In a move to serve Chicago’s growing number of seniors and to reduce costs for Northwestern Memorial Hospital, Northwestern University’s Feinberg School of Medicine will soon offer a program that trains doctors on how to provide home-based primary care.
Feinberg has been working with Schaumburg-based Home Centered Care Institute for the past year to develop a program that will coach up to 40 doctors, physician assistants, social workers and nurse practitioners to provide primary care to patients at home. Five Northwestern hospital officials will teach at the new Center of Excellence, which is set to open in early October.
Northwestern’s Center of Excellence joins seven other national home health training programs, including those at the Cleveland Clinic, the Mount Sinai Health System in New York and the University of California, San Francisco.
“Ultimately, being in your own home is where most seniors want to be. With home-based primary care, it allows physicians to meet that need,” said Dr. Lee Lindquist, chief of geriatrics at Feinberg, who leads the initiative. “With HCCI we’re able to leverage the educational abilities of Northwestern and lead the field in training the new generation of physicians in home-based medical care.”
Lindquist said many Chicagoans bought apartments in buildings like the John Hancock Center 30 years ago and are now aging in these spaces. But only 40 doctors specialize in senior care in Chicago—far below the number of geriatricians needed, she said.
In 2050, the national population of those 65 and older is projected at 83.7 million, nearly double that group’s population in 2012, according to census data. It’s the most rapidly growing population in the U.S. and is associated with the highest Medicare costs. By training more doctors in home health, Lindquist said Northwestern will meet Chicago seniors’ growing health needs and save hospitals space and money.
Although Northwestern has worked with Wheaton-based house call agency Homecare Physicians since 2014, Lindquist said Northwestern wants to respond to city patients’ health needs.
Many of these patients are over 65 and “the sickest of the sick,” with 10 separate conditions, said Dr. Tom Cornwell, founder and CEO of Home Centered Care Institute, a home health nonprofit. HCCI and Northwestern will train health professionals on the business and care necessary for home calls. Doctors will learn how to bill for transportation costs and assemble electrocardiogram equipment at a home, for example.
These home caregivers also can refer patients to cardiologists, dietitians and other specialists who will make house calls. Northwestern doctors will be able to attend this training for free, Lindquist said. Attendance at Northwestern’s Center of Excellence is $2,500 for everyone else, with a discount for students and those completing their hospital residencies.
“These patients, they are getting sick, and their only option is to call 911 to get to the hospital,” Cornwell said. “By enabling patients to stay at home, we help reduce nursing home placement and medical costs.”
Home health decreases the cost for the patient and the hospital. In 2012, Medicare started penalizing hospitals for excessive readmissions, and more than 65 percent of Illinois hospitals have since been fined, including Northwestern. By investing in home-based primary care, Cornwell said, Northwestern can reduce readmissions.
Cornwell also cited the results of a pilot program by the Centers for Medicare & Medicaid Services that provides primary care at home to chronically ill Medicare beneficiaries. Launched in 2012, the Independence at Home program aims to reduce unnecessary emergency room visits, avoidable hospitalizations and readmissions, and overall Medicare costs. It is currently active in 14 states. Illinois is not one of them.
CMS found that in the first year Independence at Home saved hospitals $25 million and led to fewer 30-day readmissions, hospitalizations and emergency department visits for patients.
Dr. Paul Chiang, medical director of Homecare Physicians, said he’s optimistic Independence at Home will eventually become a permanent Medicare benefit and expand to Illinois.
“It’s got bipartisan support,” Chiang said. “That’s pretty hard to get.”
Dr. Tom Cornwell’s last name has been corrected.