House calls from health care workers can help reduce costly admissions to the hospital or nursing home, according to a new report.
The study published Monday in the journal Health Affairs looked at the effectiveness of a UnitedHealth Group program for Medicare beneficiaries and found that people who used it had up to 14 percent fewer hospital admissions compared with other Medicare patients.
Participants in the program also were more likely to visit the doctor's office, according to research that was funded by the Minnetonka-based health insurer.
"We found that a home visiting program can lead to meaningful cuts in the amount of inpatient care used by Medicare patients," said Soeren Mattke, the study's lead author with California-based RAND Corp., in a statement. "This is significant since many other strategies to reduce inpatient care among Medicare recipients generally have been unsuccessful."
The HouseCalls program has become a regular talking point for UnitedHealth Group officials when describing how the company's Optum division is trying to improve care while making it more efficient.
UnitedHealth Group is the nation's largest health insurer. During an investors conference earlier this month, company officials said HouseCalls will deliver more than 1.1 million visits to patient homes next year.
"Our nurse practitioners, armed with secure smart tablets instead of black leather bags, help patients follow prescribed treatment plans, make annual visits to their physicians and get appropriate vaccinations," said Larry Renfro, the Optum chief executive, during the conference in New York.
The home visits are provided annually. They typically last 45 to 60 minutes and include an evaluation of current and past health problems, a review of medications, a physical exam and certain assessments. The house call generates a written care plan that's shared with the patient's regular doctor, and can generate referrals too other providers for services.
The study published Monday looked at Medicare beneficiaries eligible for the HouseCalls program between 2008 and 2012 in five states and compared their experiences with those of other Medicare enrollees.
Depending on their type of Medicare coverage, enrollees in HouseCalls saw a reduction in hospital admissions that ranged from 1 percent to 14 percent, according to the study. The report also found a slightly lower risk of nursing home admission.
In addition, beneficiaries had anywhere from a 2 percent to 6 percent increase in trips to the doctor's office. The study compared outcomes for people in the traditional Medicare program, those in Medicare health plans and beneficiaries in special Medicare health plans with certain chronic health care conditions.
The study did not estimate dollars saved through the insurer's program, said Kristy Duffey, a senior vice president with Optum.
"The study shows we've decreased hospitalizations up to 14 percent," Duffey said. "As we identify needs, we're putting those members in a perfect program. … We're going to prevent chronic conditions from even happening, and so we should be able to save dollars."
The HouseCalls program operates in 39 states including Wisconsin, but not Minnesota. It was initially developed by a Baltimore-based health plan called XLHealth, which UnitedHealth Group acquired in 2012.
The company did not disclose an acquisition price when the deal was announced in late 2011, but Bloomberg reported the price tag at roughly $2 billion.