Senate Bill Would Extend Independence at Home Demonstration

A pilot program that incentivizes the delivery of home-based health care for chronically ill patients may be extended if newly introduced legislation passes.

The Senate Finance Committee Chronic Care Working Group introduced the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016 (S. 3504) on Dec. 6. The bipartisan legislation, among other things, would extend the Independence at Home (IAH) demonstration for two additional years.

Specifically, the bill would allow IAH, which is set to expire in September 2017, to last until September 2019. The bill would also raise the maximum number of allowable beneficiaries to 15,000 from 10,000.

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IAH, which began in 2012, enables doctors and nurse practitioners to deliver in-home primary care for applicable Medicare beneficiaries. The demonstration is intended to reduce unnecessary visits to the emergency room, avoidable hospitalizations and readmissions, and to lower Medicare costs overall.

In 2015, IAH saved Medicare more than $25 million, or an average of $3,070 per beneficiary, the Centers for Medicare & Medicaid Services (CMS) found. The demonstration saved Medicare more than $10 million in 2016.

The National Association for Home Care & Hospice (NAHC) praised the newly introduced S. 3504 legislation in a statement on its website, noting that IAH physicians often work with home health agencies to achieve Medicare spending efficiencies and optimal patient outcomes.

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The Visiting Nurse Associations of America (VNAA) similarly supports the Committee’s decision to extend the IAH demonstration.

“VNAA would like to see IAH converted into a permanent program, as detailed in our June 2015 letter to the Chronic Care Working Group and in S.3130,” the organization said in a statement to Home Health Care News. “VNAA approves of extending the program through September 30, 2019 and increasing the cap on the total number of participating beneficiaries from 10,000 to 12,000 while allowing practices for up to three years to receive a shared savings payment before they are terminated from the demonstration.”

The Partnership for Quality Home Healthcare, in a statement to HHCN, also expressed pleasure that the Independence at Home Demonstration was included in the Chronic Care Act of 2016. PQHH is a Washington, D.C.-based coalition of home health providers that aims to improve the quality, efficiency and integrity of home health care.

S. 3504 was introduced by U.S. Sens. Orrin Hatch (R-UT), Johnny Isakson (R-GA), Mark Warner (D-VA) and Ron Wyden (D-OR).

Written by Mary Kate Nelson

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