At-Home Care Put to the Test Under ACA


Medical practices equipped to provide at-home care services for chronically-ill patients may be eligible for incentive payments under a new demonstration project created by the Affordable Care Act.

Starting this month, the Independence at Home Demonstration is calling for applications to test whether providing coordinated home-care services for patients with multiple chronic conditions will keep them out of the hospital, improve patient satisfaction and outcomes, and lower Medicare costs.

Up to 10,000 eligible beneficiaries, as well as up to 50 providers may participate during the study’s 3-year period. Applications from medical practices to the program are being accepted until Feb. 6.

"When critically-ill patients can remain in familiar surroundings, the benefits are many: the person retains greater control over their lives, families and caregivers report greater satisfaction with the care, and unnecessary hospitalizations are avoided," CMS acting administrator Marilyn Tavenner said in a statement.

In order for beneficiaries to participate, they must have multiple chronic conditions, have received rehabilitation treatment in the last year, be covered under fee-for-service Medicare, have been admitted to the hospital in the last year, and need assistance with at least two daily activities (such as walking or bathing). CMS will track beneficiaries’ experiences through a variety of quality measurements.

To qualify for the program, medical practices must have experience providing at-home care, they must serve at least 200 eligible beneficiaries, they must use electronic health information systems, and they must provide at-home visits and have available 24/7 coverage. They must also report required quality measures. Practices may apply separately, or multiple primary care practices within a geographic area may form a consortium in order to participate.

Practices that demonstrate a specific savings target as a result of participation in the project will receive an incentive payment if they also meet at least three of six quality measures. The amount of the incentive payment will be commensurate with the savings achieved. Saving targets will be determined on a per capita basis.

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