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Evaluation of the Independence at Home Demonstration extension
Investigator (PI): Cheh, Valerie
Performing Organization (PO): (Current): Mathematica Policy Research / (609) 799-3535
Supporting Agency (SA): Centers for Medicare and Medicaid Services (CMS)
Initial Year: 2017
Final Year: 2022
Record Source/Award ID: CMS/HHSM-500-2014-00034I/T0018
Funding: Total Award Amount: $7,830,227
Award Type: Contract
Award Information: Reports resulting from this project
Abstract: Authority: Section 3024 of the Affordable Care Act (ACA) authorized the initial demonstration and evaluation. It was extended for two years by section 971 of the Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015, and extended for an additional two years by section 50301 of the Bipartisan Budget Act (BBA) of 2018. Description: The Independence at Home (IAH) Demonstration tested whether providing home-based primary care to Medicare fee-for-service beneficiaries with multiple chronic illnesses and functional limitations, while giving IAH practices the opportunity to earn incentive payments, reduces spending, hospitalizations, and emergency department visits. The evaluation compares the spending and utilization of IAH-eligible beneficiaries with a matched comparison group not receiving home-based primary care, with additional interpretation from qualitative data collected from IAH practices. Intervention period: The initial demonstration began in June 2012 and ended in September 2017. The demonstration began again in January 2019 and continued through December 2020. Evaluation period: A five-year evaluation contract was awarded in September 2012 and ended in September 2017. A new contract to continue the evaluation was awarded in September 2017 and is expected to end September 2022. Reports: a. Report to Congress: https://innovation.cms.gov/Files/reports/iah-rtc.pdf. b. Year 4 Report: https://innovation.cms.gov/Files/reports/iah-yr4evalrpt.pdf; c. Year 5 Report: https://innovation.cms.gov/files/reports/iah-yr5evalrpt.pdf. For more information, please contact David Nyweide at 410-786-0699 or david.nyweide@cms.hhs.gov.
Abstract Archived: 2019: Authority: Section 3024 of the Affordable Care Act (ACA). Extended for two years by section 971 of the Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015. Description: The Independence at Home (IAH) Demonstration tests home-based primary care for Medicare fee-for-service beneficiaries with multiple chronic illnesses over the course of five years. Participating practices make in-home visits tailored to an individual patient's needs and coordinate their care. Practices that succeed in meeting quality measures while generating Medicare savings have an opportunity to receive incentive payments after meeting a minimum savings requirement. Eighteen practices enrolled in 2012 and, per ACA legislation, the demonstration is capped at 10,000 beneficiaries. The first year involved design and dissemination of beneficiary and caregiver surveys, site visits, and a preliminary report of baseline data was produced. The report of the demonstration experience through the program's first three years provides estimates of impacts on expenditure and utilization outcomes, results on quality and satisfaction from beneficiary surveys, and findings from qualitative data collected from the practices that focused on initiatives they undertook to improve demonstration outcomes. Reports will not be released pending issuance of the legislatively mandated report to Congress on the project in 2018. Analysis of the entire five-year demonstration will be covered in reports subsequent to the report to Congress. Intervention period: The demonstration began in June 2012 and ended in September 2017. Evaluation period: A five-year evaluation contract was awarded in September 2012 and ended in September 2017. A new contract to continue the evaluation was awarded in September 2017 and is expected to end September 2022.

2020: Authority: Section 3024 of the Affordable Care Act (ACA) authorized the initial demonstration and evaluation. It was extended for two years by section 971 of the Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015, and further extended and amended by section 50301 of the Bipartisan Budget Act (BBA) of 2018 for an additional two years. Description: The Independence at Home (IAH) Demonstration tests whether providing home-based primary care for Medicare fee-for-service beneficiaries with multiple chronic illnesses and providing an opportunity for practices to earn incentive payments if they meet certain established criteria improve beneficiaries' health outcomes and reduce health expenditures and utilization. Participating practices make in-home visits tailored to an individual patient's needs and coordinate their care. Practices that succeed in meeting quality measures while generating Medicare savings have an opportunity to receive incentive payments after meeting a minimum savings requirement. Eighteen practices enrolled in 2012 and, per ACA legislation, the demonstration is capped at 10,000 beneficiaries. The BBA of 2018 increased the demonstration cap to 15,000. A report to Congress released in 2018 covers the first three years of the IAH Demonstration. It presents estimates of impacts on expenditure and utilization outcomes, results on quality and satisfaction from beneficiary surveys, and findings from qualitative data collected from the practices that focused on initiatives they undertook to improve demonstration outcomes. Subsequent evaluation reports will cover the remaining years of the demonstration and examine outcomes related to health care expenditures, utilization, and health. Intervention period: The initial demonstration began in June 2012 and ended in September 2017. The demonstration began again in January 2019. Evaluation period: A five-year evaluation contract was awarded in September 2012 and ended in September 2017. A new contract to continue the evaluation was awarded in September 2017 and is expected to end September 2022.

MeSH Terms:
  • Caregivers
  • Fee-for-Service Plans
  • Health Policy
  • Home Care Services /*economics
  • /*organization & administration /statistics & numerical data
  • Humans
  • Medicare /*economics
  • /*organization & administration /statistics & numerical data
  • Patient Protection and Affordable Care Act
  • Patient Satisfaction
  • Primary Health Care /economics
  • /*organization & administration /statistics & numerical data
  • Quality of Health Care
  • United States
Country: United States
State: New Jersey
Zip Code: 08543
UI: 20183037
Project Status: Ongoing
Record History: ('2020: Project extended to 2022; Archived abstract to Abstract Archived 2 field and added new abstract. 2019: Project extended to 2020; Archived abstract to Abstract Archived 1 field and added new abstract. ',)