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Home Our Blog ACA Benefits for Seniors

ACA Benefits for Seniors

By Barry Zimmer on August 11th, 2015 in Medicaid

dual eligible beneficiariesMost Americans want to remain in their homes as long as possible. Aging in place hasn’t always been a viable option for many who needed extended care. With the advances in technology along with many medical breakthroughs in the past five decades, it’s now a realistic option for countless senior citizens and elderly Americans. The Centers for Medicare and Medicaid Services are going further to ensure ACA benefits for seniors across the nation.

A pilot program, known as the Independence at Home Demonstration, just completed its first year. The results are impressive and revealed many advantages a permanent program would deliver. The program provides chronically ill Medicare beneficiaries with primary care services in the home setting. In the first twelve months, 17 participating practices served more than 8,400 Medicare beneficiaries. The results were a higher quality of care for patients and lower Medicare expenditures. But those are just a few of the benefits.

“These results support what most Americans already want– that chronically ill patients can be better taken care of in their own homes. This is a great common sense way for Medicare beneficiaries to get better quality care with smarter spending from Medicare,” said CMS Acting Administrator Andy Slavitt. Citing it as a tool within the Affordable Care Act law, it can significantly bring down the long-term cost of care in a patient-centered manner.

Here are a few of the highlights:

  • CMS analysis found that Independence at Home participants saved more than over $25 million in the one year test period. This equates to an average of $3,070 per participating beneficiary. This was done while also simultaneously delivering high quality patient care in the home.
  • CMS will award incentive payments of $11.7 million to nine participating practices that succeeded in reducing Medicare expenditures and met designated quality goals for the first year of the demonstration.
  • All 17 participating practices improved quality in at least three of the six quality measures for the demonstration. Meanwhile, four participating practices met all six quality measures.
  • Medicare beneficiaries who participated had fewer hospital readmissions within 30 days.
  • Follow up care was provided within 2 days of an emergency room visit and/or hospital discharge.
  • They also reported having their medications identified by their provider within 48 hours of discharge from the hospital
  • They used inpatient hospital and emergency department services less for conditions such as high blood pressure, asthma, diabetes or pneumonia.

Simply stated, this successful program could prove to be one of the biggest advantages to the president’s new healthcare policies. With a strong focus on quality care versus quantity, our nation’s elderly are in good hands.

While it’s an ambitious one, the goal is to begin this shift in a way that’s meaningful for patients. Ideally, these payment models and care delivery will be in place within the next year.

To learn more about qualifying for Medicare, Medicaid, Social Security benefits and more, contact our offices today.

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