Friday, February 2, 2007

Home care - 2007 Blog Predictions Revisited: Or, “I Told You So”

In my January 12 blog, I made 12 predictions for 2007. This was my #1 prediction.

Home care will boom -A friend of mine started an edge business focusing on maintaining “dignity and independence” for the elderly in their homes by offering cleaning, transportation, and home care services. She can’t keep up with business.

Home care, long thought to be at the edge of health care, is booming. It’s growing faster than any other health care sector. Home care is decentralization or, as the feds like to say ‘the declining concentration of health care,’ at work. When people are old, sick, or dying, they want to be home.

That is why home health agencies, visiting nurse associations, home hospice care, durable home goods companies, and home monitoring technology firms, are growing fast – at the edge of the system.”

Prediction Affirmation –On Call Medical Group, Inc

Out of San Francisco comes an article describing how primary care physicians called “On Call Medical Group, Inc.” are exclusively devoted to making house calls (Victoria Colliver, “Their patients really feel at home,” San Francisco Chronicle, January 31, 2007). On Call Medical Group, Inc, serves seven Bay Area counties. It was started 10 years ago by Dr. Jordan Shlain. The group has since grown to six physicians and recently expanded to the Palm Springs area.

The reporter notes, “It’s part of a growing trend toward service-oriented medical care, which includes such forms of treatment as retail medical clinics in drug stores and shopping centers, and high-end practices that cater to wealthy patients. Even Medicare is getting on the bandwagon, testing the efficiency of home visits to elderly, chronically ill beneficiaries in several states, including California.“

On Call Medical Group, Inc.,charges $255 for a house call to a new patient and $195 to an established patient. The group accepts cash only and doesn’t accept payment from Medicare and Medi-Cal. Its “black bag” consists is a high-tech satchel, complete with handheld devices loaded with clinical information, prescribing data, and small quantities of dozens of medications. Other equipment includes portable EKG machines and materials to conduct lab tests in the field.

On Call Medical Group, Inc, is part and parcel of the “back to the future” movement, or if you prefer fancier terms, “decentralization,” or “declining concentration of health care.” Whatever you choose to call it, it means going to health care consumers, rather than waiting for them to come to you.

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