Using interdisciplinary teams of medical and social services professionals to provide care to patients in their homes, the IAH model provides high quality clinical care and excellent patient experience while promising to significantly lower costs for the Medicare program.
In the demonstration, up to 10,000 Medicare patients with severe chronic illness and disability have been served by medical teams
Medicare Demonstrations since 2012
17 IAH practices
which provide Home-Based
Primary Care
The IAH practices provide:
Interdisciplinary medical and social services at home
24/7 access and visits within 48 hours of discharge from hospital or ER
a mobile electronic health record (EHR)
Many elders with severe chronic illness and disability have difficulty getting to the doctor’s office, forcing them to rely on the ER or hospital due to:
Cognitive
Physical
Social
IAH teams are required to meet quality metrics:
better medication management and advance care planning
follow-up visits within 48 hours after any hospital stay or ER visit
fewer ER visits and hospitalizations and 30-day readmissions
IAH teams provide better care and reduce total Medicare costs by up to 30%
All 17 original practices met at least three of six major quality metrics and four sites met all six.
9 of 17 exceeded minimum savings thresholds for either or both years. Practices received shared savings payments of nearly $17 million with medicare receiving nearly $19 million in two years.
All reduced ER visits and hospitalizations and 30-day readmissions.
1-2 million Medicare patients with severe chronic illness and disability could benefit from national IAH program
A national IAH program could bring $10 to $15 billion in savings over the next 10 years.
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