The former ER nurse says access to the program's 24-hour care is reassuring and comforting. Key program features include: (1) an interdisciplinary care team comprised of a geriatrician, a nurse practitioner, social worker, and a licensed practical nurse that provide 24/7 on-call coverage; (2) access to CRISP, a regional health information exchange to track hospitalizations beyond MedStar Washington Hospital Center; (3) referrals to social and emotional resources for patients and their caregivers; and (4) emphasis on end-of-life care, when needed. Under the Medicare demonstration, the program continues to receive fee-for-service payments but shares in any savings that result from lower utilization of health care services, provided the care meets Medicare quality standards. In 2006, Dr. Taler was selected for a Special Achievement Award by the American Academy of Home Care Providers. Date. * 1. The program has engaged health economists in Maryland to help evaluate impact on Total Cost of Care. Dr. Taler and colleagues studied pneumonia in the long-term care setting, where this disease is common. Optimizing Medication Management During the COVID-19 Pandemic: Implementation Guide for Post-Acute and Long-Term Care Naqvi, Brandt, Hennawi_, Effects of Home-Based Primary Care on Medicare Costs in High-Risk Elders K Eric De Jonge 1, Namirah Jamshed, Daniel Gilden, Joanna Kubisiak, Stephanie R Bruce, George Taler. Eric DeJonge, executive director of MedStar Total Elder Care, said its house call program in Baltimore administered through Good Samaritan Hospital, has enrolled 105 patients since the program was . Medstar was part of a cohort of three programs (Mid-Atlantic Consortium) under the Independence at Home demonstration that reduced Medicare spending by 20 percent and yielded $1.8 million in shared savings in the, of the demonstration (2013-2014). Key program features include: (1) an interdisciplinary care team comprised of a geriatrician, a nurse practitioner, social worker, and a licensed practical nurse that provide 24/7 on-call coverage; (2) access to. What are safe medications for blood pressure? In the years leading up to the move, her mother was in and out of the hospital every month or so as Trujillo struggled to find a physician who could manage her multiple chronic conditions. Pneumonia is associated with morbidity and mortality in long-term residents; however, diagnosis and management of this condition is challenging. On occasion, team members make joint visits to resolve conflicts in the care plan, ethical questions, or safety concerns, including worries about elder abuse, mental capacity, or the safety of providers in the home. Our office is open Monday through Friday 8:30 a.m. to 4:30 p.m. The house calls reveal and address problems that are missed when care is poorly coordinated, enabling team members to identify social supports for patients that can improve quality of life, reduce the burden on caregivers, and head off problems that can lead to high-cost institutional care. HCCI closely monitors and shares published studies relevant to the field and reports on findings and outcomes in particular, those that contribute to the business case and identification of best practices in HBPC. What can I do to relieve arthritis pain in my legs and back? Please call 800-862-2166 to verify all faxed documents were received. Please indicate the date you completed New Associate Orientation. Back to Listing of State Programs Addressing Complex Patients. Through the HCCIntelligence Resource Center, we offer free access to knowledgeable experts and timely guidance. This enables them to stay apprised of patients evolving needs and ensure that hospital staff adhere to patients preferences. This may include peer support and referral to resources such as adult protective services, bill-paying assistance, and legal services. Providing Comprehensive Care for Aging Adults | MedStar Health The consortium is one of nine participating groups to earn a share of the savings they produced for Medicare. This article, published in Clinics in Geriatric Medicine, includes management recommendations. document.write(new Date().getFullYear()); Geriatricians provide 24/7 on-call coverage as well as guidance to nurse practitioners, who visit patients anywhere from several times a week to once every eight weeks. Anticipating this need, the Schaumburg, Ill.based Home Centered Care Institute has developed a house calls training program for physicians. Julie Beecher - Assistant Vice President Operations - MedStar Health The staffing models, payer mix and after-hours protocols all differ, but they generally have one thing in common. https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.12974. 5 See: American Geriatrics Society, Projected Future Need for Geriatricians, May 2016. We have found that the clinicians need education on how this practice operates most efficiently and also the sustainability of the business model, Sacks said. Along these lines, HCCI has a shadowing program with multispecialty academic hospital Cleveland Clinic. For individuals that fall under this category, receiving care outside of the home can be difficult or out of the question entirely. MedStar's Medical House Call program in Washington, D.C. began in 1999 when providers witnessed poor outcomes for patients who could not physically get to their doctor's office. Its called exercise. 22,000+ per year. To pinpoint the best medication, we recommend seeing your primary care doctor. Karen Pollock was diagnosed with progressive multiple sclerosis in 1994. For more information, call our offices in Baltimore (443-444-4720) at MedStar Good Samaritan Hospital, Montgomery County (301-570-7400) at MedStar Montgomery Medical Center, or Washington D.C. (202-877-0570) at MedStar Washington Hospital Center. "It's so much better to go their houses, see how they live, what they actually eat, where their medications are, and spend more time with them," said Nurse Practitioner Michelle Sullivan. Dr. Eric De Jonge co-founded the House Call Program at Medstar Washington Hospital Center more than two decades ago. There are 6.1 million people over the age of 85 in the United States and their ranks are expected to double by 2030. This yielded just over $1.8 million in shared savings, to be split among the three partners.2 (Some of the savings allowed the consortium to recoup the $300,000 it had invested over two years to pay for a data analyst and hire additional staff to provide care on Saturdays.). "Feeling the impact that you can have, not just me, but our team has on a daily basis and relieving suffering," De Jonge said. Joseph Shapiro Listen Listen Playlist Download Embed Transcript Dr. Eric De Jonge checks up on Nora Armwood, 94, in her home in Washington, D.C. One out of four patients in De Jonge's house. There were also decreases in the use of hospitals, emergency departments, and skilled nursing facilities. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this. This was born out in the case of Sylvia Trujillos mother. It makes a difference for caregivers to be able to call someone and get advice so they dont have to call 911., Source: https://www.medstartotaleldercare.org/about-us. Aquatic therapy is ideal for a painful back because of the warmth and buoyancy of the water. By continuing to use the site, you agree to the use of cookies. Thats a core element of how we prevent crises.. *Assessment used with permission of the author, S. Borson. "After hours, you can call and there's a physician you can talk to, with the House Call Program, I feel like I am a person and a patient," Pollock said. 1 K. Eric De Jonge, N. Jamshed, D. Gilden et al., Effects of Home-Based Primary Care on Medicare Costs in High-Risk Elders, Journal of the American Geriatrics Society, Oct. 2014 62(10):182531. The team makes house calls for primary and urgent care services and coordinates specialty care and procedures for older adults. "One day, I'm going to add up all the money this program saved Medicare," Trujillo says. Image by fernando zhiminaicela from Pixabay. Lorene Franklin has been a patient of the MedStar House Call Program through MedStar Good Samaritan Hospital in Baltimore for about a year. Medstar Health is part of the Hospitals & Physicians Clinics industry, and located in Maryland, United States. Its so easy to increase your flexibility and range of motion and stay active in this type of environment. In Washington, D.C., a dedicated team works to provide the highest quality of medical care to elders and families who are most in need. 2 Under program rules, Medicare keeps the first 5 percent of savings. We serve patients at home with a team of geriatricians, nurse practitioners (NPs), social workers, office nurses, and coordinators. Providing skills-training and support to caregivers, who may panic when their family member has difficulty breathing or is in pain, also lessens reliance on hospitals and emergency departments. This is in contrast to national studies finding that about 70 percent of African Americans die in hospitals while only 6 percent die at home. The company's mailing address is Medstar Total Elder Care, Llc 10980 Grantchester Way, Columbia, MD 21044-6097. Similarly, performance may vary from one year to the next. In addition to in-home medical and social services, they link patients and families to other health-related community resources, and support caregivers through monthly support groups and weekly meditation calls. He then joined the Family Medicine faculty at the University of Maryland, where he was an Associate Professor until he left in 1999 to join MedStar Washington Hospital Center as Director of Long-Term Care. Dr. Taler graduated from the University of Maryland School of Medicine and completed an internship at the University of Maryland Medical Center. Many elderly people suffer from multiple chronic conditions and/or functional disability, leading to high per capita costs for their medical care. In-home diagnostic tests and treatments, medications, and equipment are delivered to the patient. Social workers are actively involved with about a third of MedStars cases, providing education, emotional support, and counseling to patients and their caregivers. 2000 M Street, NWSuite 400 Washington, D.C. 20036 202.828.5100 p 202.728.9469 f, Insufficient Quality for Our Healthcare Dollar. Local YMCAs and Kids First Swim are two places that offer arthritis aquatics classes. HCCI has plans to eventually launch this program in Chicago. There tends to be a relationship thats really built in a trust when you invite somebody into your home, she said. The long-term trust you build by visiting people at home and understanding their values and their religion and wishes allow us to advocate for them when theyve reached the end of life. MedStar Washington Hospital, Medical House Call Program Privacy Policy. The team meets for two hours weekly to discuss patients with unstable conditions and gather input from consulting pharmacists, physical therapists, psychiatrists, and other specialists. What gels or ointments help with pain caused by arthritis? This nationally recognized program provides medical and social services to patients in the home, improving patient outcomes and quality of life. Medical care is right next door at MedStar Good Samaritan Hospital. Services include: house calls by NPs and MDs for primary and urgent care; full range of diagnostic tests comparable to urgent care; home delivery of medications and equipment; coordination of home nursing, physical therapy, & hospice; on-call physician 24/7; Mobile electronic health record; coordination of specialty care and procedures at MedStar Good Samaritan hospital; in-home counseling & caregiver support by social workers & other staff; coordination of in-home supports such as home health aides, respite care, and financial assistance, Care coordination/management, Multidisciplinary care teams, Hospital/health system, Skilled nursing facility, Home health care, Non-clinical setting. The patients who have great, devoted, open, responsive caregivers are the ones who almost never show up at the hospital, because they are willing to work with us, do things at home, wait for us to arrive, and then implement the plan of care, he says. Many older adults struggle to get to the doctor's office due to severe chronic illness and disability. In MedStars house calls program, 60 percent of patients die at home, while 25 percent die in the hospital and 15 percent in inpatient hospice programs. Tai chi is also a wonderful way to improve your balance, coordination, breathing, bone density, stress level, and range of motion. In fact, in the last year, she was hospitalized only once. Team members rely on a mobile electronic health record to coordinate care. 3 K. Eric De Jonge, N. Jamshed, D. Gilden et al., Effects of Home-Based Primary Care on Medicare Costs in High-Risk Elders, Journal of the American Geriatrics Society, Oct. 2014 62(10):182531. Patients like Trujillos mother were the inspiration for MedStars Medical House Call program, launched in 1999 by two geriatricians troubled by the quality of care received by patients who were too sick, frail, or disabled to visit doctors offices. And at Cleveland Clinic, they have a telemedicine program, Sacks said. Executive Director of MedStar House Call Program Director of Geriatrics, MedStar Washington Hospital Center Julie Beecher, MS, MPH Assistant Vice President of Operations Geriatrics, MedStar Washington Hospital Center Deanna Cho, LICSW Social Worker and Case and Case Management Manager Michael Kingan, DNP, NP-BC, CWOCN Schaumburg, Illinois-based HCCI is a nonprofit organization that advocates for the expansion of home-based primary care. The program provides home-based primary care services to frail older adults with multiple chronic conditions or serious illnesses. In addition, our experts are studying a variety of other topics such as engaging individuals with dementia and their caregivers, NCGA patient-reported outcome measures, and age-friendly initiatives. Services include: house calls by NPs and MDs for primary and urgent care; full range of diagnostic tests comparable to urgent care; home delivery of medications and equipment; coordination of home nursing, physical therapy, & hospice; on-call physician 24/7; Mobile electronic health record; coordination of specialty care and procedures at MedSta. Welcome to the Online MedStar Health New Associate Orientation Survey. One-third participate in the Independence at Home Demonstration. The company's filing status is listed as Active and its File Number is T00439606. It will expand our ability to train residents routinely.. As part of the program, [emailprotected] also collaborates with home health companies for support when it comes to nursing and physical therapy. WASHINGTON When the coronavirus put a strain on health systems in cities, like New York, providers created "hospital-at-home," programs for patients with acute illnesses, but no need to be hospitalized. As a nationally recognized authority on clinical and operational best practices for home-based care, HCCI helps organizations build sustainable home-based primary care programs. Our goal is to help elders live well at home, where they want to be. The idea of a doctor entering the home to treat a patient, a type of medical visit otherwise known as a house call, may bring to mind television sitcoms of yesteryear rather than the current health care landscape. Geriatrics | Senior Care | MedStar Health Please Enable Location Services in Your Browser Settings to Continue, Geriatrics | Senior Care | MedStar Health, Medication Management for Adults With Cognitive Disorders, Care at Independent, Assisted-Living, and Nursing Home Settings, CHF, COPD, Cancer and Other Serious Chronic Illness, Difficulty in Performing Daily Activities, Syndromes Such as Frailty and Urinary Incontinence, Interdisciplinary and Specialty Programs in Complex Medical Needs, Such as Dementia and Alzheimers Disease, Safe Mobility for Aging Adults (Includes Secondary Fracture Prevention, Non-Orthopedics Programs, and Pain Management), Medication Management and Deprescribing Program, Quality of Life and Preventive Care (Includes Incontinence Management, Small Procedures, Vaccines, and Health Screenings), Caregiver Support Group and Other Classes and Events, K Eric De Jonge 1, Namirah Jamshed, Daniel Gilden, Joanna Kubisiak, Stephanie R Bruce, George Taler, Behavioral and Mental Health (Psychology and Psychiatry), Chronic Obstructive Pulmonary Disease (COPD), Good Faith Estimate and No Surprise Billing. * 2. But as the COVID-19 emergency continues and more people start to embrace home-based care, theres a case being made for more education around house calls for prospective doctors. This moving, meditative martial art is a great way to be active (in a slow moving, peaceful way thats good to your body) and to meet like-minded people. Home Health Care | Assistance and Services | MedStar Health The program serves a population of frail older adults who are mostly Black women with low incomes and more than two chronic conditions. Too much uric acid can lead to gout, which can be painful. Narrowing the programs focus to the highest-risk patients uncovers the greatest opportunities for care improvement and cost savings. This photo was selected prior to the COVID-19 pandemic. Demo Day connects home health and home care providers interested in implementing new solutions at their organizations directly with the latest companies offering their solutions. Overdose Deaths Remain Higher Than in Other Countries How Harm-Reduction Programs Could Help, Informing Medicaid Policy Through Better, More Usable Claims Data, Learning from the U.K.s Mistakes in Risk Adjustment in Primary Care. Our Faculty | Home Centered Care Institute You could try arthritis aquatics classes. Managing Movement Disorders in the Elderly Please Enable Location Services in Your Browser Settings to Continue, Good Faith Estimate and No Surprise Billing, GeriatricsHealth Services/Quality/Outcomes. The MedStar House Call program, based at MedStar Washington Hospital Center, began in 1999 to provide home-based primary care to frail elders who are unable to get to their doctor's office. Lasting from one to two hours, the assessment is used to identify the constellation of clinical, psychological, and social problems the patient is facing, as well as medication discrepancies and safety hazards. On a daily basis, the Medical House Call Program serves an average of 600 frail elderly patients, most of whom live within the District of Columbia. MedStar's House Call Program targets patients 65 and older who are home-bound or otherwise struggle to get to a doctor office. Also, maintaining a healthy diet and weight are best for your back any time of the year. MedStar House Call Program (previously known as TEC-C) consists of modular and geographically-targeted teams who serve the most ill subgroup of elders in a catchment area, usually within a 25-minute driving radius. After a physical exam and a review of Robert Wood's medication, the good doctor asks if he has any questions before he begins to write out instructions for him. In homes where a caregiver is present, typically half the visit is spent with the patient discussing physical symptoms such as pain or difficulty breathing. Older people lose their sure-footedness as they age due to coordination, changes in feet, hearing loss, and equilibrium. With 85% of the people that need this kind of care not getting it, we knew that we needed to train people and bring people into the field.. PDF HSCRC Transformation Grant Playbook e-alertsoffer the latest on leading-edge efforts to improve care. Even worse off were patients with no family nearby. Since shes been with the program, shes no longer on her insulin, explains Karen. Bringing Primary Care Home: The Medical House Call Program at MedStar We recognize the numerous challenges that can be encountered by home-based primary care (HBPC) providers.