Home visit only Practices—not Medicare Advantage.

Dr. Lorene L. writes

Are home visit practices for regular Medicare viable too, or do you have to do one through a Medicare Advantage plan?”





Home visit practices for Medicare are more viable now than ever before. Medicare Advantage is more lucrative, sure, but that’s not your only choice.



You can generate around $150 for every Medicare home visit you do. Your Medicare contract does not stipulate round the clock coverage, as most commercial contracts do. And you can use whatever medical record system you like.



With the internet, the marketing is simplicity itself—and essentially free.



I know several docs who use paper-based records, submit their bills through a third-party biller and accept whatever financial penalty Medicare imposes for not using an EHR.



There are some upfront costs in malpractice insurance and getting your systems in place. But once those things are done, they require very little maintenance. With a practice of this type, your insurance costs will be very manageable.



The model is not for those who wish to churn through patients, the benefit stems from the flexibility and low intensity. Set out access rules for your patients from the outset—prescription refills, after-hours calls and the like—and you can have a great practice. I know of one doc that puts a five-mile limit on the distance of his patient’s home from his personal residence so he can walk or ride to make his visits.



He loves his life—and he has a waiting list for patients.



All the things that drive you crazy about Medicare—the EHR, ACOs, metrics—those are still optional, they’re just associated with a financial penalty.



So if you care more about the quality of your life rather than the dollars that you generate, a home-visit only practice could be your ticket—with or without Medicare Advantage.