Independence at Home Demonstration
The IAH Demonstration tests a payment incentive and service delivery model for home-based primary care for Medicare fee-for-service (FFS) beneficiaries with multiple chronic illnesses. The demonstration tests whether home-based primary care that is designed to provide comprehensive, coordinated, continuous, and accessible care to high-need patients and to coordinate health care across all treatment settings reduces preventable hospitalizations, readmissions, and emergency room visits, improves health outcomes commensurate with beneficiaries’ stage of chronic illness, improves the efficiency of care, reduces the cost of health care services, and achieves beneficiary and family caregiver satisfaction.
Beneficiaries’ care is monitored using several quality measures. A savings benchmark is established that estimates what would have been spent for applicable beneficiaries in the absence of the demonstration. Practices that generate Medicare savings relative to their benchmark in excess of a minimum savings requirement may share in savings; the proportion of savings that a practice may receive as an incentive payment is adjusted based on its performance on these quality measures.
Independence at Home: Year 3 Results
In the third performance year of the demonstration, the Centers for Medicare & Medicaid Services (CMS) found that IAH practices saved approximately 4.7 percent, equating to $16.3 million, an average of $1,431 per beneficiary of their applicable beneficiaries. CMS will provide incentive payments to seven practices (as shown in Table 1*) for an aggregate amount of $7,219,784. In the third performance year of the demonstration, 11,382 beneficiaries were enrolled in the demonstration at 15 participating practices. For the third performance year, 14 out of the 15 IAH practices improved on at least one quality measure from performance year 2. Five of the practices met the performance thresholds for all six quality measures. Click here to download the full report*