Independence At Home model aims to reduce health care costs and hospital visits of chronically ill patients by better coordinating care
 
WASHINGTON, D.C. – The Centers for Medicare and Medicaid Services (CMS) today released guidelines for Independence At Home (IAH), a new model for providing care to Medicare beneficiaries. Authored as part of the Affordable Care Act by Congressman Edward J. Markey (D-Mass.) and Senator Ron Wyden (D-Ore.), IAH makes it possible for the sickest and most vulnerable seniors to receive primary care services in the comfort and security of their own homes. Teams of health care providers will be responsible for providing and coordinating care for these individuals. If the team succeeds in providing high quality care while also lowering costs, the doctors and nurses will be able to share in the resulting savings. This innovative model of providing care will help seniors better manage their health, allow them to receive care where they are most comfortable, and reduce visits to the emergency room and hospitalizations.
 
“Through Independence at Home, our most vulnerable seniors can receive care in their living room rather than an emergency room,” said Rep. Markey. “We can improve the care that frail patients receive and save taxpayers money by catching emerging health problems early, before they require a costly hospitalization. And for the first time, the doctors and nurses caring for chronically ill patients will be able to share in the savings that result from their good work. Independence at Home will help steer our health care system toward a focus on quality and not simply the quantity of care.”
 
“Home based chronic care programs like Independence at Home have been proven to dramatically lower the cost of treating some of the most expensive patients and to provide them with better health outcomes,” said Senator Wyden. “Rep. Markey and I believe that this demonstration will prove that delivering coordinated and quality care to the Medicare community will also result in significant savings to the program. We have worked for a very long time to bring this program to fruition and despite some bureaucratic hurdles, thousands of Medicare patients will now receive excellent home based care that we hope can be expanded to the millions of Medicare beneficiaries suffering from multiple chronic conditions. This is a great step forward, and I will continue to work with CMS to make sure IAH is the success story I know it can be.”
 
Approximately four million seniors currently living with advanced chronic illnesses - such as diabetes, Alzheimer’s Disease, and heart disease - are too ill or disabled to visit their physician easily when they need care. These seniors, representing ten percent of Medicare, account for two thirds of Medicare's expenditures. The top five percent of Medicare beneficiaries, by cost, account for nearly 50 percent of Medicare’s expenditures. Additionally, because it can be difficult for chronically-ill seniors to access a physician's office for preventive care and proactive medical management, they experience unnecessary emergency room visits and avoidable hospitalizations and readmissions. Only about one-tenth of the estimated home primary care visits needed to adequately care for this population are now made. The main barrier is the lack of payments or incentives for chronic care coordination. Independence at Home will address this gap by allowing the teams of healthcare providers to keep some of the savings if they are successful in lowering the cost of care for their patients.
 
“We are all excited to see the Independence at Home program being implemented after ten years of development and vetting,” said Constance Row, Executive Director, American Academy of Home Care Physicians. “Independence at Home is both an innovative clinical and reimbursement health care delivery model that reduces Medicare costs where they are the highest by at least 5% annually, improves health care outcomes for those with multiple chronic conditions and achieves patient/caregiver satisfaction. It also provides an incentive to treat the highest cost beneficiaries with the most complex chronic conditions. We are aware of more than 150 organizations in 35 states that are interested in participating in the IAH program. We want to thank the authors of the legislation, Congressman Ed Markey and Senator Ron Wyden, for their tireless efforts in making the Independence at Home program a reality.  We also want to thank the many members of Congress who made it possible for the Independence at Home program to receive bipartisan support. As many of them have said, Independence at Home is truly the future of health care. Also, we wish to thank those at CMS who designed the implementation standards and CMS Administrator Tavenner for her leadership in issuing the implementing instructions before the January 1 statutory deadline. Finally, we wish to thank the many association and other members of the Independence at Home Coalition for their advice and support. We now have the opportunity to significantly reduce health care costs by providing better health care to those most in need.”
 
“As a geriatric physician who has provided primary care to chronically ill patients in their homes for years, I am moved and grateful that Medicare’s most frail beneficiaries will at last be able to obtain the kind of chronic care coordination services that will improve their quality of life and allow them to remain more independent in their homes and avoid unnecessary hospitalizations, emergency room visits and nursing home use,” said Dr. George Taler, Director, Washington Hospital Center Housecall program. “We are also grateful that IAH allows us to partner with other providers so that all can share in the savings achieved. Based on my experience, the Independence at Home program will have an immediate positive effect on patients suffering from multiple chronic conditions and their family caregivers.  I look forward to implementing this program.”
 
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