IS THERE A DOCTOR IN THE HOUSE?
House calls see resurgence among aging population, health care deserts
On the West Side, 93-year-old Mattie Baylis gets regular house calls from a nurse, a home health aide and a family nurse practitioner.
The in-home visits and her pharmacy home deliveries allow Baylis — who had a stroke two years ago that left her bedridden and her left side weakened — to get regular health checkups.
The house calls also relieve her caregiver — her niece Jacqueline Wooding — from having to arrange for constant transportation, order medical supplies, endure doctor’s office waits and explain her aunt’s condition over and over again.
Baylis is receiving house calls from one of 18 health care practices in the greater Chicago region taking part in the Home Centered Care Institute’s new Illinois House Call Project.
HCCI is a nonprofit organization based in Schaumburg that aims to expand primary care for people who are homebound — primarily people 65 and older — nationally. It’s helping those 18 health care providers learn the ins and outs of taking their practices to patients’ homes and enhancing their inhome primary care services.
Baylis’ nurse practitioner, April J. Odom, CEO of Physicals Plus in Flossmoor, visits Baylis at home as part of her regularly scheduled roster of house calls. In addition to wellness checks, Odom also makes house calls after a patient’s health status has changed or after a hospital stay.
On average, Odom will see six to seven patients during a scheduled house call day. Her roster of inhome patients reside primarily on the South Side and the West Side and as far west as Aurora, north to Lawrence Avenue, east to Lake Michigan and south to Sauk Village.
During her visit with Baylis, Odom checked her strength, orientation and her skin for any wounds caused by her being bed-bound. She talked with Baylis’ caregiver about any changes in Baylis’ sleep, appetite or other routines.
Odom checks her patients’ vital signs, reviews medications to see whether they need refills, makes sure they’re taking their medicines
as prescribed and documents their well-being since previous visits.
Odom’s house calls are covered mainly by Medicare and Medicaid, and some private insurances. Claims are billed to the insurance company, and the patient is responsible for any co-pays and deductibles just as they would be with a regular office visit. People with HMOs or managed-care insurance plans might need a doctor’s referral for the in-home primary care services.
Each practice decides who qualifies for a house call, but it’s usually based on the patient’s age, number of chronic conditions, recent hospitalizations and lack of ability to move and do daily activities.
“My patients need to see me — not just hear me,” said Odom, who is pursuing her doctorate in nursing. “It’s sometimes difficult to assess a patient over the phone or video, including when [phone or internet] signals pose a challenge. So I’ve been able to establish much better relationships and trust with patients by seeing them in person.”
The goal of the house-calls project is to help health care practices such as Odom’s serve 3,000 new patients over the next three years, including people who live on the South Side and West Side.
For the elderly, homebound and often frail patients, the goal is to keep them from rushing repeatedly to the emergency room — an expensive and often inconvenient way to get care. Patients get the kind of higher-quality care that they miss when they are unable to go to the doctor’s office regularly.
CVS announced last month that it would acquire Signify Health, which runs a network of doctors who make in-person house calls, for roughly $8 billion. That’s in part because the COVID-19 pandemic prompted people to seek alternatives to hospital care. And Americans 65 and older are expected to account for 20% of the nation’s population by
2050, up from
16.5% today, acording to America’s Health Rankings.
A return to house calls represents more than just taking a homebound patient’s vital signs, said Samantha Hyche, a family nurse practitioner who set up her own family practice, SAJ, in October 2020 in Flossmoor, and whose practice is among the 18 getting help.
“Sometimes just walking into a room with a smile on your face can make all the difference in a patient’s day,” said Hyche, who has 20 house-call patients and makes house calls three days a week, mostly on the South Side and Northwest Side, and sees patients in her clinic two days a week.
“It may be just holding a patient’s hand and saying, ‘If you need me, just call me. I’m here,’ ” Hyche said.