National demonstration continues to prove advantages of primary medical care at home

June 14, 2019

The Centers for Medicare & Medicaid Services (CMS) recently released the fourth-year results from the national demonstration project Independence at Home (IAH). Expenditures for beneficiaries within the 14 IAH practices across the country were 8.9% below their spending targets, an average reduction of $2,814 per beneficiary and a total savings of $32.9 million dollars.

Housecall Providers’ IAH beneficiaries saved 28.8% over a matched group of local individuals living with similar chronic conditions but not receiving home-based medical care. Housecall Providers met all six-quality measures, as they have done in all prior years, and as a result, will receive $800,183 as its share of the cost savings.

Fourteen home-based primary care practices completed the first four years of the demonstration, which began in June 2012 and ended in September 2016. For participants to be eligible for IAH they must have two or more chronic conditions, be covered by Original (fee-for service) Medicare, need assistance with two or more functional dependencies (e.g., walking or feeding), have had a non-elective hospital admission within the year as well as received acute or subacute rehabilitation services within the last 12 months.

U.S. Sen. Ron Wyden, D-Ore., who co-sponsored the legislation that created Independence at Home, urged Housecall Providers to consider taking part in the demonstration project back in 2012. “Housecall Providers continues to be a nationwide leader when it comes to providing quality care for seniors in their homes and keeping health costs down for Medicare,” says Sen. Wyden. “Oregonians should be proud of the pioneering work Housecall Providers is doing to show what the Medicare program of the future ought to look like.”

Through the utilization of home-based primary care teams, IAH tests a service delivery and payment incentive model designed to improve health outcomes for people with chronic conditions. In the project’s first year, Housecall Providers showed a 32% savings, and the following years, a 24% savings over the matched group.

“Participating as a co-chair on the American Academy of Home Care Medicine’s legislative and policy workgroup has enhanced my understanding of the significance of the IAH demonstration,” says Housecall Providers CEO Rebecca Ramsay. “Through this demonstration, we are learning how to set up a sustainable model that could help transform the standard of care for people living with serious illness. The commitment of our staff to their patients and the quality care they provide shows they understand the importance of IAH and what is at stake.”

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