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June 26, 1991

Educating Physicians in Home Health Care

Author Affiliations

Williamsport (Pa) Hospital and Medical Center

Williamsport (Pa) Hospital and Medical Center

JAMA. 1991;265(24):3246. doi:10.1001/jama.1991.03460240042017

To the Editor.—  The Council on Scientific Affairs' article1 on the education of physicians in home health care struck home. I recently left a private practice, in which we made a significant number of house calls, to take a faculty position. Although there were many factors in my decision, one important factor was the poor reimbursement our practice received for many of our services, including house calls, and the nonexistent reimbursement for the management of home health care.Poor reimbursement is mentioned in the article, but I feel this point needs to be strongly emphasized. Family physicians make a large number of house calls in this country and treat many housebound patients. Reimbursement rates for house calls are often ridiculously low. In my experience, even this low reimbursement was often denied because visits were often deemed "medically unnecessary" by unpublished criteria. Fighting for reimbursement, when successful, was usually not