Landmark, Blue Shield of CA Expand Home Care Program

Landmark Health and Blue Shield of California are expanding a tag-team home care program launched earlier this year for patients with complex health issues and multiple chronic conditions.

Blue Shield of California and subsidiary Care1st Health Plan have been collaborating since April with Landmark Health, an in-home medical company with private equity backing, as part of a program to provide “the 21st century version of house calls” for the chronically ill. Initially rolled out for eligible members enrolled in select Medicare plans, the program is now being expanded to also include those with Blue Shield individual and employer-sponsored health plans, as well as Care1st Medi-Cal and Cal MediConnect plans.

Medi-Cal is California’s Medicaid health care program.

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“When we don’t feel well, we often want to stay at home, and it’s a relief to be able to get our care there,” Dr. Malaika Stoll, senior medical director for Blue Shield of California, told Home Health Care News. “Landmark serves individuals with complex illness, many of whom face challenges getting to office visits. Of course, Blue Shield also covers office-based and hospital care when needed, but by offering home-based care, we give our members options.”

Once rumored to be up for sale, Huntington Beach, California-based Landmark and its physician-led medical teams carry out house calls across 13 states, offering medical, behavioral, social and palliative care service. Apart from its U.S. operations, Landmark — founded by former CEO Adam Boehler, who later left to lead the Center for Medicare & Medicaid Innovation (CMMI) — also has an international office in Bengaluru, India.

San Francisco-based Blue Shield of California is a not-for-profit, independent member of the Blue Cross Blue Shield Association, serving more than 4 million members and generating more than $17 billion in annual revenue.

About 2,000 Blue Shield and Care1st members were previously eligible for the home-based care services offered through the program. With the expansion, Landmark services will become available to about 10,000 additional eligible members.

“We are still in the early stages of the Landmark program rollout,” Stoll said. “Just in the first few months with our Medicare members, we’ve seen more than 800 people benefit from the program.”

There is no additional cost for eligible members who participate in the program or receive services provided by Landmark. Similarly, there are also no caps on Landmark services utilized.

Covered services provided by non-Landmark providers through a referral from Landmark, however, may be subject to cost-sharing based on members’ health plan benefits and coverage.

While its program with Landmark is meant to provide in-home access to care for individuals suffering from multiple, specific chronic conditions, it is not meant to replace care provided by primary care physicians or specialists, according to Blue Shield.

Landmark’s care model has been shown to reduce emergency room visits by 39% and mortality rates by 53%.

“Avoiding unnecessary emergency department visits and hospitalizations is good from a quality perspective and also helps keep care affordable for everyone,” Stoll said.

Blue Shield of California also collaborates with Los Angeles-based technology startup Heal, a doctors-on-demand company that recently raised another $20 million.

The Landmark program is available to eligible Blue Shield and Care1st members in the San Francisco Bay Area, Sacramento, San Diego, San Bernardino, Riverside, and the greater Los Angeles and Orange County areas.

Written by Robert Holly

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