Projected Savings and Workforce Transformation from Converting Independence at Home to a Medicare Benefit

The Independence at Home ( IAH ) Demonstration Year 1 results have confirmed earlier studies that showed the ability of home‐based primary care ( HBPC ) to improve care and lower costs for Medicare's frailest beneficiaries. The first‐year report showed IAH savings of 7.7% for all programs and 17% for the nine of 17 programs that surpassed the 5% mandatory savings threshold. Using these results as applied to the Medicare 5% claims file, the effect of expanding HBPC to the 2.2 million Medicare beneficiaries who are similar to IAH demonstration participants was projected. Total savings ranged from $12 billion to $53 billion depending on the speed and extent of dissemination of HBPC among this IAH ‐like population. Using a fixed growth rate, as hospitalists experienced in their first decade, 35% coverage would be achieved at the end of 10 years, with total 10‐year savings through IAH reaching $37.5 billion and $17.3 billion accruing to the Centers for Medicare and Medicaid Services as a net reduction in overall expenditures, with $12.6 billion from Medicare Parts A and B savings.