Can homebound Medicare patients benefit from home-based care? CMS demonstration project aims to find out.
Purpose: To test whether in-home primary care for homebound Medicare beneficiaries can improve quality of care and reduce high-cost events, such as hospitalizations and emergency department visits.
Duration: June 2012 to June 2015
Eligibility: Participating teams led by physicians or nurse practitioners must have experience providing home-based care and serve an average of 200 or more beneficiaries annually (either individually or as part of a consortium). Participants must also use EHRs, remote monitoring, and mobile diagnostic technology.
Patients: Patients must be Medicare beneficiaries under Part A and Part B; have two or more chronic conditions; been hospitalized within the past 12 months; received acute or sub-acute rehabilitation services, such as in a skilled nursing facility, within the past 12 months; and require assistance with activities of daily living.
Quality measures: Six quality measures are tied to payment incentives, including number of hospital admissions; number of 30-day readmissions; number of ED visits; contact with patients within 48 hours of admission to and after discharge from the hospital or ED; medication reconciliation in the home; and documentation of patient preferences.
Incentives: Practices that exceed the minimum savings requirement (MSR) set by Medicare by 5 percent and meet at least three of the six quality measures listed above are eligible to receive 50 percent to 80 percent of the remaining savings achieved. Practices that exceed the MSR by 10 percent and meet the quality targets are eligible to receive 25 percent to 50 percent of the remaining savings.