Evaluation of the independence at home demonstration: An examination of the first six years

This report describes the implementation and impacts of the Independence at Home (IAH) demonstration with a focus on demonstration Year 6. The report examines the effects of the demonstration payment incentive on: (1) Medicare expenditures, hospital use, and health outcomes; and (2) how IAH practices changed the way they delivered care during the demonstration and whether those changes affected the quality of care. Also, the report assesses whether home-based primary care reduces Medicare expenditures and hospital use for chronically ill, functionally limited patients dually eligible for Medicare and Medicaid who start home-based primary care. Finally, the report examines the association between home-based primary care use and end-of-life expenditures by chronically ill, functionally limited patients. (author introduction)