Northwell Health: House Calls program cuts Medicare costs 

Northwell Health said Monday that it earned $1.3 million in Medicare incentive payments for lowering the cost of treating chronically ill, frail seniors through its home-based primary care service.

The New Hyde Park-based health system said its House Calls program's clinicians reduced costs during the program’s third year by $8,784 per patient for a total savings to Medicare of $2.4 million.

Northwell Health’s House Calls was one of 15 practices in the United States participating in a demonstration project known as Independence at Home, which was established as part of the Affordable Care Act. The Centers for Medicare & Medicaid Services, or CMS, analyzed performance data from practices from June 1, 2014 to May 31, 2015, the most recent period for which information is available.

About 1,300 people are actively in the Northwell system at any given time, and those patients are about 85 years old on average, said Dr. Karen Abrashkin, medical director of Northwell Health House Calls. 

"The essence of the service is to deliver the kind of care patients want in this phase of their life," Abrashkin said. "More than anything, the patients say they don't want to go back to the hospital."

The drop in hospital visits is the major factor reducing costs, she added.

CMS awarded a total of $7.2 million in incentive payments to the seven practices that succeeded in reducing Medicare costs and met quality goals.

The quality goals included patient follow-ups within 48 hours of a hospital admission, discharge or emergency department visit, and annual documentation of patient preferences. 

Patients in the House Calls program receive coordinated care, similar to treatment and referrals they would receive from a primary care physician, including ultrasound or radiology procedures, electrocardiograms (EKG), sleep studies, lab work, physical exams, occupational and speech therapy, social work services, intravenous fluids or prescription refills.

Physicians, nurse practitioners and other clinicians are available for urgent, same-day visits during the week.

Patients are seen, on average, about every two to three months, Abrashkin said.

"Many of our patients don't need to be seen more often, but if there is anything off, call right away and we will set up an urgent visit," she said.

The House Calls team also is accessible 24/7 to answer clinical questions from patients and caregivers, or arrange urgent services.