Health care policy experts estimate that Medicare spends almost 50% on just 5% of the nation’s sickest. Section 3024 of the federal Patient Protection and Affordable Care Act is testing whether returning to the old-fashioned house call can improve that figure. The law sets up a three-year demonstration program for some of the most expensive chronic health care consumers, designed to provide primary and related care to reduce hospitalizations and drug interactions and improve overall health. A 30-year old model run by the federal Veteran’s Administration has reduced hospital days by 62% and overall costs by 24%.
The new program, known as Independence at Home (IAH), will pay providers normal Medicare rates for reasonable and necessary services, except that that they will be paid 80% of any savings over 5%.
