Betting That a House Call Is Cheaper Than a Trip to the ER

From the Wall Street Journal Health Blog:

You twist your ankle, or you get a nasty flu and spike a high fever. It doesn’t feel like a life-and-death situation, but it’s pretty bad the middle of the night, or you can’t get in to see your doctor. So you head for the emergency room.

Not only is this unpleasant and inconvenient; it also sends the cost of treating that fever through the roof.

Enter Carena, a little company out in Seattle, that’s betting that self-insured companies can save money by having employees skip some trips to the ER and get a house call from a family doc instead.

The company’s big break came a few years back, when it cut a deal to do house calls for most of Microsoft’s 85,000 Seattle-area employees. Now it’s looking to expand the business, and recently got a contract that covers some 45,000 employees of the Commonwealth of Kentucky. (The company also has a smaller, separate business providing on-site care for employees.)

It works like this: A sick or injured employee calls a nurse line. More than half the time, the employee will be told the situation isn’t an emergency, and can wait for a trip to the doctor or the urgent care center. About 10% of the people who call are told to head for the ER immediately. But that leaves about 20-25% of the calls, where the patient shouldn’t wait but doesn’t need the high-intensity, high-cost care of the ER.

In those cases, Carena sends a doctor to the employee’s house for a house call. (The docs work exclusively for Carena, and make about what a private practice family doc makes.)