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Home Model Saves $9.1 Billion

CMS: Independence At Home Demo Saves Medicare $9.1 Billion

Inside Health Policy

February 19, 2019

CMS says the Independence at Home Demonstration saved about $9.1 billion in its third year, once incentive payments to practices were taken into account -- results praised by Sens. Ron Wyden (D-OR) and Ed Markey (D-MA), who would like to make the demonstration permanent.

“The numbers don’t lie -- care at home lowers health care costs by avoiding costly hospital care and provides quality health care to seniors with chronic illnesses. That’s a win-win proposition, and I will push for Independence at Home to continue so the program can realize its full potential and be available to all seniors who need it in the future,” Wyden said in a statement.

Independence at Home uses primary care teams to provide care in the home, improve health outcomes and reduce spending for Medicare beneficiaries living with multiple chronic conditions. The home-based primary care program was initially part of the Affordable Care Act, and has been extended multiple times since, most recently for two years, through 2020, by the Bipartisan Budget Act of 2018. Democratic senators had pushed to make the demo permanent through the CHRONIC Care Act, which was later incorporated into the 2018 funding bill, but the Finance Committee settled on the two-year extension because of the Congressional Budget Office’s higher score for making the demo permanent.

Markey says in a statement that he and Wyden will continue to push to make the demonstration permanent.

CMS says the IAH practices saved around 4.7 percent, or about $16.3 million, in the third year of the demo. CMS will also provide about $7.2 million in incentive payments to seven practices, leaving about $9.1 million in overall savings to Medicare.

More than 11,000 beneficiaries were enrolled in the demo at 15 practices, so CMS used a method to proportionately reduce the number of beneficiaries for the purpose of calculating incentive payments because the original statute limited the number of beneficiaries in the demo to 10,000. The 2018 budget bill raised that cap to 15,000.

CMS says that for the third performance year, all but one practice improved on at least one quality measure compared to the previous year, and five of the practices met performance thresholds for all six quality measures. -- Michelle M. Stein (

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