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Affordable Care Act payment model saves more than $25 million in first performance year

Independence at Home practices succeed in improving care, lowering costs
June 18, 2015

The Centers for Medicare & Medicaid Services (CMS) today announced positive and promising results from the first performance year of the Independence at Home Demonstration, including both higher quality care and lower Medicare expenditures.

"These results support what most Americans already want-- that chronically ill patients can be better taken care of in their own homes. This is a great common sense way for Medicare beneficiaries to get better quality care with smarter spending from Medicare," said CMS Acting Administrator Andy Slavitt.  "The Independence at Home Demonstration is one of the tools of the Affordable Care Act that can bring down the long-term cost of care in a patient-centered manner."

The CMS analysis found that Independence at Home participants saved over $25 million in the demonstration’s first performance year – an average of $3,070 per participating beneficiary – while delivering high quality patient care in the home.  CMS will award incentive payments of $11.7 million to nine participating practices that succeeded in reducing Medicare expenditures and met designated quality goals for the first year of the demonstration.

According to CMS’ analysis, all 17 participating practices improved quality in at least three of the six quality measures for the demonstration in the first performance year. Four participating practices met all six quality measures. Medicare beneficiaries who are participating in Independence at Home practices, on average:

  • Have fewer hospital readmissions within 30 days;
  • Have follow-up contact from their provider within 48 hours of a hospital admission, hospital discharge, or emergency department visit;
  • Have their medications identified by their provider within 48 hours of discharge from the hospital;
  • Have their preferences documented by their provider; and
  • Use inpatient hospital and emergency department services less for conditions such as diabetes, high blood pressure, asthma, pneumonia, or urinary tract infection.

The Independence at Home Demonstration provides chronically ill Medicare beneficiaries with primary care services in the home setting. In the first performance year, 17 participating practices served over 8,400 Medicare beneficiaries.

The Independence at Home Demonstration is part of the innovative framework established by the Affordable Care Act to move our health care system toward one that rewards doctors based on the quality, not quantity, of care they give patients. The Administration earlier this year announced the ambitious 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.

To learn more about the Independence at Home Demonstration, including individual practice results, visit: http://innovation.cms.gov/initiatives/Independence-at-Home/.

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