PPSV Principal and Co-Founder Jim Pyles Authors Medicare Reform Bill Providing New Cost-Saving Medicare Benefit for those Suffering from Multiple Chronic Illnesses
October 8, 2008
The Independence at Home Act, (S 3613, HR 7114), authored by PPSV founding partner Jim Pyles, was introduced by Sen. Ron Wyden (D-OR) and Rep. Ed Markey (D-PA) on September 26th. It is cosponsored in the House by Congressmen Chris Smith (R-NJ) and Rahm Emanuel (D-IL) and in the Senate by Senators Barbara Mikulski (D-MD), Ben Cardin (D-MD) and Sheldon Whitehouse (D-RI). The IAH Act proposes to amend Title XVIII of the Social Security Act to provide certain high cost Medicare beneficiaries suffering from multiple chronic conditions with access to coordinated medical services in lower cost treatment settings, such as residences, provided by a team of health care professionals directed by a qualified physician or nurse practitioner. The IAH Act is designed to generate immediate savings under Medicare – at least 5% above the cost of the program – that can be used for other purposes. The bill provides an incentive for additional savings through innovation by allowing IAH organizations to retain 80% of savings beyond 5%.
“For too long, people struggling with multiple chronic conditions have had to handle their health challenges while wading their way through a complex system of multiple specialists, with too little guidance and coordination,” said Senator Wyden. “The Independence at Home Act will not only improve patients’ health and offer them more freedom – it should also lead to finding better ways to deliver care and cut costs.”
“Our bill puts patients first by promoting coordinated care designed to quickly identify and treat emerging health problems and, where possible, avoid hospitalizations, improving patients’ quality of life while also cutting costs. Patients and their families will spend less time juggling conflicting diagnoses and multiple doctors, and more time focused on living their lives as independently as possible, in their own homes,” said Rep. Markey.
Jim Pyles states: The IAH Act is intended to fundamentally change the 1965-era Medicare service delivery model from ‘institutional health care first’ to ‘home care first’. We cannot hope to extend health insurance to the 47 million uninsured using the current service delivery model that promotes high cost, fragmented and uncoordinated health care and produces poor outcomes. The Independence at Home Act promotes coordinated health care in the lowest cost settings for the highest cost beneficiaries and holds providers accountable for savings and improved outcomes. The IAH Act also provides economic incentives for providers to use innovation and technology to find new ways of providing healthcare that reduce costs and produce better outcomes. Lastly, the IAH Act provides healthcare that Americans want by keeping them as independent as possible for as long as possible. This benefit is particularly important at a time of economic recession which is hardest on family caregivers who often suffer from chronic illnesses themselves and on the ‘sandwich generation’ who hold down two jobs, make sure their children do their homework and take care of elderly parents with chronic illnesses.”
The bill has been endorsed by consumer and provider groups such as AARP, the Visiting Nurse Associations of America, the National Family Caregivers Association, the American College of Nurse Practitioners, the American Academy of Home Care Physicians, the American Association of Homes and Services for the Aging, and Intel Corp.
For more information, contact Jim Pyles, who represents the American Academy of Home Care Physicians, at 202.466.6550 or jim.pyles@ppsv.com. Powers Pyles Sutter & Verville, PC is a Washington, DC-based law firm that focuses on healthcare, education, disability and the law of tax-exempt organizations.
