Housecalls Are Back and Booming. Are They a Threat to PCPs?

Neil Chesanow

Disclosures

July 20, 2016

In This Article

An Enduring Concept?

Whether the housecall revival will prove cost-effective is an open question. DMH, a traditional primary care practice that focuses on making housecalls to very sick patients, has been part of the CMS Independence at Home Demonstration for more than 4 years. The agency is still collecting and evaluating data; it's a slow process.

Los Angeles Times business columnist Michael Hiltzik, an outspoken critic of Uber housecalls, questions whether the Uber model is appropriate for healthcare.

"The real question is whether healthcare harbors the same inefficiencies that Uber has exploited," Hiltzik writes.[8] "That involves the question of whether healthcare is a service that can be reduced to fundamentals like local transportation. Is diagnosing or treating a disease the same thing as driving a car?"

Even those who have invested in Uber-housecall firms, like Tom Rodgers of McKesson Ventures, are cautious in their forecasts.

"The actuaries inside commercial payers and CMS will tell you that the jury is still out on whether they lower costs for the system," he says. "The economics for the housecall model," he admits, "are a challenge."

But RetraceHealth's Thompson Aderinkomi, for one, has a different perspective.

"It's not surprising that there are critics," he says. "But they're singing the same song that has been sung about every major innovation since the beginning of time. They'll be silenced once the model takes off. Every new thing looks like it won't work at first—until it does."

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