HHS: New Options for Medicare & Medicaid Patients to Get At-Home Care

As part of its ongoing attempts to provide care in the most preferred and cost-effective setting, the Department of Health and Human Services (HHS) announced on Thursday it had finalized the Community First Choice rule, a new state plan option offered under Medicaid that gives participating states a larger federal reimbursement for providing community-based attendant services and supports to those who would otherwise be in an institutional setting.

Participating states in the rule will get a six percentage point increase in federal Medicaid matching funds for providing services to Medicaid beneficiaries who would prefer to receive care in a home- and community-based setting rather than in a nursing home or other institution. CMS will partner with primary care practices, led by physicians or nurse practitioners, to assess whether or not it would be effective from both a health and cost standpoint for those beneficiaries to receive care in a non-institutional setting. 

HHS Secretary Kathleen Sebelius also announced the participants in the Independence at Home Demonstration program, which encourages primary care practices to provide home-based care to chronically ill Medicare patients. The 16 participants will test how delivering primary care services in a home setting can improve the quality of care and also reduce costs for those with chronic illnesses. 

“We know that people frequently prefer to receive services in their own homes and communities whenever possible. The rule and demonstration announced today give people choice and provide states with flexibility to design programs that better meet the needs of beneficiaries,” Secretary Sebelius said in a statement. “Prior to passage of the Affordable Care Act, many families had few choices beyond nursing homes or other institutions for their loved ones. The actions taken today will help change that and can lead to better health for these individuals.”

More than 130 organizations applied for the Independence at Home demonstration, representing hundreds of healthcare providers who are interested in this model of care, says HHS. The 16 participating organizations chosen for the demonstration can be viewed here

Both the demonstration and the new rule are made possible by the Affordable Care Act, HHS noted. 

The demonstration will run from June 1, 2012 and conclude on May 1, 2015. 

Written by Alyssa Gerace

Alyssa Gerace




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