HHS Announces 3 New Home & Community-Based Care Options under Affordable Care Act

Home Health Care - HHS Announces 3 New Home & Community-Based Care Options under Affordable Care ActThe U.S. Department of Health & Human Services (HHS) announced yesterday three new programs made possible under the Patient Protection & Affordable Care Act (the “Affordable Care Act,” which some call “Obamacare”) to help Medicare and Medicaid beneficiaries receive care at home or in their communities, rather than having to be admitted to a hospital or nursing home.

“Prior to passage of the Affordable Care Act, many families had few choices beyond nursing homes or other institutions for their loved ones. The actions taken today will help change that and can lead to better health for these individuals,” Kathleen Sabelius, Secretary of Health & Human Services, said in a press release issued by HHS on April 26, 2012.

“Studies have shown that home- and community-based care can lead to better health outcomes,” the release stated.

The new programs announced on April 26 include:

  1. Community First Choice Option – HHS announced the Final version of the new Community First Choice Rule, which is a new state plan option under Medicaid. States choosing to participate in this plan option will receive a six percentage point increase in federal Medicaid matching funds for providing community-based attendant services and supports to beneficiaries who would otherwise be confined to a nursing home or other institution. The funding for this program was provided by the Affordable Care Act.

    More information on the new Community First Choice Option if found in a Fact Sheet provided by HHS.

    The new final rule on the Community First Choice Option may be viewed at www.ofr.gov/inspection.aspx.

  2. Independence at Home Demonstration – HHS announced the first 16 primary care health care provider organizations that will participate in the new Independence at Home Demonstration project, delivering home-based primary care to Medicare beneficiaries who elect to participate. These 16 primary care providers were selected “from a competitive pool of more than 130 applications representing hundreds of health care providers interested in delivering this new model of care,” HHS said. “They will test whether delivering primary care services in the home can improve the quality of care and reduce costs for patients living with chronic illnesses.”

    “The Independence at Home demonstration, which is voluntary for Medicare beneficiaries, provides chronically ill Medicare beneficiaries with a complete range of in-home primary care services,” HHS stated in its release. “Under the demonstration, the Centers for Medicare & Medicaid Services (CMS) will partner with primary care practices led by physicians or nurse practitioners to evaluate the extent to which delivering primary care services in a home setting is effective in improving care for Medicare beneficiaries with multiple chronic conditions and reducing costs. Up to 10,000 Medicare patients with chronic conditions will be able to get most of the care they need at home,” HHS said.

    The demonstration project is scheduled to begin on June 1, 2012, and conclude May 31, 2015. This initiative is also developed and funded under the Affordable Care Act.

    More information on the Independence at Home Demonstration project and the organizations selected to participate is found on the CMS website.

  3. Home and Community-Based Services State Plan Option – HHS announced that it is seeking comment on a proposed new rule providing for another and separate Home and Community-Based Services state plan option under Medicaid. This plan option was originally authorized in 2005, and then was enhanced by the Affordable Care Act. “Like the Community First Choice Option, this benefit will make it easier for states to provide Medicaid coverage for home and community-based services,” HHS said in its announcement.

    The proposed new rule on the Home and Community-Based Services State Plan Option may be viewed at www.ofr.gov/inspection.aspx.

“The announcements made [on April 26] are one part of the Obama administration’s efforts to help people with disabilities and those living with chronic illness stay in their own homes when they wish to do so,” HHS said in its announcement.

“We know that people frequently prefer to receive services in their own homes and communities whenever possible. The rule and demonstration announced today give people choice and provide states with flexibility to design programs that better meet the needs of beneficiaries,” Secretary Sebelius said.

“Our goal is to provide person-centered support to every Medicare and Medicaid beneficiary, regardless of their physical ability or chronic health conditions,” said Marilyn Travenner, Acting Administrator of the Centers for Medicare and Medicaid Services (CMS). “These services and programs will help keep these individuals’ health stable, and keep them home where they want to be, while giving us even more tools to achieve better care for the patient, better health for the population, all at lower costs.”

As part of this effort, Secretary Sebelius also announced on April 16, 2012, the creation of the new Administration for Community Living, which will bring together the Administration on Aging, the Office on Disability and the Administration on Developmental Disabilities into one “coordinated and stronger entity” under HHS.

The new Administration for Community Living is dedicated to “enhancing and improving the broad range of supports that individuals with disabilities and seniors may need to live with respect and dignity as full members of their communities” — rather than in nursing homes or other institutions.

More Information

See related HelpingYouCare™ reports on:

HHS Announces New Administration on Community Living to Help Seniors & Disabled Live At Home

Medicare to Provide Expanded Primary Care At Home for Seniors under New Affordable Care Act Initiative

Medicare Announces Inclusion of Patient Survey Data in Home Health Compare Tool

New Trend: Hospital Care At Home? Study Finds Home X-Rays Beneficial for Elderly

States Slash Home Health Care & Adult Day Care Services for the Neediest; Likely to Increase Costs

New Virtual Assisted Living Model: Technology + Paid Staff and Volunteers Enable Seniors to Remain in Their Own Homes

For more information about Home Health Care, see the HelpingYouCare™ resource page on Information About Home Health Care.

For information on care facilities, see the HelpingYouCare™ resource pages on About Senior Housing and Care Facilities, including:

To help you find home health care or other care providers and resources in your area, see CareHelpFinder™, the HelpingYouCare™ senior-care resource locator tools to:

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