The traditional house call, where a physician visited a patient’s home, declined significantly by the late 20th century due to the rise of specialized clinics and hospitals. However, the concept has seen a dramatic resurgence, transforming into a structured service known as the medical home visit. This revival is driven by an aging population, improved portable technology, and a focus on patient-centered care. This article explains how this service has been modernized and how it functions today for patients seeking convenient and comprehensive healthcare outside of a clinic setting.
Defining the Modern Medical Home Visit
The modern medical home visit is a planned, structured healthcare service delivered directly to a patient’s residence. This deliberate medical appointment is distinct from an emergency call and is designed to provide primary, urgent, or chronic care management. Providers are often Nurse Practitioners (NPs) and Physician Assistants (PAs) who are fully licensed to diagnose, treat, and prescribe medication. Advanced practice providers, such as NPs and PAs, are now the largest group making these house calls, offering a cost-effective model.
This model focuses on routine and complex management in the home setting, particularly for patients with mobility limitations or chronic conditions. The home environment provides the medical team with valuable information about a patient’s diet, safety hazards, and social support, which is unavailable in an office setting. By bringing the “exam room” to the patient, the modern medical home visit offers continuity of care for those who have difficulty traveling.
Range of Services Provided
The scope of a modern medical home visit is broad, often encompassing nearly all the services available in a traditional outpatient office, thanks to advances in portable equipment. Providers perform comprehensive physical examinations, health screenings, and medication reviews. Basic diagnostic testing can be done on-site, including blood draws for lab work and rapid tests for conditions like strep throat, influenza, and COVID-19.
Minor procedures and treatments are also routinely performed, such as minor wound care, administering vaccinations, and giving therapeutic injections. In some cases, providers arrange X-rays within the home using mobile imaging companies. While major imaging or surgical procedures remain restricted to clinics or hospitals, bringing routine and intermediate care to the patient is a key benefit. The primary goal is to ensure patients, particularly those recently discharged, receive follow-up care to prevent rehospitalization.
Scheduling and Payment Logistics
Patients can access medical home visits through several different business models, including specialized medical groups, direct-to-consumer services, and established primary care networks. Many services offer same-day or next-day appointments, which patients can book through mobile apps or online scheduling software. This quick response time is a significant convenience factor.
Financial logistics vary depending on the provider and the patient’s insurance coverage. Many house call programs accept Medicare and Medicaid, particularly when focused on home-based primary care for patients unable to travel. Private insurance coverage is also common, often requiring a co-pay similar to an urgent care visit. Direct-pay or subscription models are prevalent, where a single flat fee covers the visit, exam, and treatment plan.
Home Visits vs. Telehealth
Medical home visits and telehealth are complementary services that address different diagnostic needs. Telehealth, which relies on video conferencing and remote monitoring, is suited for virtual follow-ups, prescription refills, and assessment of non-physical symptoms. It is an efficient tool for routine questions or for conditions where a physical exam is not strictly necessary.
A physical house call, in contrast, offers the ability to perform a hands-on assessment and utilize portable diagnostic equipment, which is impossible with virtual care. The provider can conduct a physical exam, listen to lung and heart sounds, and take blood samples, necessary for diagnosing acute, non-emergent physical symptoms. The provider’s presence allows for direct observation of the patient’s living environment, providing crucial context for their overall health and care plan.