President Obama Signs into Law Legislation Extending Home-Based Demonstration Model
August 3, 2015 04:09 PM
U.S. President Barack Obama signed into law the Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 (S. 971) on Thursday, July 30. The legislation extends for an additional two years a home-based demonstration model, Independence at Home, which was originally implemented under the Affordable Care Act.
The U.S. Senate passed the legislation in April, and the U.S. House of Representatives passed it in July (see previous NAHC Report articles hereand here). The bill was originally introduced by Senators Ron Wyden (D-OR), Edward J. Markey (D-MA), Michael Bennet (D-CO), Richard Burr (R-NC), and Johnny Isakson (R-GA).
Independence at Home focuses on certain high risk patients with chronic illnesses and provides incentives for improved quality outcomes and reduced expenditures. The model uses home-based primary care teams directed by physicians and nurse practitioners.
The Centers for Medicare & Medicaid Services (CMS) announced in June that Independence at Home resulted in $25 million in Medicare savings during its first year. The model also resulted in reduced hospital readmissions and improved quality outcomes (see previous NAHC Report article here). CMS Acting Administrator said the results support “that chronically ill patients can be better taken care of in their own homes,” something he said that “most Americans already want.”
The National Association for Home Care & Hospice (NAHC) supports Independence at Home, while also advocating for an expanded focus on chronic care management with a broader population than covered under Independence at Home. When the bill was introduced, NAHC President Val J. Halamandaris called it “a good step in what needs to be an increased focus on home and community-based care.”
NAHC recommends that Congress establish a separate care management benefit for those with chronic obstructive pulmonary disease, congestive heart failure, diabetes, and certain neurological disorders. The services should include: 1) an interdisciplinary team approach to care management that includes physicians, nurses, therapists, medical social workers, and pharmacists; 2) evidence-based care plan development; 3) direct patient care services in the home setting; 4) application of telehealth services for appropriate remote monitoring as needed by the individual patient; 5) care counseling, care coordination, medication management, and oversight of services related to activities of daily living; 6) use of interoperable electronic health care records and efficient electronic-based communication tools; 7) patient education and support; and 8) integration and support of informal caregivers such as family members.
For more information about Independence at Home on the CMS website, click here.