Insurance Company Benefits

Insurance companies improve the outcomes of their beneficiaries, reduce spending, and increase profits. The highest cost beneficiaries are usually those with multiple chronic conditions.

• 10% of Medicare beneficiaries use 63% of the total costs of Medicare through unnecessary use of ER and hospital for routine care.
• Multiple complex chronic conditions cause exhaustive efforts to leave home and limit access to traditional ambulatory medical clinics/offices.
• Exhaustive efforts making trips to outpatient medical offices create non-compliant beneficiaries. Many of these beneficiaries will cut pills in half or skip doses to try to stretch prescriptions to prolong the need for an office visit.

Regular home medical visits to patients with multiple chronic conditions reduces unnecessary ER visits and hospitalizations and reduces length of stays for those who do need admitted on occasion. Frequently, beneficiaries will ignore exacerbation of symptoms to avoid exhaustive trip to medical clinic until they get to a point to call the ambulance and go to the ED for care that could have been prevented through use of routine in-home primary care medical visits (i.e. house calls).

Routine primary care delivered in the home improves coordination of care, enhances stability, and increases accuracy of ICD-9 codes that impact Medicare Rate Adjustments (MRAs).