South Routt Medical Center starts new house call program |

South Routt Medical Center starts new house call program

Michael Schrantz

South Routt Medical Center nurse practicioner Linda Casner

— The medical house call is making a resurgence in South Routt County.

South Routt Medical Center is bringing back the practice in a limited form as a way to improve care and help meet new hospital regulations.

"It's kind of a back-to-the-future approach to medicine," said Dr. Dan Smilkstein, the center's medical director.

"The original motivation was just to reach out to members of the community and make sure we're supporting them. This is a community-supported health care center."

"It's making a house call," added Ann Trout, president of the center's board. "It will be with people who we identify as high risk and would otherwise have difficulty accessing medical care."

The service aims to bring a medical provider to people who are at high risk for re-admission, who are dealing with chronic issues or who are socially isolated, Smilkstein said.

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A section of the Affordable Care Act lowers government repayment for hospitals that have excessive readmission rates, and this program is partly in response to that.

Five percent of medical patients can equal 50 percent of what's spent on care, Smilkstein said, and "impacting just a few people can have a huge impact on the economics."

The center has partnered with Yampa Valley Medical Center to receive discharge information for those who live in its district to use to follow up with them.

"This also is not intended to replace anyone's primary care physician," Trout said. "It's really meant to meet with people in their homes and review discharge instructions again with them in their home setting and make sure that they understand everything."

Nurse practitioner Linda Casner will do the house calls with a medical assistant, typically on Thursdays. She will be able to do some diagnostic and blood tests and some prescribing, according to Smilkstein.

Smilkstein said there are similar programs popping up in urban areas or by for-profit services and in Canada, as well, but there's no template to build off.

"How do you exactly get to people and educate them to improve health care at their site and at their home?" he asked. "The patient education part is critical. Ultimately, there has to be patient responsibility."

Now, center staff are trying to get the word out about the program and assess who might be considered high risk.

Those who want to participate in the program should call the center at 970-736-8118.

Health care throughout time has swung between personal physicians and increased specialization, Smilkstein said. With the Affordable Care Act, the focus is once again on centralizing care.

"Just the value of having human contact with people — I believe there's a huge healing component there," Smilkstein said.

"We cover a pretty large geographical area," Trout said. "Really, when you look at the program, it's pretty innovative, but it is kind of like going back to a proven method of health care in home visits."

To reach Michael Schrantz, call 970-871-4206 or email

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