Independence at Home Demonstration

Under the Independence at Home Demonstration, the CMS Innovation Center will work with medical practices to test the effectiveness of delivering comprehensive primary care services at home and if doing so improves care for Medicare beneficiaries with multiple chronic conditions. Additionally, the Demonstration will reward health care providers that provide high quality care while reducing costs.

Participating Practices

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There are 17 participating sites involved in the Independence at Home Demonstration.(List)
To view an interactive map of this Model, visit the Where Innovation is Happening page.

Individual Practices (Announced April 2012):

  • Boston Medical Center (Boston, Massachusetts)
  • Christiana Care Health Services (Wilmington, Delaware)
  • Cleveland Clinic Home Care Services: Medical Care at Home Program (Independence, Ohio)
  • Comprehensive Geriatric Medicine P.C. d/b/a Doctors on Call (Brooklyn, New York)
  • Doctors Making Housecalls, LLC (Durham, North Carolina)
  • Housecall Providers, Inc. (Portland, Oregon)
  • MD2U (Louisville, Kentucky)
  • National House Call Practitioners Group (Austin, Texas)
  • North Shore – Long Island Jewish Health Care Inc.: Physician House Calls Program (Westbury, New York)
  • RMED, LLC (Jacksonville, Florida)
  • Visiting Physicians Association, P.C. – Flint/Saginaw/Marysville (Flint, Michigan)
  • Visiting Physicians Association, P.C. – Lansing/Ann Arbor (Okemos, Michigan)
  • Visiting Physicians Association, P.C. – Milwaukee (West Allis, Wisconsin)
  • Visiting Physicians Association of Texas, PLLC – Dallas (Irving, Texas)

Consortia (Announced August 2012):

  • America's Disabled Homebound (Chicago, Illinois)
  • Treasure Coast Healthcare, LLC (Stuart, Florida)
  • Mid-Atlantic Consortium
    • Medical House Calls Program at MedStar Washington Hospital Center (Washington, DC)
    • Schnabel In-Home Care Program, Division of Geriatric Medicine, University of Pennsylvania Health System (Philadelphia, Pennsylvania)
    • Virginia Commonwealth University House Calls Program (Richmond, Virginia)

Background

Home-based primary care allows health care providers to spend more time with their patients, perform assessments in a patient’s home environment, and assume greater accountability for all aspects of the patient’s care. This focus on timely and appropriate care is designed to improve overall quality of care and quality of life for patients served, while lowering health care costs by forestalling the need for care in institutional settings.

The Independence at Home Demonstration will build on these existing benefits by providing chronically ill patients with a complete range of primary care services in the home setting. 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 Independence at Home Demonstration also will test whether home-based care can reduce the need for hospitalization, improve patient and caregiver satisfaction, and lead to better health and lower costs to Medicare.

Initiative Details

Selected primary care practices will provide home-based primary care to targeted chronically ill beneficiaries for a three-year period. Participating practices will make in-home visits tailored to an individual patient’s needs and coordinate their care. CMS will track the beneficiary’s care experience through quality measures. Practices that succeed in meeting these quality measures while generating Medicare savings will have an opportunity to receive incentive payments after meeting a minimum savings requirement.

Participation in this home-based care demonstration is voluntary for Medicare beneficiaries.

Participating Practices Requirements

As part of their application, the participating practices were required to demonstrate experience providing home-based primary care to high-cost chronically ill beneficiaries. Participating practices include primary care practices and other multidisciplinary teams that:

  • Are led by physicians or nurse practitioners
  • Are organized for the purpose of providing physician services
  • Have experience providing home-based primary care to patients with multiple chronic conditions and
  • Serve at least 200 eligible beneficiaries.

The primary care teams also include physician assistants, pharmacists, social workers, and other staff.

Additional Information

For more information, including archived materials, visit the CMS.gov Independence at Home webpage.



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