On December 21, 2011, the Centers for Medicare & Medicaid Services (CMS) released a call for applications for the Independence at Home Demonstration, a program to encourage better coordination of care through home-based primary care.
Under the Independence at Home Demonstration, the CMS Innovation Center will work with medical practices to test the effectiveness of delivering comprehensive primary care services at home and if doing so improves care for Medicare beneficiaries with multiple chronic conditions. Additionally, the Demonstration will reward healthcare providers that provide high quality care while reducing costs.
Importance of Home-based Primary Care
Home-based primary care allows health care providers to spend more time with their patients, perform assessments in a patient’s home environment, and assume greater accountability for all aspects of the patient’s care. This focus on timely and appropriate care is designed to improve overall quality of care and quality of life for patients served, while lowering health care costs by forestalling the need for care in institutional settings.
The Independence at Home Demonstration will build on these existing benefits by providing chronically ill patients with a complete range of primary care services in the home setting. Medical practices led by physicians or nurse practitioners will provide primary care home visits tailored to the needs of beneficiaries with multiple chronic conditions and functional limitations.
The Independence at Home Demonstration also will test whether home-based care can reduce the need for hospitalization, improve patient and caregiver satisfaction, and lead to better health and lower costs to Medicare.
Under the Independence at Home Demonstration, eligible participants will work with CMS to provide home-based primary care to targeted chronically ill beneficiaries for a three-year period. Participating practices will make in-home visits tailored to an individual patient’s needs and coordinate their care. CMS will track the beneficiary’s care experience through quality measures. Participation in this home-based care demonstration is voluntary for Medicare beneficiaries.
Practices that succeed in meeting these quality measures while generating Medicare savings will have an opportunity to receive incentive payments after meeting a minimum savings requirement.
The Demonstration is intended to encourage the delivery of high quality primary care in a home setting. Participants will need to demonstrate experience providing high quality primary care in the home. This demonstration will include primary care practices and associated multidisciplinary teams that:
- Are led by physicians or nurse practitioners Are organized to provide primary medical care services,
- Have experience providing home-based primary care to patients with multiple chronic conditions, and
- Serve at least 200 beneficiaries with multiple chronic conditions during each year of the demonstration.
Teams may also include pharmacists, social workers, and other supporting staff.
The Demonstration may include up to 10,000 beneficiaries meeting these criteria and up to 50 practices.
The Demonstration will provide chronically ill Medicare beneficiaries a broader array of services they can receive at home. Medicare beneficiaries who wish to participate must:
- Have multiple chronic conditions
- Be covered by original, fee-for-service Medicare
- Require someone’s assistance with two or more activities of daily living such as bathing, dressing, eating or walking. Have had a medically-necessary hospital admission within the last 12 months
- Have received rehabilitation services in the last 12 months
Applications and Letters of Intent, if applicable, are due on February 6, 2012. Deadline information and applications for the Independence at Home Demonstration are available at
The CMS Innovation Center
The Innovation Center was created by the Affordable Care Act to test new models of health care delivery and payment, offer technical support to providers to improve the coordination of care, and diffuse lessons learned and best practices widely throughout the health care system. Its mission is to transform the Medicare, Medicaid and CHIP programs to deliver better care for individuals, better health for populations, and lower growth in expenditures through quality improvement for Medicare beneficiaries.
Additional information about this demonstration can be found at
Questions on this demonstration may be submitted to CMS at: IndependenceAtHomeDemo@cms.hhs.gov