Independence at home demonstration could become permanent

A 3-year pilot program, Independence at Home (IAH), has been shown to reduce the number of emergency admissions and lower Medicare costs by providing a range of primary-care services to patients in their own homes. The IAH program could become enshrined in law if a bill is passed in the Senate, with the aim of becoming a nationwide initiative and filling the gap in care between hospital and home for sick and elderly patients.

A pilot program that incentivizes home-base health care delivery might become a permanent, national Medicare program if lawmakers’ recent legislation is approved.

The bill aims to convert the Independence at Home (IAH) demonstration, a three-year pilot that completed its first performance year in 2015 and provides chronically ill patients with primary care services in the home setting, from its limited reach to the entire nation of Medicare beneficiaries. The program aims to reduce unnecessary emergency room visits and avoidable hospitalizations and readmissions, provide primary care within a patient’s own home and reduce Medicare costs overall.

IAH was extended for another two years last year by the House and Senate. During its first year, the program saved more than $25 million, or an average of $3,070 per beneficiary, according to the Centers for Medicare & Medicaid Services (CMS).

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The bill to make the program permanent was introduced by Senators Edward J. Markey (D—Mass.), John Cornyn (R—Texas), Michael Bennet (D—Colo.) and Rob Portman (R—Ohio) in early July.

“It’s time to turn the successful experiment that is Independence at Home into a nationwide practice,” Senator Markey said in a statement. “We can design Medicare so that it works smarter, not harder for its beneficiaries. Independence at Home allows teams of doctors and nurses to continue to care for severely ill Medicare patients in the home, bringing the house calls of yesteryear into the 21st century.”

During the first year of the demonstration, 17 participating practices improved quality in at least three of the six quality measures, according to CMS. The agency will award incentive payments of $11.7 million to nine participating practices that reduced Medicare expenditures and met quality goals during the first demonstration performance year, CMS said last year.

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“I have seen the benefits the Independence at Home program has provided for seniors in Northeast Ohio during the demonstration program—it has reduced hospital readmissions, prevented costly hospital and nursing home admissions, and most importantly kept patients healthy and in their preferred care setting,” Senator Portman said.

More than 100 industry groups have said they support the Independence at Home demonstration.

“IAH successfully fills a critical gap in health care for our frail and elderly that few programs have been able to achieve,” Dr. Mindy Fain, president of the American Academy of Home Care Medicine, said in a statement. “Independence at Home will help care providers better coordinate care management, reduce costs and allow individuals to have more control over their care plan.”

If approved, the bill would make the program permanent within 18 months after the date of the legislation’s enactment.

Written by Amy Baxter