The CMS Innovation Center’s ongoing “Independence at Home Demonstration” http://innovation.cms/initiatives/Independence-at-Home works with medical practices to test the effectiveness of delivering comprehensive primary care services at home and improving care for 200 eligible Medicare beneficiaries that have multiple chronic conditions.
In the first year, the Demonstration has proven to provide higher quality care and has lowered Medicare expenditures. Earlier this year, the Administration announced the goal of tying 30 percent of Medicare payments to quality and value through alternative payment models by 2016 and 50 percent of payments by 2018.
The Demonstration enables physicians or nurse practitioners provide chronically ill patients a complete range of primary care services in the home setting tailored to the needs of beneficiaries with multiple chronic conditions and/or functional limitations.
The CMS reports that 17 participating practices serving over 8,400 Medicare beneficiaries improved quality in at least three of the six quality measures for the demonstration in the first year with four participating practices meeting six quality measures.
Medicare beneficiaries who are participating in the Demonstration on average had:
- Fewer hospital readmissions within 30 days
- Follow-up contact from their provider within 48 hours of a hospital admission, hospital discharge, or emergency department visit
- Their medications identified by their provider within 48 hours of discharge from the hospital
- Their preferences documented by their provider
- Used their inpatient hospital and emergency department services less for conditions such as diabetes, high blood pressure, asthma, pneumonia, or urinary tract infection.