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November 16, 2005

Trends in House Calls to Medicare Beneficiaries

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;294(19):2431-2436. doi:10.1001/jama.294.19.2435-b

To the Editor: A 1997 analysis declared house calls a “vanishing practice.”1 Home nursing and rehabilitation services have increased in recent decades, but a concurrent decline in physician home care has been observed.2,3 However, a number of factors may lead to a comeback in house calls. These include the aging of the United States population4; advances in portable medical devices, information technology, point-of-service laboratory tests, and handheld computers5; and the 1998 Medicare increase of nearly 50% in allowable reimbursement for home visits. The 2004 allowed charge for a “comprehensive” visit to an established patient is approximately $110.6 We examined trends in annual house call volume and expenditures, as well as the types of clinicians making house calls to fee-for-service Medicare beneficiaries.