Today, Congressman Edward J. Markey (D-Mass.) and Senator Ron Wyden (D-Oreg.) praised the Centers for Medicare and Medicaid Services (CMS) announcement of the selection of 16 practices and programs to participate in Independence at Home (IAH), an innovative healthcare model the lawmakers authored in the Affordable Care Act. The Boston Medical Center and Housecall Providers in Portland are among the selected programs. The IAH model brings home-based primary care to some of Medicare's sickest and most frail seniors who are unable to make it to a doctor's office. A team of doctors and other health care professionals coordinates the patients' care and provides primary care services in the comfort of their own home. If the team is successful in providing high-quality care for the patient while lowering costs, they are eligible to share in a significant portion of the savings. The IAH pilot programs will begin on June 1, 2012 and continue for three years.
IAH is modeled after the highly successful Home-Based Primary Care program run by the Department of Veterans' Affairs (VA) for decades. Under the VA program, hospital stays have dropped by more than 60 percent. Nursing home days went down by 88 percent. Patients avoid unnecessary hospitalizations and their families receive much needed relief from providing care for their loved one.
"Thanks to Independence at Home, our most vulnerable seniors can receive care in their living room rather than an emergency room," said Rep. Markey. "This vital program will enable teams of doctors and nurses to care for severely ill Medicare patients in the home, bringing the house calls of yesteryear into the 21st century, going from the black bag to the Blackberry. Coordinating care and closely monitoring patients to catch health problems early are hallmarks of Independence at Home, enabling seniors to remain in the comfort of their home for as long as possible. This not only saves money but also increases the peace of mind of patients in their twilight years. I congratulate Boston Medical Center for being selected to participate in this innovative demonstration to fix the broken and fragmented way our frail, chronically ill seniors receive care today. I will continue to work with my colleagues and CMS to make the Independence at Home program accessible to all Medicare beneficiaries and their family caregivers in the future."
"With Independence at Home, we have an opportunity to both improve the health outcomes for thousands of Medicare beneficiaries and to dramatically reduce the cost of treating these most expensive patients at the same time," said Senator Wyden. "Congressman Markey and I have worked for years to see home-based healthcare brought to the Medicare system but we still have work to do. With only 10,000 patients in the demonstration project it will take time for the program to reach its full potential but I am confident that the benefits and cost savings of home-based care will prove that the program deserves to be a larger part of the Medicare equation. Today's announcement, however, is great news for the thousands of patients and hundreds of providers who will benefit from home-based care right now."
"Boston Medical Center is honored to have been chosen as a recipient for the Independence at Home Demonstration," said Boston Medical Center President and CEO Kate Walsh. "Given our history of providing the longest continuously operating in-home medical service in the United States, BMC is uniquely qualified to help determine whether home-based care for individuals with multiple chronic conditions can reduce the need for hospitalization, improve patient and caregiver satisfaction, and lead to better health and lower Medicare costs. We look forward to participating in this important program."
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 10 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.