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House Call Program Shows $25 Million in Initial Savings, CMS Says

By Kerry Young, CQ Roll Call

June 18, 2015 -- Medical professionals making in-home visits to the frail elderly produced more than $25 million in savings in the first year of a federal test program that also showed a trend of reduced hospital readmissions, according to the Centers for Medicare and Medicaid Services (CMS).

"These results support what most Americans already want--that chronically ill patients can be better taken care of in their own homes," Andy Slavitt, the acting CMS administrator, said recently in discussing the agency's Independence at Home demonstration project.

Slavitt described the approach as "a great common sense way" to improve the quality of care provided to Medicare beneficiaries. The three-year effort enrolls practices that can make in-home visits and work to coordinate care of people in the health program. Nine of the 17 organizations that participated met their spending targets in the first year, allowing them to receive bonus payments ranging from $275,427 for Doctors Making House Calls of North Carolina to $2.9 million for the Visiting Physicians Association of Michigan, according to CMS.

Other participants in this effort include Boston Medical Center and Cleveland Clinic Home Care Services, which didn't meet the bonus targets in the first year.

The Independence at Home project is part of broader efforts within CMS to study whether greater coordination of care will produce the expected savings and improvements in health. While there's strong bipartisan support in Congress for moving Medicare away from its strong reliance on fee-for-service payments, Democrats and Republicans disagree on how best to do it.

House GOP appropriators, for example, recently tried to derail the CMS' Innovation Center, which runs the Independence at Home program and other projects meant to test different approaches to care. The Labor-Health and Human Services-Education subcommittee approved this draft measure in a voice vote, with Democrats objecting to the measure. The bill would rescind $6.8 billion from the Innovation Center, which is roughly the balance remaining from the $10 billion provided for it by the 2010 health law.

Such cuts are unlikely to become law as long as President Obama remains in office. But they signal that Republicans may block any attempt to renew funding for the Innovation Center when the initial $10 billion tranche is exhausted. For Rosa DeLauro of Connecticut, the ranking Democrat on the House Labor-HHS panel, the announcement from CMS about the early results of the Independence at Home program provides yet another reason to defend the Innovation Center.

"I have long made the case that the Innovation Center can improve quality and reduce costs, and today we are seeing evidence of that," she told CQ HealthBeat in a statement. "To take away its funding is short-sighted and foolish. I will continue to fight for this important project to be fully funded."

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