Medical house calls are catching on in Portland
With a confluence of problematic medical conditions, including fibromyalgia, asthma and high blood pressure that make it difficult for her to stand without passing out, the 70-year-old Portland woman requires an ambulance every time she has to go to the emergency room. And that’s not only costly, it’s time-consuming, she said.
But under an in-home health care service run by Landmark Health, the septuagenarian has dramatically reduced her emergency room visits and improved her health, she said.
“Before I was going to the emergency room like 10 times in six months,” Tucker said. “Now, I don’t have to go as much, maybe three or four times in the last eight months. So now I just feel much better.”
Tucker’s visits from Landmark are part of a growing national trend toward in-home health care.
A recent analysis by Grand View Research valued the U.S. home health care market at $756.8 million in 2014, a number expected to grow 10.9 percent by 2022. And according to U.S. Bureau of Labor Statistics, health aides and personal care aides used in home settings are expected to rise by 70 percent from 2010 levels to 13 million in 2020.
Landmark, which is headquartered in Huntington Beach, California, and started services in Oregon in the summer, covers about 2,500 patients in Portland and so far has visited about 500 of them, said Jill Donovan, Landmark’s Portland General Manager.
House calls have also been shown to save money. Portland-based Housecall Providers participated in Medicare’s Independence At Home Demonstration Project, saving the agency more than $25 million in one year by providing primary care in the home setting for patients with multiple chronic conditions.
With the help of mobile labs, X-rays and other portable devices, home-based care tends to be more high tech than old school house calls, but the focus on preventative health care is what really helps increase patients’ quality of life, said Julie Crites, a nurse who works with Tucker.
“When Bobbi has the first sign of symptoms, we can come out and treat her before she gets pneumonia,” Crites said. “Prevention is really a huge part of what we do.”
The Landmark service is covered by Health Net in Oregon for Medicare Advantage patients and saves money by cutting down on ER trips, Donovan said.
“Patients prefer it and it’s cheaper than acute care, because the costs of emergency room visits are so high,” Donovan said. “Patients have no copays and it cuts down on readmission issues.”
The company partners with health plans across the country and analyzes data on the highest-use patients.
Patients with five or more chronic conditions benefit most from the service, since they are almost always admitted when they go to the ER.
“We see this as a holistic approach,” Donovan said. “We also have a psychiatrist and psychological case management for patients. A lot of the chronically ill suffer from anxiety and depression. We see a lot of patients in Portland with those issues, and so we have professionals who can go into homes and provide those services.”
The service also includes dietitians who can go through a patient’s home, look at what they’re consuming and give advice or even go shopping with the patient, Donovan said.
The company, which has 25,000 patients nationally, hopes to expand in the Portland region even further and is looking for more trained staff, Donovan said.
“It takes passionate individuals,” she said. “And this trend is going to get even bigger as Baby Boomers continue to age. We’re almost always growing faster than we can handle. We actually had to slow down some because we want to assure quality.”
Landmark is a bit different than other in-home care services in the area because the company’s teams work with the patient’s regular doctor to coordinate care.
“We supplement,” Donovan said. “We have a team of three physicians that see the most sick patients, and we have several nurse practitioners and physician’s assistants. But what sets us apart is that we work with the patient’s regular health care providers rather than taking over those services.”
For Tucker, the care has been immensely helpful, especially since she can call for in-home care at pretty much any time, she said.
“Whenever I need them, (my nurses) will come,” she said. “I’ve called at almost midnight and they came and gave me an IV. They know what to do, and what they do at my house. I get the same care as I would in the ER.”
It also helps her stay healthy so she can keep volunteering at her church and in her community with Meals on Wheels, she said.
“I’m 100 percent happy with them,” Tucker said. “They know what to do. I can call anytime. It’s a lifeline.”