Medicare to tackle chronic illnesses with home care

By Bernie Monegain
09:48 AM

Up to 10,000 Medicare patients with chronic conditions will be able to get most of the care they need at home under a new demonstration project developed by the Centers for Medicare & Medicaid Services. The pilot is underpinned by the use of information technology.

CMS defines the home practice  as one that “uses electronic health information systems, remote monitoring, and mobile diagnostic technology.”

“This program gives new life to the old practice of house calls, but with 21st Century technology and a team approach,” said CMS Acting Administrator Marilyn Tavenner.

Created by the Affordable Care Act, the new Independence at Home Demonstration greatly expands the scope of in-home services Medicare beneficiaries can receive. The Independence at Home Demonstration will provide chronically ill patients with a complete range of primary care services.

Participation in the Demonstration is voluntary for Medicare beneficiaries.

“In my days as a practicing nurse, I saw many patients whose health improved when they were happier with their living conditions,” said Tavenner. “When a critically-ill patient can remain in familiar surroundings, the benefits are many: The person retains greater control over their daily lives, families and caregivers report greater satisfaction with the care, and unnecessary hospitalizations are avoided.”

CMS will join with medical practices to test the effectiveness of delivering primary care services in a home setting on improving care for Medicare beneficiaries with multiple chronic conditions. Medical practices led by physicians or nurse practitioners will provide primary care home visits tailored to the needs of beneficiaries with multiple chronic conditions and functional limitations.

The demonstration will reward healthcare providers that show a reduction in Medicare expenditures through an incentive payment if they succeed in providing high-quality care while reducing costs. CMS will use quality measures to ensure beneficiaries experience high quality care.

Medical practices eligible to participate in the demonstration must include physicians or nurse practitioners who have experience delivering home-based primary care. Up to 50 practices will be selected and each must serve at least 200 Medicare fee-for-service beneficiaries with multiple chronic conditions and functional limitations.

Practices in the demonstration will be responsible for coordinating patient care with other health and social service professionals. The new demonstration is one of a series of CMS initiatives to build a Medicare program that offers beneficiaries better care and better health at an affordable cost. It will be supported by the CMS Innovation Center, which was created by the Affordable Care Act to develop and test new models of healthcare delivery and payment, and disperse best practices throughout the health care system.

Applications and Letters of Intent, if applicable, are due on Feb, 6, 2012. Additional information about this demonstration, including how to apply, can be found here.

Questions may be submitted to CMS at: IndependenceAtHomeDemo@cms.hhs.gov.

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