[Congressional Record (Bound Edition), Volume 154 (2008), Part 16]
[EXTE]
[Page 22878]
[From the U.S. Government Publishing Office, www.gpo.gov]




                INTRODUCTION OF INDEPENDENCE AT HOME ACT

                                 ______
                                 

                         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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