Home Visits Don't Reduce Heat-Related ED Use in Older Adults

Medicaid home visits before heat events are not associated with changes in emergency department visits among older adults during extreme heat, a study shows.

Feb. 6, 2026 at 8:23am

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A retrospective cohort study found that regular Medicaid home visits prior to heat events were not associated with changes in emergency department (ED) visits during heat events among older dual-eligible enrollees. While the visits did not reduce acute care use, they could have facilitated appropriate care-seeking when heat-related symptoms arose.

Why it matters

As climate change increases the frequency and intensity of extreme heat events, understanding how to protect vulnerable older adults is crucial. This study suggests that while home visits may not directly reduce ED use, they could play a role in ensuring timely care for heat-related issues.

The details

Researchers linked Medicare and Medicaid claims with zip-code-level weather data for 597,388 community-dwelling, dual-eligible adults aged 65 or older across the US between May and October in 2018 and 2019. They compared outcomes between participants who experienced at least one extreme heat event and received at least one weekly Medicaid home visit in the month preceding, and those who did not receive visits. The primary outcome was all-cause ED visits per 1000 enrollees during heat events and the following 2 days.

  • An extreme heat day was defined as a day when the maximum temperature exceeded 90°F.
  • Consecutive extreme heat days were grouped into extreme heat events, which lasted 1-5 days.

The players

Hyunjee Kim, PhD

Researcher at the Center for Health Systems Effectiveness, Oregon Health Science University, Portland, Oregon.

National Institute on Aging

The organization that funded the study.

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What they’re saying

“We found that regular Medicaid home visits prior to heat events were not associated with changes in ED visits during heat events among older dual-eligible enrollees.”

— Hyunjee Kim, PhD, Researcher

“While these findings suggest that home visits did not reduce acute care use during extreme heat, they could mean that such visits facilitated appropriate care-seeking when heat-related symptoms arose.”

— Hyunjee Kim, PhD, Researcher

What’s next

The study was limited by potential selection bias and the inability to examine mortality as an outcome. Future research should explore how home visits and other interventions can be optimized to protect vulnerable older adults during extreme heat events.

The takeaway

This study highlights the need for more effective strategies to safeguard older adults from the health impacts of climate change-driven extreme heat, beyond just home visits. Comprehensive approaches addressing access to cooling, caregiver support, and community infrastructure may be necessary to truly reduce heat-related morbidity and mortality in this population.