House call practice attracts $11.5 million investment

With house calls becoming more common -- and better paying -- at least one medical practice that specializes in this area has attracted investor interest.

On March 30, Triangle Capital Corp. in Raleigh, N.C., announced the investment of $11.5 million in Home Physicians Management, a house call practice based in Chicago with more than 100 physicians and podiatrists in Illinois and Maryland. Triangle does not have an ownership stake in the practice. Rather, the money refinances Home Physicians' unsecured debt.

Still, analysts say Triangle's move is a vote of confidence in the company's model.

"Home Physicians provides care for patients who are elderly or have disabilities that prevent them from accessing traditional primary care medicine without assistance," said Garland S. Tucker III, Triangle's president and chief executive officer. "We believe this is an underserved segment of the health care market with significant growth potential."

Physicians are not directly employed by Home Physicians Management because of laws restricting who can own medical practices. Rather, physicians are employees of a connected entity that supplies services to Home Physicians Management.

The economic feasibility of house call medicine has long been challenging. But analysts say that has changed slowly over the past decade as Medicare increased payment rates and an aging population raised demand. The program paid for more than 2.3 million house calls in 2009, up from 1.5 million in 1995, according to an analysis of Medicare data by the American Academy of Home Care Physicians.

Experts expect the number of home visits to increase because of several aspects of the Patient Protection and Affordable Care Act. They include the Independence at Home program, which will provide incentives for primary care teams to provide house calls. Some hospitals and large health systems may incorporate house calls into an accountable care organization, and others may use them to avoid penalties for high readmission rates.

Triangle "thought it was a good investment in a company that reduces total health care costs," said Craig Reiff, CEO of Home Physicians. "We provide access to health care, improve outcomes and reduce hospitalizations. It gives us better access to growth capital. We can not only fund our current operations but also expand to select new markets as well."