Health and financial security Medicare What's Buzzing

Medicare finding ways to cover house calls and save money at once

Written by Diane Archer

Can Medicare deliver better care at home to older patients with multiple chronic conditions and save money in the process? Based on Year One practice results of Medicare’s Independence at Home Demonstration, the answer is a resounding “Yes.” In its first year, the Demonstration both improved health outcomes for patients with multiple chronic conditions and saved Medicare $25 million.

The Demonstration is funded through the Affordable Care Act with the goal of improving quality of care and quality of life for older patients with multiple care needs. It is designed to keep patients at home and out of institutions—be they hospitals or nursing home. The Demonstration gives doctors and nurse practitioners more time with their patients and allows them to assess their home environment. And, it is designed to improve both caregiver and patient satisfaction.

Patients in the Demonstration must be enrolled in traditional Medicare, have two or more chronic conditions and have been hospitalized in the prior 12 months. They receive comprehensive primary care tailored to their needs for a three-year period. The care team coordinates their care. The Centers for Medicare and Medicaid Services is tracking the patients’ care experiences through quality measures. Providers in the demonstration that succeed at reducing costs receive incentive payments.

Begun in 2012, fifteen sites throughout the country are engaged in this project, including Boston Medical Center, Cleveland Clinic Home Care Services, North-Shore Long Island Jewish Health Care and Dallas VPA.

This demonstration is one of a number of pilots Medicare is supporting to test ways of delivering care that allow older adults to age in place. Click here to read about another such project. Right now, other than through these demonstration projects, Medicare only covers limited home care services for patients needing physical therapy or nursing care and for whom leaving home requires a considerable and taxing effort.



  • It would be good for a lot of elderly and disabled people to be able to have home care. But there is, in my opinion, a much greater need for something that effect’s so many people both physically and financially – AND THAT IS TO ADD DENTAL TO MEDICARE WITH GOOD COMPREHENSIVE COVERAGE!!! ¡!!!

  • A few years ago, I broke my back–and, sadly, lived alone. My wife had died a few years earlier. I needed some medical assistance after the hospital dismissed me. They came once a week (not enough for what help I needed) and spent time with me, helping me to grow strong enough to “get back on my feet.” I have suffered with that back injury since then; but I have been able (so far!!) to live alone, drive my car as needed, and manage my life by myself. I am grateful for the help that Medicare gave me. It made THE difference in my ability to continue to live alone, grow older, and survive. My compliments to that Medicare Program. Let’s pray it continues to provide a greater variety of assistance for people in need!!! If one thinks about it, that program is much less costly than a hospital stay–and provides the same or better services. As my back continues to deteriorate again (from a recent accident) I pray the home-care program is still available. It, to me, was the best medical services I could receive. It was much better, to me, than staying in a crowded hospital where nurses (and perhaps doctors, too) are worked to death–without ever having the time they need to spend on individual persons. Keep that home-health care alive and available to those who need it, I humbly request it for myself and so many others with similar needs. Ken Minor, North Port, FL

Leave a Comment

Read previous post:
Pneumonia vaccine: Medicare covers it

You should do what you can to avoid getting pneumonia, especially if you’re older. Pneumonia is a lung infection that...