Unless the patient needs really intensive, round-the-clock care, most hospital-type care can be done in the patient’s home — where it’s safer, more comfortable and less expensive. That lesson is so well accepted that it was written into the federal health care reform law — to provide financial incentives for outfits called Independence at Home Organizations.
The problem is that the rules for the new home care organizations are supposed to go into effect on January 1, 2012, but Medicare is behind on writing the rules. So there will be delay in getting this started. The current rules discourage moving hospital-style care home because, among other things, Medicare won’t pay for home visits.
An internist named Jack Resnick, M.D., writing an op-ed in the New York Times, talks about his own practice on New York City’s Roosevelt Island, caring for infirm and elderly patients. He makes a persuasive case for the home care organizations, writing:
Patients who are treated at home by a doctor and nursing staff who know them intimately and can be available 24/7 are happier and healthier. This kind of care decreases the infections, mistakes and delirium, which, especially among the elderly, are the attendants of hospital care. And it is far more efficient.