Nurse listening to chest of patient in home

Home health has reaped big benefits from the Independence at Home demonstration model, according to a recent evaluation by the Center for Medicare & Medicaid Innovation

CMMI found in 2020 — the seventh year of the model — IAH beneficiaries spent 19.4% more for home health services compared to what other Medicare beneficiaries spent on home health. 

Home health agencies provided in-home nursing, therapy, social work and aide services to participating Medicare beneficiaries. CMMI said the more extensive home health services IAH beneficiaries received may have played a significant role in preventing or slowing declines in health and functional status of seniors during the COVID-19 pandemic.

IAH was designed to test whether a payment incentive for providing in-home primary care reduces healthcare spending and improves quality of life for Medicare beneficiaries. To participate in the model, enrollees must have two or more chronic conditions, require help from another person to perform at least two activities of daily living, have been hospitalized within the last 12 months, and have used acute or subacute rehabilitation services in the last 12 months. 

In its evaluation of IAH, CMMI also found that in-home primary care played a sizable role in enrollees’ overall healthcare. Medicare beneficiaries participating in the program received on average a primary care visit every five weeks, compared to every nine weeks for other Medicare beneficiaries. CMMI said the additional physician visits may have been valuable in attending to the health needs of seniors during the pandemic. 

In 2020, CMMI found those beneficiaries requiring the most help with activities of daily living saw significantly larger reductions in hospital admissions, emergency room visits and avoidable hospital admissions than other Medicare beneficiaries. 

The IAH demonstration model was launched in 2012. In 2020, 10 primary care practices participated in the model and provided care for 5,000 Medicare beneficiaries.