Bipartisan Legislation Introduced to Make Independence at Home Program Permanent

This innovative home-based primary care Medicare program brings primary care medical services to Medicare beneficiaries with multiple chronic conditions in their homes. It has already saved $25 million in its first year. A new bill introduced March 2 would make it permanent.

U.S. Senators Edward J. Markey (D-Mass.), Rob Portman (R-Ohio), Michael Bennet (D-Colo.), and John Cornyn (R-Texas) reintroduced legislation (S.464) last Thursday to convert the Independence at Home (IAH) demonstration into a permanent, national Medicare program. Independence at Home is an innovative, team-based model that is bringing measurable, high-quality care to patients suffering from multiple debilitating diseases such as Alzheimer’s, ALS, congestive heart failure, diabetes and Parkinson’s, while significantly lowering costs for the Medicare program.

Independence at Home empowers teams of doctors, care givers and other health care professionals to coordinate and provide primary care services in the comfort of patients’ own homes, reducing unnecessary emergency room visits and avoidable hospitalizations and readmissions, as well as the costs associated with them.  According to the Centers for Medicare and Medicaid Services (CMS), the Independence at Home payment model saved more than $25 million in its first performance year alone, an average of $3,070 per participating beneficiary.

UA chief of the Division of Geriatrics, General Internal Medicine and Palliative Medicine, co-director of the UA Center on Aging and the Anne and Alden Hart Endowed Chair in Medicine Mindy Fain, MD, is president of the American Academy of Home Care Medicine, which endorsed the legislation.

She informed her department chair, Monica Kraft, MD, head of the UA Department of Medicine, and the Robert and Irene Flinn Endowed Chair of Medicine at the UA College of Medicine – Tucson, of the news Friday.

“This is terrific,” Dr. Kraft said. “This suggests that more of our seniors will have this benefit covered by Medicare.”

“Yes! It will support our home-based primary care program through a shared savings model — we would actually be able to provide great care, save Medicare significant dollars, and our program would be in the black. In Arizona, there are an estimated 35,000 home-bound seriously ill patients who would be eligible and would benefit,” Dr. Fain replied.

“Through Independence at Home, our most vulnerable seniors are receiving care in their living rooms rather than emergency rooms,” Sen. Markey said. “We are improving the care that frail patients receive and saving taxpayers money by catching emerging health problems early. Independence at Home is helping steer our health care system toward a focus on quality and not simply the quantity of care. I thank Sens. Portman, Bennet and Cornyn for their partnership on this legislation to ensure that this innovative program is permanently accessible to all Medicare beneficiaries and their family caregivers in the future.”

“The Independence at Home program works, and I've seen that firsthand in Northeast Ohio,” said Sen. Portman. “It has made a difference by reducing hospital readmissions, preventing costly hospital and nursing home admissions, and, most importantly, keeping our seniors healthy and in their preferred care setting. Our bipartisan legislation would make the program permanent so that it can continue to help, and make it accessible to Medicare beneficiaries in Ohio and across the nation so that it can help more of our seniors.”

“Expanding the Independence at Home program will allow Colorado seniors with chronic conditions to obtain the care they need, while staying out of the hospital,” said Senator Bennet. “This legislation builds on our state’s dedication to creating a robust coordinated care network that empowers caregivers and improves patient lives.” 

A copy of the legislation can be found HERE.

In 2012, Independence at Home began as a three-year demonstration program. In 2015, the U.S. House and Senate approved a two-year extension. Sens. Markey and Ron Wyden (D-Ore.) are the original co-authors of the Independence at Home provision in the Affordable Care Act.

“We are thrilled that this bipartisan group of Senators is advancing legislation to create a national Independence at Home (IAH) program for some of our nation’s most frail and elderly,” Dr. Fain added. “IAH care for elders with severe chronic illness and disability has proven to be incredibly successful and should be accessible across the country.  We have proven that IAH provides the care patients and their families want and need and it also saves Medicare money.”

Upon passage as part of the health care law, the Independence at Home program:

  • Established a voluntary patient-centered, pilot program in 13 Independent Practices and one Consortium;
  • Utilized a coordinated health care delivery model to ensure that Medicare beneficiaries with multiple chronic conditions who also need help with the activities of daily living can remain independent for as long as possible in the comfort of their own homes;
  • Reduced costs by coordinating the care of these patients and reducing duplicative and unnecessary services, preventing hospitalizations, and lowering other health care costs;
  • Created an incentive for additional savings through investment in health IT and other technologies; and
  • Developed a new, attractive career path for primary care physicians by enabling them to lead IAH organizations and receive reimbursement for house calls.

“Banner Health Acquiring Tucson Home Health Agency” | Posted Jan. 12, 2017
“UA Geriatrics, Palliative Care Chief Supports U.S. Senate Bid to Advance At-Home Primary Care” | Posted July 25, 2016

Release Date: 
03/06/2017 - 5:15pm