New “Independent at Home” Demo Revitalizes the House Call

The Centers for Medicare & Medicaid Services (CMS) would like to reintroduce the concept of the “house call” to modern medicine with a new demonstration project. Under the “Independence at Home Demonstration,” participating practices will provide home-based primary care to targeted chronically ill Medicare patients for a three-year period. In-home visits will be tailored to an individual patient’s needs, and CMS will track beneficiaries’ care experiences through quality measures.

The demonstration will reward health care providers that show a reduction in Medicare expenditures through an incentive payment if they succeed in providing high-quality care while reducing costs. Participation is voluntary, and CMS is accepting applications now. Applications and letters of intent, if applicable, are due by Feb. 6, 2012.

Medical practices eligible to participate in the demonstration must be:

  • Led by physicians or nurse practitioners (teams may also include pharmacists, social workers, and other supporting staff)
  • Organized to provide primary medical care services
  • Experienced at providing home-based primary care to patients with multiple chronic conditions
  • Able to care for at least 200 beneficiaries with multiple chronic conditions during each year of the demonstration

Up to 50 practices will be selected to participate in the program. Practices in the demonstration will be responsible for coordinating patient care with other health and social service professionals.

Medicare beneficiaries who wish to participate in the demonstration must:

  • Have multiple chronic conditions
  • Be covered by original, fee-for-service Medicare
  • Require someone’s assistance with two or more activities of daily living such as bathing, dressing, eating, or walking
  • Have had a medically-necessary hospital admission within the last 12 months
  • Have received rehabilitation services in the last 12 months

For more information, see the program Fact Sheet.


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3 Responses to “New “Independent at Home” Demo Revitalizes the House Call”

  1. Marisha Chilcott, M.D. says:

    Just hearing about this and thought you might be interested?

  2. Elizabeth Murphy says:

    Ok, this sounds a lot like Home Health Care. Under the direction of the PCP, some being Visiting Home Physicians, Home Health Care assist as part of the team of home care providers in caring for Acute to Chronic Ill patients at home. The savings to Medicare, Medicaid, Medicare replacemnt, and private insurance is tremendous. Long term hospital stay, SNIF Units, and Nursing/ rehab. Facilities are extremly costly In comparison to Home Care. HomeCare has taken a beating, have been financially cut, has endured heavy critisisum and has endured extreme audits by State and the Federal government. Senator Kennedy states once in an Interveiw on CNN that Home Care saved 3 billion in health care in one quarter. Yet Home Care is under attack. A few bad apples should not hurt the Home Care system. “Independence at Home” is not a new concept.

  3. Janet says:

    For a long time we have known that teaching to the test does not promote a great knowledge base, it often shows a teacher just jumping through the hoops.

    I am bothered by the incentive pay by Medicare under the guise of rewarding health care providers who show a reduction in Medicare costs. How more controlling can a payer get than to reward the physician who cuts the most corners or is just jumping through the hoops?

    Payers need to do what they do best, pay claims and stop trying to control the physician through “incentives”.

    Making house calls is nothing new.

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