For 91-year-old Rhode Island resident, Elvira, living alone, in a high-tourist area, can be challenging. She suffers from depression, anxiety and isolation that is only heightened during the off-season, when the population dwindles.

During that off-season time, Elvira became afraid to leave her long-time home and started missing her doctor’s appointments, a scenario that could be all too familiar for some Rhode Island seniors. In addition to being socially isolated, seniors may not be getting the comprehensive healthcare they need.

Blue Cross & Blue Shield of Rhode Island (BCBSRI) recognized the need for better support for in-home care for those managing multiple or complicated health conditions – and HouseCall by Blue was born. Launched in 2015, this coordinated care program focuses on improving access to high-quality healthcare by providing in-home and phone support to those who are physically unable to visit their healthcare provider. The program sends physicians, nurses, nurse practitioners, behavioral health providers, pharmacists, nutritionists and social workers to members’ homes day or night, and also offers a dedicated phone line that members can call 24/7/365 to talk to a practitioner.

It’s the HouseCall by Blue program that helped Elvira get the care that she needed. The HouseCall by Blue team visited Elvira in her home and set up a regular connection for her with a physician over the phone who worked with her on progressive muscle relaxation and deep breathing exercises. Now, Elvira can identify when she is feeling stressed and anxious, and use coping mechanisms to help manage her feelings. Without this program, Elvira would have had to leave her home to get this level of care.

The direct and constant face-to-face communication that is the hallmark of HouseCall by Blue allows members to remain in their homes and helps avoid unnecessary emergency services for things such as respiratory infections, headaches or back pain. There is a significant positive impact on care when a provider can visit a patient the same day to help manage their care or help them transition back home from the hospital or a skilled nursing facility. That visit can give members the added comfort and confidence to remain at home during their recovery.

HouseCall by Blue also focuses on preventive care. Patients complete a comprehensive evaluation, identifying the resources they may need, which is then shared with their primary care provider to create a personalized health plan. The provider receives regular, real-time information allowing them to develop a deeper and more complete knowledge of their patient.

HouseCall by Blue complements the care delivered by primary care providers and specialists, ensuring treatment plans are carried out accurately. Some recent statistics include:

• In 2018, HouseCall by Blue completed 7,082 in-home visits.
• More than 1,000 BCBSRI members are enrolled in the program.
• From April 2018 to November 2018, the average monthly readmission rate for patients in the program was 10 percent. Rates at the 80th percentile or lower (or, under 20 percent) are considered optimal by Centers for Medicare & Medicaid Services (CMS).

The team leading HouseCall by Blue’s 24/7/365 phone and in-home services also offers caregiver training, including crisis management skills and access to community resources. For more information about how BCBSRI is helping members access the help they need, wherever and whenever they need it, visit bcbsri.com/medicare/member/yourhealth or call (401) 277-2958 or 1-800-267-0439 (TTY: 711).

Smita Wadhwani, RN, BSN, is the director of case management at BCBSRI.