Projected Savings and Workforce Transformation from Converting Independence at Home to a Medicare Benefit.

Available online from MWHC library: 1995 - 2000, then 2006-present, Available in print through MWHC library: 1999 - 2006

Copyright Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

The Independence at Home (IAH) Demonstration Year 1 results have confirmed earlier studies that showed the ability of home-based primary care (HBPC) to improve care and lower costs for Medicare's frailest beneficiaries. The first-year report showed IAH savings of 7.7% for all programs and 17% for the nine of 17 programs that surpassed the 5% mandatory savings threshold. Using these results as applied to the Medicare 5% claims file, the effect of expanding HBPC to the 2.2 million Medicare beneficiaries who are similar to IAH demonstration participants was projected. Total savings ranged from 2 billion to 3 billion depending on the speed and extent of dissemination of HBPC among this IAH-like population. Using a fixed growth rate, as hospitalists experienced in their first decade, 35% coverage would be achieved at the end of 10 years, with total 10-year savings through IAH reaching 7.5 billion and 7.3 billion accruing to the Centers for Medicare and Medicaid Services as a net reduction in overall expenditures, with 2.6 billion from Medicare Parts A and B savings.

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