The Return Of The Little Black Bag In Healthcare

Right around the same time some private physicians are refusing to accept new Medicare patients in fear of lower government reimbursements, another physician based concept is taking hold. The Academy of Home Care Physicians has a mission statement that promotes the art, science and practice of medicine in the home. Established in 1988, the Academy “envisions a healthcare system in which any patient who needs it can receive comprehensive primary care in their home.” Research shows that for every elderly person in a nursing home, there are three more patients equally as sick and fragile who are living at home. In a recently article published in The New England Journal of Medicine on “Why Health Care is Going Home,” Dr. Steven H. Landers stated that, “Our financing system, malpractice laws, and consumer culture all encourage utilization of costly services and have contributed to unsustainable increases in the cost of care. In home care is often less costly, and since it is highly desirable for patients, it offers a potential win–win solution.”

He added that, “The transformation of patients’ homes into central venues for health care may take years or decades, depending on how the national and institutional politics play out. New payment models are needed to cover services that haven’t previously been offered at home and to realign physicians’ incentives. Yet, ultimately, health care organizations that do not adapt to the home care imperative risk becoming irrelevant.” In today’s generation of physicians, few have been educated in medical school or continuing education to provide the kind and level of care that could be made available. Few have been educated to provide home health agencies with professional support as medical directors; fewer still have learned the advanced team techniques that allow them to work with other health professionals, nurse practitioners, physician assistants, pharmacists and others by providing continuity of care across the care continuum. Concerns over reimbursement also have been a barrier.

The American Academy of Home Care Physicians serves the needs of thousands of physicians and related professionals and agencies interested in improving care of patients in the home. Members and volunteers work to reduce barriers and enhance practice education. Notable successes include fostering increased reimbursement, sponsoring multiple educational and scientific seminars and providing the practice community with a variety of helpful publications. Academy members include home care physicians who make house calls, care for homebound patients, act as home health agency medical directors or refer patients to home care agencies. Specialties include internal medicine, family practice, pediatrics, geriatrics, psychiatry, emergency medicine and more.
Other members are directors of agencies actively planning for future home care organizations, medical directors of managed care plans, nurse practitioners who make house calls, physician assistants, and administrators of medical groups interested in home care. The services provided by home care agencies and physicians are billed under a set of codes designated by the Centers for Medicare and Medicaid. Physicians, nurse practitioners, clinical nurse specialists and physician assistants are required to oversee or directly provide progressively more sophisticated and more frequent home visits.

Beyond the licensure and certification processes, no similar evaluation mechanism exists for skills obtained through continuing education and practice experience. The Home Care Credentialing Examination fills this gap and enables home care medical providers to demonstrate their proficiency. Patients also benefit from proficiency testing and the Academy’s recognition of those who receive the credential since the exam assesses the knowledge and skills identified by respected experts as necessary to provide safe and effective medical care in the home. Upon the completion of this educational activity, the participant should be better able to:
Discuss and apply knowledge of clinical problems, effective approaches to end of life/palliative care, functionality, social services and legal/ethical concerns related to home care. Attest to his or her added competency in home care medicine by demonstrating knowledge, skills and proficiency in managing common problems faced in home care. As a public service, The American Academy of Home Care Physician’s website provides a list of its members and medical groups that provide home care.

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About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.