The new health reform law includes a component called the Independence at Home (IAH) program, which is set to take effect on or before January 1, 2012. But a few Democratic proponents of the plan are pushing CMS to implement the program even sooner -- within the next six months.
The IAH program aims to benefit chronically ill Medicare beneficiaries by encouraging teams of physicians and nurse practitioners to make house calls to the most vulnerable Medicare recipients. The VA enacted a similar program and successfully reduced hospital admissions by 25 percent and total healthcare costs by 15 percent, according to The Hill.
Currently, 5 percent of Medicare recipients account for 40 percent of total Medicare costs, a number which could be drastically reduced with improved efficiency in delivering care to this population. The program will hold providers responsible for reducing healthcare costs -- if costs aren't reduced by 5 percent, they don't get paid by Medicare. The cost savings are divided between the provider and Medicare, providing further incentive for practitioners to comply.
This system represents a shift in thinking, according to George Taler, a physician at the Washington Hospital Center and an AAHCP (American Academy of Home Care Physicians) board member, who is quoted in The Hill's article as saying, "In the current system, the more we do, the more we get paid. And so we do more." Under the new program, physicians would earn more money by saving money, and so it creates a paradigm shift.
The IAH program is being implemented as a three-year pilot program, although proponents are encouraging CMS to extend the program beyond an initial three years and to include at least 5,500 participants in the program.