A house-call-based practice is a viable solution for improving care delivery for patients with advanced multiple sclerosis (MS) and disability. This according to a recent study that implemented a house-call program, Multiple Sclerosis at Home Access (MAHA), designed to provide comprehensive services while focusing on preventing common complications. Key aspects included monthly house calls, continuity among providers, and a multidisciplinary team led by a provider bridging sub-specialty and primary care. A total of 21 patients (EDSS ≥ 7.5) completed 1 full year of the program. Researchers found:

• Over the 2-year pre- and post-evaluation period, half of the hospital admissions were related to secondary and generally preventable complications.
• Aside from a single “outlying” individual important to the evaluation, in the year following implementation of the program, decreases were found in number of individuals hospitalized, hospitalizations/skilled facility admissions, and days in hospital.
• The total number of overall ER visits decreased; ER-only visits increased (ie, ER visits without hospital admission).
• Patient satisfaction reports and quality indicators were positive.
• 50% of patients were able to participate in supplementary tele-visits.