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Anne Hennies, 98, of Bellerose, gets a home (Credit: Steve Pfost)

Anne Hennies, 98, of Bellerose, gets a home visit from Dr. Kristofer Smith as part of a North Shore-Long Island Jewish Health System program to provide home-based health care to about 350 elderly patients. (June 19, 2012)

Home-based health care for the elderly

Dr. Kristofer Smith's recent visit to a patient at her Queens home was not your typical doctor's appointment -- a 15-minute visit with a harried-looking physician in a cold exam room. It was part of a three-year program the North Shore-Long Island Jewish Health System is participating in under the federal Affordable Care Act to provide home-based health care to about 350 elderly. The hope is to take care of their medical problems before those spiral out of control, reducing expensive visits to the emergency room and time in the hospital. The program is just one experiment to keep people out of the hospital. The Affordable Care Act and private health insurers are moving toward a system in which doctors and hospitals will be rewarded for keeping patients healthy, instead of being reimbursed for each service -- called fee-for-service -- used to treat them when they are sick.

Anne Hennies, 98, of Bellerose, gets a home
(Credit: Steve Pfost)

Anne Hennies, 98, of Bellerose, gets a home visit from Dr. Kristofer Smith as part of a North Shore-Long Island Jewish Health System program to provide home-based health care to about 350 elderly patients. (June 19, 2012)

Dr. Kristofer Smith chats with Anne Hennies of
(Credit: Steve Pfost)

Dr. Kristofer Smith chats with Anne Hennies of Bellerose after performing a regularly scheduled checkup. “I think it is easily the most rewarding work I have ever done,” Smith said of his home visits. “If you pay for things differently, you can spend the time winning back the trust of your patients that the current model doesn’t provide.” (June 19, 2012)

Dr. Kristofer Smith examines Anne Hennies during a
(Credit: Steve Pfost)

Dr. Kristofer Smith examines Anne Hennies during a routine check up at her Bellerose home. The home visit is part of a program to take care of the medical problems of elderly patients before those spiral out of control. (June 19, 2012)

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Anne Hennies, 98, discusses her health issues with
(Credit: Steve Pfost)

Anne Hennies, 98, discusses her health issues with Dr. Kristofer Smith during his visit to her Bellerose home. (June 19, 2012)

Dr. Kristofer Smith examines Anne Hennies at her
(Credit: Steve Pfost)

Dr. Kristofer Smith examines Anne Hennies at her Bellerose home. Her legs were bruised and swollen, the result of poor circulation and inadvertently going off her diuretic for three days. (June 19, 2012)

Dr. Kristofer Smith examines Anne Hennies during a
(Credit: Steve Pfost)

Dr. Kristofer Smith examines Anne Hennies during a routine checkup at her Bellerose home. (June 19, 2012)

Dr. Kristofer Smith checks Anne Hennies blood pressure
(Credit: Steve Pfost)

Dr. Kristofer Smith checks Anne Hennies blood pressure at her Bellerose home during a regularly scheduled visit. (June 19, 2012)

Dr. Kristofer Smith and Anne Hennies discuss her
(Credit: Steve Pfost)

Dr. Kristofer Smith and Anne Hennies discuss her health at her Bellerose home during a regularly scheduled checkup. Hennies asked whether it it would be good for her to get up and walk around. “It’s better to do it with an aide around,” Smith said. (June 19, 2012)

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Dr. Kristofer Smith talks with Anne Hennies at
(Credit: Steve Pfost)

Dr. Kristofer Smith talks with Anne Hennies at her Bellerose home during a regularly scheduled checkup. Hennies fell a few months ago and her legs were her bruised and swollen, the result of poor circulation and inadvertently going off her diuretic for three days. (June 19, 2012)

Dr. Kristofer Smith, left, greets Anne Hennies, 98,
(Credit: Steve Pfost)

Dr. Kristofer Smith, left, greets Anne Hennies, 98, at her Bellerose home before performing a regularly scheduled checkup. (June 19, 2012)

Dr. Kristofer Smith chats with Anne Hennies, 98,
(Credit: Steve Pfost)

Dr. Kristofer Smith chats with Anne Hennies, 98, at her Bellerose home before performing a regularly scheduled checkup. (June 19, 2012)

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