Evaluation of the Independence at Home Demonstration: An Examination of Year 7, the First Year of the COVID-19 Pandemic

The Independence at Home (IAH) demonstration is a congressionally mandated test of whether a payment incentive and service delivery model for providing home-based primary care reduces health care spending and improves quality of care for chronically ill and functionally limited Medicare beneficiaries. Participating home-based primary care practices can earn incentive payments if (1) their patients’ Medicare spending is less than a given spending target and (2) their performance on selected quality measures meets specified thresholds. IAH began in 2012 with 18 participants, 14 of which were included in the evaluation. By Year 7, 10 participants remained. IAH Year 7 was 2020, coinciding with the first year of the COVID-19 pandemic.