ArticleJournal of the American Geriatrics Society2019
Integrated Home- and Community-Based Services Improve Community Survival Among Independence at Home Medicare Beneficiaries Without Increasing Medicaid Costs.
Article in Journal of the American Geriatrics Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The effectiveness of alternatives to residential care for older people with on-going health and social care needs: a systematic review.BMC geriatrics · 2026Pooled it
- Community health worker interventions for older adults with complex health needs: A systematic review.Journal of the American Geriatrics Society · 2021Pooled it
- Home-Based Primary and Palliative Care in the Medicaid Program: Systematic Review of the Literature.Journal of the American Geriatrics Society · 2021Pooled it
- Rural-Urban Variability in Home and Community-Based Service Use Among Veterans.Journal of the American Geriatrics Society · 2026Article
- Unexpected consequences of community-based integrated care services reform: increased hospitalization expenses among older adults in China, 2011-2018.Frontiers in public health · 2026Article
- Widely Integrated Services in Home (WISH) for homebound older adults: a study protocol for a randomized encouragement trial.BMC geriatrics · 2024Article
- Factors Impacting the Implementation of Mobile Integrated Health Programs for the Acute Care of Older Adults.Prehospital emergency care · 2024Article
- Patients' and next of kin's expectations and experiences of a mobile integrated care model with a home health care physician - a qualitative thematic study.BMC health services research · 2023Article
- Use of Home-Based Clinical Care and Long-Term Services and Supports Among Homebound Older Adults.Journal of the American Medical Directors Association · 2023Article
- Home-based primary care visits by nurse practitioners.Journal of the American Association of Nurse Practitioners · 2022Article
- Assessing Health Care Use Trajectories After the Onset of Functional Disability: Application of a Group-Based Trajectory Model.The journals of gerontology. Series B, Psychological sciences and social sciences · 2022Article
- Primary care provider notions on instituting community-based geriatric support in Uganda.BMC geriatrics · 2022Article
- A Home-Based Care Research Agenda by and for Homebound Older Adults and Caregivers.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2021Article
- Unmet needs for assistance related to subjective cognitive decline among community-dwelling middle-aged and older adults in the US: prevalence and impact on health-related quality of life.International psychogeriatrics · 2021Article
- Continuity of care and health care cost among community-dwelling older adult veterans living with dementia.Health services research · 2021Article
- Modified STEADI Fall Risk Categories Predict Incident Cognitive Impairment.Journal of the American Geriatrics Society · 2021Article
- Preparedness and response activities of the US Department of Veterans Affairs (VA) home-based primary care program around the fall 2017 hurricane season.BMC public health · 2020Article
- Implications of 2020 Skilled Home Healthcare Payment Reform for Persons with Dementia.Journal of the American Geriatrics Society · 2020Article
- "What Would It Take to Transform Post-Acute Care?" 2019 Conference Proceedings on Re-envisioning Post-Acute Care.Journal of the American Medical Directors Association · 2020Article
- Receipt Of Home-Based Medical Care Among Older Beneficiaries Enrolled In Fee-For-Service Medicare.Health affairs (Project Hope) · 2020Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
objectivesTo determine the effect of home-based primary care (HBPC) for frail older adults, operating under Independence at Home (IAH) incentive alignment on long-term institutionalization (LTI).
designCase-cohort study using HBPC site, Medicare administrative data, and National Health and Aging Trends Study (NHATS) benchmarks.
settingThree IAH-participating HBPC sites in Philadelphia, PA, Richmond, VA, and Washington, DC.
participantsHBPC integrated with long-term services and supports (LTSS) cases (n = 721) and concurrent comparison groups (HBPC not integrated with LTSS: n = 82; no HBPC: n = 573). Cases were eligible if enrolled at one of the three HBPC sites from 2012 to 2015. Independence at Home-qualified (IAH-Q) concurrent comparison groups were selected from Philadelphia, PA; Richmond, VA; and Washington, DC.
interventionHBPC integrated with LTSS under IAH demonstration incentives. MEASUREMENTS: Measurements include LTI rate and mortality rates, community survival, and LTSS costs.
resultsThe LTI rate in the three HBPC programs (8%) was less than that of both concurrent comparison groups (IAH-Q beneficiaries not receiving HBPC, 16%; patients receiving HBPC but not in the IAH demonstration practices, 18%). LTI for patients at each HBPC site declined over the three study years (9.9%, 9.4%, and 4.9%, respectively). Costs of home- and community-based services (HCBS) were nonsignificantly lower among integrated care patients ($2151/mo; observed-to-expected ratio = .88 [.68-1.09]). LTI-free survival in the IAH HBPC group was 85% at 36 months, extending average community residence by 12.8 months compared with IAH-q participants in NHATS.
conclusionHBPC integrated with long-term support services delays LTI in frail, medically complex Medicare beneficiaries without increasing HCBS costs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.