Independence at Home
With a proven track record of generating better health outcomes at much lower costs, Independence at Home has been called the future of Medicare and proof that health savings can be generated, not by cutting benefits but by coordinating care and keeping seniors healthy.
The Independence at Home Act demonstration project – included in the Affordable Care Act – is scheduled to begin in 2012. It will allow a small group of Medicare beneficiaries to receive individualized, at-home care for their chronic conditions. A similar project run by the Department of Veterans Affairs has been proven to reduce hospital stays by 62 percent, nursing home days by 88 percent and costs by 24 percent.
For many seniors suffering from chronic conditions, family members are their primary caregivers. Many seniors can’t afford nursing home care or to hire a personal caregiver and that burden falls on the family. What Independence at Home does, that is different from more conventional health service options, is give seniors and their family the assurance that they will be getting high quality medical attention in their homes from a trained professional, and they will not be forced into an assisted living facility. IAH caregivers can simply help to organize prescriptions or be sure that small ailments aren’t signs of larger problems – cutting down unnecessary doctor or emergency room visits.
How it Works:
The Independence at Home program, Section 3024 of the Affordable Care Act (ACA), addresses the needs of those with multiple chronic conditions:
- The IAH program makes a new chronic care coordination demonstration available to 10,000 Medicare beneficiaries who suffer from multiple chronic diseases and disabilities and who have been hospitalized and received rehabilitation services within the past 12 months.
- The IAH program is designed to allow America’s seniors to remain as independent as possible and avoid unnecessary hospitalizations, ER visits and nursing home admissions.
- Enrollment in an IAH program is completely voluntary, and participating beneficiaries do not relinquish access to any existing Medicare benefit or any practitioner or provider.
- Primary care is available to beneficiaries in their homes through “housecalls” by physician/nurse practitioner-directed teams of health care professionals tailored to the beneficiaries’ chronic conditions.
- The IAH program holds participating practitioners and providers strictly accountable for (a) good outcomes, (b) patient/caregiver satisfaction and (c) minimum savings to Medicare of 5% annually.
- The IAH program addresses the public’s three greatest fears with respect to chronic disease—(a) not being able to pay for care, (b) loss of independence, and (c) becoming a burden to family and friends.
The Proof is in the Programs:
Independence at Home-style programs have been in force since the 1970s. One such program run by the Department of Veterans Affairs has shown significant results in lowering costs, improving outcomes and reducing the burden on family caregivers.
Patients served through The VA’s Home Based Primary Care have an average of eight chronic conditions, take more than 12 medications and have two or more limitations in activities of daily life. Despite the hurdles, the program – which operates in 250 locations in every state and D.C. -- has reduced hospital days by 62%, nursing home days by 88%, and costs by 24% through improved, individualized home based care. Click here for more information about the success of this program.
Other programs have seen similar results, proving that this type of program can be effective on many scales. Below are a few of the statistics of this program’s success.
Inspiris: Operates IAH-style programs in 23 locations across the country based in TN
- Reduced hospital inpatient admissions by 63%-64%
- Reduced hospital readmissions by 33%
- Reduced health care costs in the last 6 months of life by 61%
- Reduced overall health care costs by 42% to 52% when compared to a control group that did not receive home-based primary care
The University of Pennsylvania Medical Center, Operated an IAH-style ElderPAC program for 14 years fordual eligible Medicare/Medicaid beneficiaries:
- Reduced hospitalizations by 60%
- Reduced months in the nursing home by 75%
- Reduced Medicaid costs by 24%
- Reduced Medicare costs by 40%
- Increased survival rates by 47%.
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