Elderly, Ailing—and Treated at Home

A few years ago, Luberta Whitfield suffered a stroke that left her right side paralyzed. The wheelchair-bound 87-year-old has emphysema and diet-controlled diabetes, is dependent on oxygen, and recently tore the right rotator cuff on her good arm. She also, amazingly, still lives in her own apartment.

Ms. Whitfield is a participant in Independence at Home, a congressionally authorized pilot program. The program gives the sickest Medicare patients primary care right where they live. Since launching in 2012, it has been a tremendous success, delivering high-quality care at a lower cost than traditional Medicare.

Unfortunately, because of a legislative quirk, the administration lacks the legal authority to extend the program across the U.S. The project has enrolled 10,000 patients, but that is the limit imposed by the law. Congress should make the program a permanent part of Medicare. It would benefit not only patients hoping for higher quality of life, but also taxpayers.

To qualify for the program, applicants need to have been hospitalized within the past year and to suffer from two or more chronic conditions. They must also require help with basic daily tasks, and have needed some kind of rehabilitation services, such as a stay in a skilled nursing facility, in the past 12 months. These patients are so sick that more than 23% die each year, and they average an extremely high $45,000 in annual Medicare spending, according to Centers for Medicare and Medicaid Services analysis.