Newswise — The American Academy of Home Care Medicine is pleased to share that the Independence at Home (IAH) Demonstration saved Medicare approximately $33 million in Year 4, or about $384 per beneficiary per month (PBPM). This follows savings from Years 1-3 that, when combined with Year 4, amount to about $63 million in savings and high-quality care for Medicare. These results highlight the value of a home-based primary care (HBPC) model to serve complex, frail elders, with an emphasis on a high-touch and high-tech mobile team care.
The IAH Demonstration began in 2012 to test a delivery and payment model for HBPC teams that focus on caring for ill and disabled patients in the home. Initially a 3-year demonstration, the IAH Demonstration has been extended twice by Congress and CMS due to successful saving results and will run through December 2020.
The IAH program tests whether accessible primary care for high-need patients can improve patient and family experience while reducing total costs and hospital admissions. IAH practices care for patients who meet the following criteria: have 2 or more serious chronic conditions; need assistance with 2 or more Activities of Daily Living (ADLs); and have had a hospitalization and received post-acute skilled nursing or rehabilitation services in the past 12 months.
Year 4 IAH Results
Year 4 savings from the Demonstration resulted from mainly reduced inpatient hospital admissions and skilled nursing facility (SNF) services. The greatest savings came from reduced hospital utilization, which contributed to approximately 40% of the PBPM savings.
Over a 4-year period, CMS estimates that the IAH Demonstration led to over 1,800 fewer hospital admissions, over 3,400 fewer emergency room (ER) visits, and more than 400 fewer unplanned readmissions. The greatest reductions occurred in Year 4, which led to over 800 fewer hospital admissions, 1,500 fewer emergency department visits, and 200 fewer unplanned readmissions.
Eric De Jonge, President of AAHCM, notes, “The Academy salutes the accomplishments of the IAH practices in their provision of high-quality and cost-effective care in Year 4.”
IAH Demonstration Outlook
The IAH Demonstration is now in Year 6, which will end in December 2019. Year 7 will begin January 2020 and run through December 2020. Year 5 results are expected in fall 2019, and Years 6 and 7 results will be shared in 2020 and 2021. Given the high-quality results and the costs savings for Medicare, the IAH Demonstration has proven to be one of the most successful new clinical and payment models supported by CMMI and CMS.