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Congress Moves on In-Home Care

Congress recently voted to extend the Independence at Home (IAH) demonstration program and repeal the Independent Payment Advisory Board (IPAB). These developments move both bills towards being considered by the full House and, if passed, will certainly affect the home care industry.

Independence at Home Bill

The IAH demonstration program is a part of the Children’s Health Insurance Program (CHIP) markup that was held by the House of Representatives Energy and Commerce Committee. This committee voted and approved the IAH program. When this program was originally created, it was to provide primary care services that were both robust and comprehensive to patients in their homes. This design of this program was to test whether in-home care (1) reduced hospitalizations and (2) improved patients’ health and satisfaction while decreasing Medicare program costs. IAH was originally drafted to last five years. During its first two years, those goals were being met. Patients were very satisfied with their in-home care and Medicare saved money. According to a Centers for Medicare and Medicaid Services study, over $10 million was saved by the program’s 15 participating providers during Year 2. The new legislation will extend the program by another two years and the number of beneficiaries will go from 10,000 to 15,000.

The Repeal of IPAB

The vote to repeal the IPAB by the House Ways and Means Committee will prevent the 15-member IPAB board from being implemented. If implemented, this committee would be able to recommend cost cuts to Medicare that would go into effect automatically if certain financial projections are met. Congress would be permitted to override IPAB recommendations only if they could find alternative ways to save the same amount of money. The IPAB board if triggered could cause budget cuts that would have a detrimental effect on home health care.

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