HHS Announces New Affordable Care Act Options for Community Based Care
Medicaid and Medicare Introduce Greater Flexibility for Beneficiaries to 
Receive Care at Home or in Settings of Their Choice

New opportunities in Medicaid and Medicare that will allow people to more 
easily receive care and services in their communities rather than being 
admitted to a hospital or nursing home were announced on April 26 by HHS 
Secretary Kathleen Sebelius.

HHS finalized the Community First Choice rule, which is a new state plan option 
under Medicaid, and announced the participants in the Independence At Home 
Demonstration program. The demonstration encourages primary care practices to 
provide home-based care to chronically ill Medicare patients.

Both are made possible by the Affordable Care Act. Studies have shown that home 
- and community-based care can lead to better health outcomes.

The final rule released today on the Community First Choice Option provides 
states choosing to participate in this option 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.

Also today, the first 16 organizations that will participate in the new 
Independence at Home Demonstration were announced. 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. These 16 
organizations 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.

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. Under the demonstration, 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.

The demonstration is scheduled to begin on June 1, 2012, and conclude May 31, 
2015.

HHS is also seeking comment on a proposed rule that describes a separate Home 
and Community-Based Services state plan option, which was originally authorized 
in 2005 then 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.

The announcements made today 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.

For more information:

§  Administration for Community Living website <http://www.hhs.gov/acl/>

§  Community First Choice Option fact 
sheet<http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4350&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date>

For more information on the Independence at Home demonstration and the 
organizations selected to participate visit the Center for Medicare & Medicaid 
Innovation website<http://innovation.cms.gov/initiatives/independence-at-home/>.

The rules may be viewed at the Office of the Federal Register 
website<http://www.ofr.gov/inspection.aspx>.

Full text of this excerpted CMS press 
release<http://www.cms.gov/apps/media/press/release.asp?Counter=4351&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date>
 (issued April 26).

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