Melnick and his colleagues present data on House Calls, an in-home program that provides, coordinates, and manages care primarily for recently discharged, high-risk, frail, and psychosocially compromised patients to reduce preventable emergency department visits and hospital readmissions, providing an example for other programs across the United States to serve this population that has complex needs. Their findings show that the initial House Calls structure, staffing patterns, and processes differed across the geographic areas that it served, and evolved over time. In the same time period, all areas experienced a reduction in operating costs per patient and showed substantial reductions in monthly per patient health care spending and hospital utilization after enrollment in the House Calls program, compared to the period before enrollment. Despite more than five years of experience, the program structure continues to evolve and adjust staffing and other features to accommodate the dynamic nature of this patient population.
Citation: Melnick, G. A., Green, L., & Rich, J. (2016). House Calls: California Program for Homebound Patients Reduces Monthly Spending, Delivers Meaningful Care. Health Affairs.