Will Boston Pilot Program Prove to CMS that Home Care Cuts Costs?

In an effort to examine the economic and health benefits of home care, Centers for Medicare & Medicaid Services is following 16 home care organizations through a recently announced pilot program, Independence at Home. Boston Medical Center is one of the participating home care organizations and began providing home care and house calls in 1875, reported a Boston Globe article

The center currently serves 575 people, costing each patient about $3,000 per year, half of which is covered by Medicare and other insurance companies. 

The Boston Globe reports: 

Programs like the one at Boston Medical Center are not common. Home care accounts for about 1 percent of all Medicare billing for “evaluation and management services,” essentially time spent talking with doctors, versus tests or procedures, said Gary Swartz, associate executive director of the American Academy of Home Care Physicians.

Hospitals increasingly are under pressure to do more to manage the care of their sickest patients. Starting this fall, as required by the federal health law, they will be penalized for high rates of patients returning to the hospital within 30 days of discharge from a stay for pneumonia, heart attack, or heart failure. Increasingly, doctors are being paid in ways meant to reward them for preventing costly acute care, particularly for patients with chronic illnesses.

But studies of the cost of home care are mixed. One, published in 2000 in the Journal of the American Medical Association, followed 1,966 patients with restricted mobility connected to 16 Veterans Affairs medical centers. Researchers found that the half who received home care had a better quality of life, as did their caregivers. But care for those patients cost about 12 percent more over the one-year study period.

If the Boston program saves more than 11 percent, the agency will share savings with the hospital. The pilot also will track various quality measures, including patient satisfaction and how often people visit an emergency room or are hospitalized with preventable conditions. And it will measure how providers feel about their work, in a field in which recruitment of doctors is difficult.

Swartz, whose organization is assisting with the pilot, said expanding the shared savings program beyond 10,000 patients nationally would require action by Congress. But if the federal agency shows that home care saves money over time, he said, more doctors may be inspired to get out of the office.

Read the full article here.

Written by Erin Hegarty

Erin Hegarty



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