What to consider if you're offered a home visit If the clinician could diagnose me with a serious health condition, the company could raise my risk score and get a higher Medicare reimbursement each time I visit the doctor. I've received two more calls since I first declined the home visit, each more persistent than the last. To provide an incentive for insurers to cover sicker patients, the plans are paid commensurately more for their care. He explains that the risk adjustment system was created to ensure that plans don't enroll only the healthiest patients, who are less likely to run up charges for expensive procedures and hospital stays. Generally speaking, the more diagnoses recorded, the higher the payment," Dr. "The home visits conducted by Medicare Advantage plans allow for the capture of more diagnoses, which in turn increases the risk score that adjusts plan payments from Medicare. As we develop more health problems, our risk score increases. He told me that each of us covered by these plans is assigned a risk score. As an associate professor of health policy at Harvard Medical School, he understands the arcane regulations that cover how Medicare reimburses my Medicare Advantage plan for the care I get. I don't have any serious conditions and my doctor consistently receives top grades from all the ratings systems. But what still puzzled me was why my insurer would want to incur the extra expense of duplicating the exam and tests I had just gotten from my doctor. And I learned that the extra exam had reduced hospitalizations, primarily for patients with diabetes, heart failure, or chronic obstructive pulmonary disease. I learned that these visits are legitimate - in fact, over a million patients have signed up for them so far. I declined, feeling a little creeped out - especially after checking with my doctor and learning that she knew nothing about this. And she'd even throw in a $25 Walmart gift card if I completed the exam. Since I work full-time, I could schedule the visit for a weekend. The home visit would last 45 minutes to an hour and would include a health history, a physical exam, screenings, and health advice. The only reason she could give was that the clinician would have more time to spend with me than my own doctor did. I'd also just had my annual physical, my immunizations and screenings were up to date, and I felt great. I assured her I could easily get to my doctor's office if I needed to. I have a Medicare Advantage plan, and I thought I was being offered this visit because the caller assumed I was frail and house-bound. So I was more than a little surprised when a woman representing my health insurance plan called to schedule me for a home visit from either a nurse practitioner or physician. Both he and his patients realized they were perhaps better served by going to his clean, well-equipped office for whatever care they needed. But he stopped visiting people at home long before he retired. When I was growing up, my doctor still made house calls when we were too sick to get to his office. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Please note the date each article was posted or last reviewed. ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content.
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