Introduction of Independence at Home Act

Floor Speech

INTRODUCTION OF INDEPENDENCE AT HOME ACT -- (Extensions of Remarks - September 27, 2008)

SPEECH OF
HON. EDWARD J. MARKEY
OF MASSACHUSETTS
IN THE HOUSE OF REPRESENTATIVES
FRIDAY, SEPTEMBER 26, 2008

* Mr. MARKEY. Madam Speaker, I rise to introduce the Independence at Home Act. I am pleased to introduce this important legislation today with my colleagues in the House, Representatives. Chris Smith (R-NJ) and Rahm Emanuel (D-IL), and my colleagues in the Senate, Senators Ron Wyden (D-OR), Barbara Mikulski (D-MD), Benjamin Cardin (D-MD) and Sheldon Whitehouse (D-RI).

* Our legislation is designed to improve the quality of care received by a particularly vulnerable portion of the Medicare population--beneficiaries with multiple chronic and debilitating diseases, including Alzheimer's, Parkinson's, ALS, diabetes and other conditions. Medicare beneficiaries with multiple chronic conditions account for a disproportionate share of Medicare spending compared to their representation in the overall Medicare population. Specifically, CMS reports that each year, 10 percent of the Medicare population accounts for two-thirds of all Medicare fee-for-service program payments. Because this population sees an average of 13 physicians and fills about 50 prescriptions per year, beneficiaries with multiple chronic conditions often receive disjointed care from health providers, including conflicting information and multiple diagnoses for the same symptoms.

* The Independence at Home Act addresses the critical needs of these patients, for whom coordinated care has the greatest potential to achieve positive results. Through the creation of a 3-year demonstration project in 26 states, our legislation provides for patient-centered health care directed by physicians and nurse practitioners working as part of a team of caregivers qualified to deliver quality health services for this specific Medicare patient group. The Independence at Home program is designed to fund better health care and improved health care technology through savings it achieves, using an innovative health care delivery model to permit the growing number of Medicare beneficiaries with multiple chronic conditions to remain as independent as possible for as long as possible and to receive care in a setting that is preferred by the beneficiary involved and the family of such beneficiary.

* In addition to delivering holistic, preventive care that enables patients to remain in their own homes, the Independence at Home demonstration projects hold providers accountable for quality outcomes, patient satisfaction, and a mandatory minimum 5 percent savings on an annual basis compared to Medicare costs that would have been incurred if the beneficiary had not participated in the demonstration project. Our bill generates these savings by providing comprehensive and coordinated care to the highest cost Medicare beneficiaries with multiple chronic conditions, reducing duplicative and unnecessary services and avoiding unnecessary hospitalizations and emergency room visits. As demonstrated by the Veterans Administration and many other existing programs, the Independence at Home Act has the potential both to promote quality, effective care and significantly reduce costs.

* Our bill has been endorsed by the American Academy of Home Care Physicians; AARP; the American Academy of Nurse Practitioners; the National Family Caregivers Association; the Family Caregiver Alliance/National Center on Caregiving; the American Association of Homes and Services for the Aging; the Maryland-National Capital Home Care Association; the Visiting Nurse Associations of America, and Intel Corp.

* I look forward to working with my colleagues on both sides of the aisle to move this important legislation.

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