Independence at Home: A New Model for Providing Care to Medicare Beneficiaries

Strategic Insights -

The Centers for Medicare and Medicaid Services (CMS) has released guidelines for Independence at Home (IAH), a new model for providing care to Medicare beneficiaries. Authored by Congressman Edward J. Markey (D-Mass.) and Senator Ron Wyden (D-Ore.), IAH allows teams of healthcare providers to provide and coordinate care for the sickest and most vulnerable seniors in the comfort and security of their own homes. This innovative model aims to improve healthcare outcomes, reduce costs, and increase patient satisfaction.

Key Takeaways:

  • IAH is designed to provide primary care services to Medicare beneficiaries with advanced chronic illnesses, such as diabetes, Alzheimer's Disease, and heart disease, in the comfort of their own homes.
  • Approximately four million seniors are too ill or disabled to visit their physician easily when they need care, accounting for two-thirds of Medicare's expenditures.
  • The top 5% of Medicare beneficiaries, by cost, account for nearly 50% of Medicare's expenditures.
  • IAH will address the lack of payments or incentives for chronic care coordination by allowing teams of healthcare providers to share in the savings if they succeed in lowering the cost of care for their patients.
  • The program will help seniors better manage their health, reduce emergency room visits and hospitalizations, and improve health outcomes for those with multiple chronic conditions.
  • Over 150 organizations in 35 states are interested in participating in the IAH program, and it has received bipartisan support from Congress.
  • The program is expected to reduce Medicare costs by at least 5% annually and provide an incentive to treat the highest-cost beneficiaries with the most complex chronic conditions.

Statistics:

  • Approximately four million seniors are living with advanced chronic illnesses and are too ill or disabled to visit their physician easily when they need care.
  • These seniors account for two-thirds of Medicare's expenditures, while only 10% of Medicare beneficiaries.
  • The top 5% of Medicare beneficiaries, by cost, account for nearly 50% of Medicare's expenditures.
  • IAH is expected to reduce Medicare costs by at least 5% annually.
  • Over 150 organizations in 35 states are interested in participating in the IAH program.

Sources:

  • Centers for Medicare and Medicaid Services (CMS)
  • Congressman Edward J. Markey (D-Mass.)
  • Senator Ron Wyden (D-Ore.)
  • American Academy of Home Care Physicians, Exec. Dir. Constance Row
  • Washington Hospital Center Housecall program, Dir. Dr. George Taler