Bennet, Colleagues Introduce Bipartisan Bill to Make Innovative Home-Based Primary Care Medicare Program Permanent

Independence at Home program brings primary care medical services to Medicare beneficiaries with multiple chronic conditions in their homes; has already saved $25 million in first year

Washington, D.C. - Colorado U.S. Senator Michael Bennet joined Senators Edward J. Markey (D-MA), John Cornyn (R-TX), and Rob Portman (R-OH) to introduce a bill to convert the Independence at Home (IAH) demonstration into a permanent, national Medicare program. Independence at Home is an innovative, team-based model that is bringing measurable, high-quality care to patients suffering from multiple debilitating diseases such as Alzheimer's, ALS, congestive heart failure, diabetes and Parkinson's, while significantly lowering costs for the Medicare program.

Independence at Home empowers teams of doctors, care givers and other health care professionals to coordinate and provide primary care services in the comfort of patients' own homes, reducing unnecessary emergency room visits and avoidable hospitalizations and readmissions, as well as the costs associated with them. According to the Centers for Medicare and Medicaid Services (CMS), the Independence at Home payment model saved more than $25 million in its first performance year alone, an average of $3,070 per participating beneficiary.

"In Colorado, we've demonstrated how a strong coordinated care network and transitional care can lead to better results at a lower cost to patients, hospitals, and our health care system," said Senator Bennet. "The expansion of the Independence at Home model builds on these efforts by allowing seniors in Colorado with chronic conditions to get the care they need while staying out of the hospital."

A copy of the legislation can be found HERE. A similar bill is being worked on for introduction in the House of Representatives.

In 2012, Independence at Home began as a three-year demonstration program. Last year, the House and Senate approved a two-year extension. The Senate Finance Committee's Chronic Care Working Group is currently considering making IAH nationwide in scope. This also builds upon legislation Bennet introduced in 2009 called the Medicare Care Transitions Act. Bennet worked closely with Mesa County health care providers and Senate leadership to ensure Colorado's model of patient care was included in the Affordable Care Act.

Conversion of the IAH demonstration into a national program is supported by a multitude of organizations, advocates and caregivers, as evidenced by their support for conversion in comments to the Chronic Care Working Group. A full list of these groups can be found HERE.

"This legislation would streamline this critical area of rehabilitation research at NIH so that we can best serve our growing number of patients to maximize their health, ability to function, independence, and full participation in community activities," said Dr. Scott Laker, M.D., Assistant Professor, Physical Medicine and Rehabilitation, at University of Colorado School of Medicine and Chair, Health Policy and Legislation for the American Academy of Physician Medicine and Rehabilitation (AAPM&R).

"IAH successfully fills a critical gap in health care for our frail and elderly that few programs have been able to achieve," said Dr. Mindy Fain, President of the American Academy of Home Care Medicine. "In the process, it improves patient satisfaction and health outcomes, while simultaneously saving money. We are delighted that a bipartisan group of U.S. Senators has introduced this legislation."

"Alzheimer's disease makes treating patients with multiple diseases more expensive and more challenging. For example, a patient with diabetes and Alzheimer's costs Medicare 81 percent more than a patient who only has diabetes," said Robert Egge, Alzheimer's Association Chief Public Policy Officer. "Independence at Home will help care providers better coordinate care management, reduce costs, and allow individuals to have more control over their care plan."

"Converting and extending the Independence at Home Demonstration will enable more patients and their family caregivers to receive high quality care at home," said Kathleen Kelly, MPA, Executive Director of the Family Caregiver Alliance, National Center on Caregiving. "The Family Caregiver Alliance supports the legislation because family caregivers are better able to cope with care demands when there are true health partners to call upon when patient care needs change over time. IAH conversion would enable more primary care practices to participate in this program."

Upon passage as part of the health care law, the Independence at Home program:

  • Established a voluntary patient-centered, pilot program in 13 Independent Practices and one Consortium;
  • Utilized a coordinated health care delivery model to ensure that Medicare beneficiaries with multiple chronic conditions who also need help with the activities of daily living can remain independent for as long as possible in the comfort of their own homes;
  • Reduced costs by coordinating the care of these patients and reducing duplicative and unnecessary services, preventing hospitalizations, and lowering other health care costs;
  • Created an incentive for additional savings through investment in health IT and other technologies; and
  • Developed a new, attractive career path for primary care physicians by enabling them to lead IAH organizations and receive reimbursement for house calls.

More information about the Independence at Home program and CMS's program evaluation can he found HERE.