Bruce Kinosian, WHYY 'The Pulse, House Calls Revived

Bruce Kinosian, WHYY 'The Pulse, House Calls Revived

A WHYY "The Pulse" radio show and article looks at how LDI Senior Fellow Bruce Kinosian and the Affordable Care Act are both executing something of a "back to the future" effort to resurrect house calls.

The house call, which went extinct as high-tech hospital medicine came to dominate health care, was given a new life in the "Independence at Home" initiative of the Affordable Care Act. That program
Brice Kinosian
Bruce Kinosian, MD.

established test demonstrations using house calls for Medicare patients who have functional impairments or multiple chronic conditions -- the 10 percent of Medicare patients who account for two-thirds of Medicare spending.

New mobile bedside tech
In Philadelphia, Kinosian, a VA staff physician and Associate Professor of Medicine at Penn's Perelman School of Medicine, invited a Pulse reporter to accompany him on his own house call rounds where he demonstrated how a bag of miniaturized, smartphone-powered medical tools can be used to provide surprisingly sophisticated levels of care at a home bedside. These included a pulse oximeter, glucometer, ultrasound device, echocardiogram, blood clot doppler and blood analyzer.

25% cost reduction
"You can pretty much be a walking Emergency Room with equipment you carry in your pockets," Kinosian told the Pulse. He said that in demonstrations so far, the house call strategy has cut care costs by about 25 percent.

"I think that Independence At Home is going to radically transform how healthcare gets delivered and gets paid for in this country," Kinosian said. "There's probably 1.5 million medicare beneficiaries that are eligible for Independence At Home."