Under the Independence at Home Demonstration, the CMS Innovation Center worked with medical practices to test the effectiveness of delivering comprehensive primary care services at home and if doing so improved care for Medicare beneficiaries with multiple chronic conditions. Additionally, the Demonstration rewarded health care providers that provided high quality care while reducing costs.
As of January 2023, there was one participating site involved in the Independence at Home Demonstration. To view an interactive map of this Model, visit the Where Innovation is Happening page, and select this model from the drop-down menu on the left side of the page.
Individual Practices (Updated January 2023):
- North Shore Long Island Jewish Health Care Inc.: Physician House Calls Program (Westbury, New York)
Background
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 built 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 provided primary care home visits tailored to the needs of beneficiaries with multiple chronic conditions and functional limitations.
The Independence at Home Demonstration also tested whether home-based care reduced the need for hospitalization, improved patient and caregiver satisfaction, and lead to better health and lower costs to Medicare.
The Consolidated Appropriations Act, 2021, which was signed into law on December 27, 2020, authorized a three-year extension of the Independence at Home Demonstration under Section 1866E of the Social Security Act. The extension period began January 1, 2021 and ended December 31, 2023.
Initiative Details
Selected primary care practices provided home-based primary care to targeted chronically ill beneficiaries for a three-year period. Participating practices made in-home visits tailored to an individual patient’s needs and coordinated their care. CMS tracked the beneficiary’s care experience through quality measures. Practices that succeeded in meeting these quality measures while generating Medicare savings had an opportunity to receive incentive payments after meeting a minimum savings requirement.
Participation in this home-based care demonstration was voluntary for Medicare beneficiaries.
Participating Practices Requirements
As part of their application, the participating practices were required to demonstrate experience providing home-based primary care to high-cost chronically ill beneficiaries. Participating practices included primary care practices and other multidisciplinary teams that:
- Were led by physicians or nurse practitioners
- Were organized for the purpose of providing physician services
- Had experience providing home-based primary care to patients with multiple chronic conditions and
- Served at least 200 eligible beneficiaries.
The primary care teams also included physician assistants, pharmacists, social workers, and other staff.
Evaluations
Latest Evaluation Reports
Prior Evaluation Reports
- Two Pager: Year Seven Evaluation Findings-At-A-Glance Report (PDF)
- Two Pager: At-A-Glance Report (PDF)
- Two Pager: Year Six Evaluation Findings-At-A-Glance Report (PDF)
- Two Pager: Year Five Evaluation Findings-At-A-Glance Report (PDF) (PDF)
- Two Pager: Year Four Evaluation Findings-At-A-Glance Report (PDF) (PDF)
Financial Results
- Independence at Home Demonstration Year Nine Results Fact Sheet (PDF)
- Independence at Home Demonstration Year Eight Results Fact Sheet (PDF)
- Independence at Home Demonstration Year Seven Results Fact Sheet (PDF)
- Independence at Home Demonstration Year Six Results Fact Sheet (PDF)
- Independence at Home Demonstration Year Five Results Fact Sheet (PDF)
- Independence at Home Demonstration Year Four Results Fact Sheet (PDF)
- Independence at Home Demonstration Year Three Results Fact Sheet (PDF)
- Independence at Home Demonstration Year Two Results Fact Sheet (PDF)
- Independence at Home Demonstration Fact Sheet (PDF) (updated: 01/2019)
Press Releases
Additional Information
- Independence at Home Revised Actuarial Methodology Specifications - May, 2021 (PDF) (PDF)
- Report to Congress (PDF)
- Practice Year One Results (PDF)
- Archives
For additional information, please contact the following mailbox resource: IndependenceAtHomeDemo@cms.hhs.gov.