NP doing home calls?

Trauma Columnist · Jul 30, 2008

We have an MD home visit hospice service in our area. I have referred several of my pts to them and the pts/families have always been very happy with the physician visits.

I agree that NPs and PAs would be a natural extension of this service. I live in a rural area and could see this taking off here too.

Let us know what you decide - sounds very interesting.

Joan Z · Jul 30, 2008

I hate to show my age but I remember when doctors used to make "house calls" regularly--the idea being that the patient was too sick to travel!

I mentioned to the physicians I work with that I would be interested in doing that. In addition to avoiding getting more germs in the waiting room I thought it might be nice as a service (not to mention marketing ploy) to save some folks some $. They are looking into reimbursement.

I think it would be a great niche for NPs and PAs to fill.

Joan

mrspopeye · Jul 30, 2008

I once had a part-time, independent practice of house calls as a NP, and it was a great opportunity, especially in a rural community. I was the clinical manager of a home care agency for 10 years as a RN, and I used those business relationships as a foundation for building the practice once I became a NP. At the time, I was employed by an internal medicine physician, who served as my collaborating MD and did billing for me for a 10% fee. Reimbursement was very good from Medicare, and was actually quite a bit more profitable that working in the office. I would do a couple of calls on the way in and on the way home, or some close to the office if I did not have any appointments to supplement my income. You can find a lot of great information, including billing tips, through the American Academy of Home Care Physicians web site.

VivaRN · Jul 30, 2008

Within the current market though can someone explain to me how this model is as profitable as having an office? I would love to do this but fear it would not take off r/t not being able to see as many pts per day, or not billing for as many procedures. Not that these practices are best for pts (because they're not) but I'm wearing my financial hat. What about the cost of gas?

Does it work because there isn't as much overhead needed to run it, therefore don't need as much income? (I am still learning to understand these concepts...)

What a great idea!

ANPFNPGNP · Jul 31, 2008

I have recently ran across a couple of ads from a local weekly health-care publication that is seeking NP's and PA's to join a "Visiting Physician" service. The ads seek the above-mentioned non-physician providers to make in-home visits. I know home visits based on necessity (backed by a corresponding ICD-9 code) as a physician service are covered by Medicare Part B and it makes sense that NP's and PA's can be thrown into the mix because of our ability to directly reimburse Medicare. Has anyone seen this trend where you live? I actually called one of the companies who placed the ad and was told most visits are to home-bound seniors and that the provider does not drive the car - a driver drives the provider to the location using a company car! Pay was decent for NP's and PA's ($60/hr) averaging 7-8 hours a day. Seems pretty tempting but I wonder what the catch is, any thoughts?

Interestingly, a director of a home health company just told me about some company that's moving to town and this is exactly what they do. I would be just a little nervous about going to someone's home though.

Sixty per hour doesn't sound like much, considering home health RN's are making $40 per visit with gas paid and full benefits. I know a PT ASSISTANT who is getting paid $40 for 30 minute visits and she has a company car! So, $60/hr for one of us is NOT very good! :no: