Home Health & Hospice Week

While the Independence at Home (IAH) demon-stration tests home-based primary care, it has an effect on home health too.

“Many IAH beneficiaries used home health services extensively, and IAH practices tended to have close relationships with home health agencies,” notes a report on the seventh year of the IAH demo in 2020.

“A larger share of IAH beneficiaries (90.8 percent) used home health relative to comparison beneficiaries (79.6 percent) in Year 7,” says the report by contractor Mathematica. “Also, IAH beneficiaries had 19.4 percent higher home health spending than comparison beneficiaries in Year 7, which represents an increase of more than 40 percent since Year 6, when the gap between IAH and comparison beneficiaries was 13.5 percent.” The higher spending was probably due to more home health episodes and visits, Mathematica expects.

Plus: “Frequent visits from a home health agency may have combined with the higher number of primary care visits for IAH beneficiaries to reduce loneliness and feelings of social disconnection, which are associated with an increased risk of sickness and death,” the report observes.

IAH reduced spending by about $459 per-beneficiary per-month (10.7 percent), or $22.6 million in aggregate and $4.2 million after accounting for incentive payments, the report says. “Lower spending on hospital admissions partly drove the total spending reduction and fell the most for beneficiaries who needed help from another person with all or nearly all activities of daily living, such as feeding and dressing,” the report summary highlights.

The 55-page report is at https://innovation.cms.gov/ data-and-reports/2023/iah-year7-eval-report.