May 21, 2009

Wyden, Markey Introduce "Independence at Home" Act

Legislation Seeks Solutions to Coordinate Care for Chronically Ill in Their Homes

Washington, D.C. - With the goal of keeping chronically ill Medicare patients in their homes and also improving their health care, U.S. Senator Ron Wyden (D-Ore.) and U.S. Representative Ed Markey (D-Mass.) co-chairman of the Bi-Partisan Congressional Task Force on Alzheimer's Disease and senior member of the Energy and Commerce Committee, today introduced the "Independence at Home Act." The bill will create a pilot program to bring primary care medical services to Medicare beneficiaries with multiple chronic conditions in their homes. It will offer incentives for providing patients with care options that offer greater independence and quality of life while reducing costs. Pilot programs will be set up in 26 states and has attracted bipartisan support in both the House and Senate, including: Senators Richard Burr (R-NC), Ben Cardin, (D- Md.) and Sheldon Whitehouse (D-RI) and Representative Chris Smith (R-NJ).

"Patients with multiple chronic conditions spend far too much of their time trying to coordinate an inefficient and expensive patchwork of healthcare delivery systems, leaving little time to enjoy their lives," Wyden said. "The Independence at Home Act will address the challenges of caring for persons with chronic conditions by better integrating their care and working with their caregivers to manage their conditions and medications."

"Our current health care system does a poor job caring for seriously ill Americans, who often are ‘lost in transition', struggling to manage multiple illnesses as they transition between emergency room, hospital, nursing facility and home," Markey said. "Our bill holds great promise for reducing hospitalizations, preventing medication errors, and lifting the spirits of those who, after a lifetime of contributions to our society, deserve the dignity and peace of mind that comes with living independently."

The Independence at Home Act:

• Establishes a three-year Medicare pilot project using a patient-centered health care delivery model to ensure that Medicare beneficiaries with multiple chronic conditions can remain independent for as long as possible in a comfortable environment;
• Advances Medicare reform by creating incentives for providers to develop better and lower-cost health care for the highest cost beneficiaries;
• Incorporates lessons from past Medicare pilot projects;
• Provides for coordinated-care programs that hold physician, nurse practitioners, physician assistants, and other team members accountable for quality, patient satisfaction, and mandatory annual minimum savings;
• Generates savings by providing better care to Medicare beneficiaries with multiple chronic conditions and reducing duplicative and unnecessary services, hospitalization, and other health care costs; and
• Allows for continuation of home-based coordinated care as an ongoing Medicare benefit after successful evaluation of Phase I.

Persons eligible for the program include Medicare beneficiaries with functional impairments, two or more chronic health problems, and recent use of other health services. Each Independence at Home (IAH) patient will receive a comprehensive assessment at least annually. The IAH organization, responsible for all aspects of care coordination, will be required to demonstrate savings of at least 5 percent annually compared with the costs of serving non-participating Medicare chronically ill beneficiaries. The IAH organization may keep 80 percent of savings beyond the required 5 percent savings as an incentive to maximize the financial benefits of being an IAH member. Any savings beyond 25% would be shared with 50% directed to the IAH Organization and 50% to Medicare.

"Improving home health care will improve the quality of care for millions of elderly Americans coping with chronic illness," said Whitehouse. "By reducing trips to the hospital and providing high quality patient care at home, these demonstration projects will prevent expensive emergency room visits and ease the burden of illness on patients and their families."

"The Independence at Home Act would drastically improve the ability to coordinate in home medical care," Burr said. "This optional program will reduce re-hospitalizations and allow end-of-life care in a more comfortable setting. When loved ones are in and out of the hospital it can have a devastating impact, emotionally and physically, on the patient and the family. This program allows for better quality of care in a more comfortable environment."

"Coordinated care that puts the patient at the center of medical decisions is essential for all Americans, but particularly for those diagnosed with multiple chronic illnesses," said Cardin. "The Independence at Home Act will result in improved patient care while saving time and overall costs."

"Congressman Ed Markey of Massachusetts and I founded and co-chair the Congressional Task Force on Alzheimer's Disease to focus congressional attention on the disease and advocate for increased federal investments in Alzheimer's research and services programs" Smith said. "This bill is a product of those efforts and of the need for federal action. It aims to improve the quality of care and lead to better experiences to those suffering from AD. The urgency of AD research and legislation cannot be underestimated. AD research for better treatment and progress toward the goal of eradicating this devastating illness must be a national priority in medical research funding."

The following organizations have announced their support for the Independence at Home Act:

• The AARP
• The Alzheimer's Foundation of America
• The Alzheimer's Association
• The American Academy of Home Care Physicians
• The American Academy of Nurse Practitioners
• The American Academy of Physician Assistants
• The America Society of Consultant Pharmacists
• The National Family Caregivers Association
• The Family Caregiver Alliance/National Center on Caregiving
• The American Association of Homes and Services for the Aging
• The Maryland-National Capital Home Care Association
• The Visiting Nurse Associations of America
• The American College of Nurse Practitioners
• US Public Interest Research Group
• Wyeth
• National Council on Aging
• Urban Medical House Calls (Boston, MA)
• Housecall Providers, Inc. of Portland, Ore.
• MD2U Doctors Who Make House Calls (Louisville, Ky.)
• Intel Corp
• American Academy of Neurology
• Massachusetts Neurologic Society
• Housecalls Doctors of Texas
• Naples Health Care Associates