.D.