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Medicare House Call Program Appears on Track for Extension

By Kerry Young, CQ Roll Call

July 1, 2015 -- A Medicare program that tests whether house calls by physicians and other medical professionals can improve the care of frail elderly people with chronic diseases has won significant GOP support, even though the effort was launched as part of the Affordable Care Act.

The House could soon clear a bill (S 971) that would extend by two years the Independence at Home project, initially authorized for three years in the health law (PL 111-148, PL 111-152). The Senate passed the extension bill April 22 by voice vote, and Rep. Mike Burgess, R-Texas, introduced in May an identical House measure (HR 2196). The House Ways and Means Committee on June 2 agreed by voice vote to report the Senate-passed version of the bill to the full chamber.

In the committee's report, Ways and Means members noted that lawmakers long expressed an interest in such home care, with legislation having been introduced in each chamber since the 110th Congress (2007-2009). The Centers for Medicare and Medicaid Services (CMS) last month announced that the Independence at Home program appeared to have lowered Medicare expense by $25 million in its first year.

Unlike like other CMS programs testing new approaches to payment, the Independence at Home model doesn't provide upfront financial assistance to medical practices and organizations seeking to participate. Instead, participating organizations stand to get incentive payments if they meet targets for quality of care and savings.

Sen. Edward J. Markey, D-Mass., has described the program as "bringing the house calls of yesteryear into the 21st century." He has said he intends to see it expanded a demonstration model into a permanent Medicare program. It could have great benefit for people facing Alzheimer's disease as well as other chronic conditions, he said.

"It is a program where nurse practitioners, physicians, and nursing homes are able to say: `We are going to help to keep your loved one at home. We will give you the help that makes that possible'," Markey has said.

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