Research - Cost-Savings Case Studies

Multiple studies have validated the cost savings and population health benefits associated with Home-Based Primary Care.

Mount Sinai Visiting Doctors:

This New York City visiting doctors program, in operation for more than 15 years, allows for aging in place by providing in-home health care and chronic disease management for 1,100 elders. The program consistently demonstrates success, including:

  • 66% reduction in hospitalizations

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House Call Program at Montefiore Health System:

This house call program has been providing chronic disease management and advanced illness management for high-cost elders in the Bronx area of New York City for more than five years.  For its roster of 400 patients, outcomes include:

  • 42% reduction in hospitalizations
  • 33% reduction in total costs

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House Call Program at the MedStar Washington Hospital Center:

This house call program provides home-based medical care services and chronic disease management for an active roster of more than 700 Washington, DC-area patients, each with three or more chronic diseases. Data from the program has evidenced:

  • Better patient care
  • More primary care visits (house calls), more home health and more hospice
  • 25% reduction in hospital length of stay
  • 75% reduction in end-of-life hospitalizations

As compared to 2,161 matched controls, the program generated:

  • 17% lower Medicare costs, which resulted in $8,477 savings per beneficiary
  • 9% reduction in hospitalizations
  • 10% reduction in ED visits
  • 27% decrease in skilled nursing home days

Two-year savings came to $6.1 million.

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Reference: De Jonge, E., Jamshed, N., Gilden, D., Kubisiak, J., Bruce, S., & Taler, G. (2014). Effects of Home-Based Primary Care on Medicare Costs in High-Risk Elders. Journal of the American Geriatrics Society, 1825-1831.

Naylor Transitional Care Study:

A study of patients with congestive heart failure discharged from the hospital and receiving transitional care via nurse practitioner house calls found:

  • 50% reduction in 90 day readmissions
  • 50% reduction in costs

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Reference: Naylor, M., Brooten, D., Campbell, R., Maislin, G., McCauley , K., & Schwartz, J. (2004). Transitional Care of Older Adults Hospitalized with Heart Failure: A Randomized, Controlled Trial. Journal of the American Geriatrics Society, 675-684.

Veteran Health Administration (VA) Home Based Primary Care Program (HBPC):

Launched in 1972, this house call program currently serves 30,000 veterans. The program has generated significant cost savings and reduction in resource utilization, including:

  • 24% total cost savings, including 63% hospital cost savings and 87% nursing home cost savings (2002 data)
    • 63% hospital cost savings
    • 87% nursing home cost savings
    • Total savings over $103 million
  • 59% reduction in hospital days, 89% reduction in nursing home days and 21% reduction in 30-day readmissions (2006 data)Patients dually enrolled in VA and Medicare demonstrated additional benefits:

Patients dually enrolled in VA and Medicare demonstrated additional benefits:

  • 13.4% total cost savings, including
    • 16.7% VA cost savings and
    • 10.8% Medicare cost savings
    • $9,132 overall savings per veteran across 11,334 veterans served
  • 25% reduction in hospitalizations
  • Highest patient satisfaction of any VA program

Reference: Edes, T., Kinosian, B., Vukovic, N., Nichols, L., Becker, M., & Hossain, M. (2014). Better Access, Quality, and Cost for Clinically Complex Veterans with Home-Based Primary Care. Journal of the American Geriatrics Society, 1954-1964.