Markey, Wyden Encourage CMS to Implement "Independence at Home" Within 6 Months

Press Release

IAH Program Included in Health Care Reform Law, Sponsors Receive Award from American Academy of Home Care Physicians

Representative Edward J. Markey (D-Mass.) and Sen. Ron Wyden (D-OR.), authors of the Independence at Home demonstration program included as Section 3024 of the Patient Protection and Affordable Care Act (P.L. 111-148), today sent a letter to Acting CMS Administrator Marilyn Tavenner encouraging CMS to implement the program as soon as possible prior to the law's January 2012 deadline, with a goal of implementation within the next 6 months.

The Independence at Home program enables Medicare beneficiaries with multiple chronic conditions, such as Alzheimer's Disease, diabetes, congestive heart failure and other permanent conditions, to maximize their independence by bringing primary care to them in their homes furnished by physician and nurse practitioner directed teams of health care professionals tailored to the beneficiaries' specific chronic conditions Individuals with multiple chronic diseases account for up to 85 percent of Medicare spending and typically suffer poorly managed, disjointed care under the current highly fragmented, fee-for-service, traditional Medicare reimbursement system.

"We believe strongly that there are numerous reasons for implementing the IAH program sooner rather than later," the lawmakers wrote in the letter. "There is also strong evidence that the clinical house call model at the heart of the IAH program works and can be implemented quickly."

In the letter, the lawmakers also:

- Suggest that CMS enter into agreements with a sufficient number of IAH health providers so that at least 5,500 Medicare beneficiaries participate to ensure that the demonstration program is adequately tested.

- Recommend that the implementing specifications for the IAH demonstration program provide for an 80 percent/ 20 percent split of savings for providers beyond the first 5 percent savings threshold during the 3-year term of the IAH demonstration, as long as providers meet certain quality of care requirements. Such a division of savings is intended to address the economic risk providers assume to participate in the IAH demonstration program, as providers are accountable for achieving at least 5 percent savings for caring for Medicare beneficiaries participating in the IAH program as compared to the cost of caring for these patients in the absence of the IAH program.

- Call for CMS to expand the IAH program beyond 3 years to include additional beneficiaries if it is saves money and improves care.

On Tuesday morning, Markey and Wyden also received an award from the American Academy of Home Care Physicians at a ceremony kicking off "Independence at Home Day" on Capitol Hill.

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