Harvard Pilgrim Health Care and Landmark Health (Landmark), an industry leader of in-home medical care, have entered into an agreement to offer a new care coordination program for chronically ill Medicare Advantage members with complex health and social needs.
The Landmark program brings care to high-need patients where they reside, treating the whole patient with a dedicated focus on long-term outcomes. Their physicians and advanced practice providers (Complexivists®) bring medical, behavioral and palliative care to patients through routine and urgent house call visits. These providers are supported by a local multidisciplinary team – including behavioral health clinicians, pharmacist, nurse, social workers and dietitian – who provide education, support and care over the phone and in the home.
“In collaboration with Landmark Health, Harvard Pilgrim will further advance its whole person, complex care coordination services for members with special health care needs and guide them to better health outcomes,” said Michael Carson, president and CEO of Harvard Pilgrim Health Care. “Harvard Pilgrim understands that one size does not fit all when it comes to helping members with complex care conditions. Landmark’s proactive care coordination augments Harvard Pilgrim’s multifaceted efforts to bring high-quality care directly to where it best benefits its members.”
“House calls give our providers quality time with patients to develop relationships, trust and insights inside the home that allow us to tailor proactive care to their unique health situations,” states Dr. Michael Le, Chief Medical Officer and co-founder at Landmark. “Landmark is excited to deepen our roots and serve more patients in Massachusetts.”
A key driver of patient health outcomes is a high level of coordination with patients’ regular doctors, specialists and caregivers, as well as community services. Landmark’s in-home care is supplemental and designed for those with complex health needs due to multiple chronic conditions such as diabetes, heart disease, lung disease, and cancer. This highly collaborative and holistic approach to care is driving real results for Landmark’s patients nationally, including a 28 percent decrease in hospitalizations and a 39 percent reduction in emergency room visits.1
The program is voluntary and offered at no cost to eligible Harvard Pilgrim Health Care Medicare Advantage members who have multiple chronic conditions, living in the following Massachusetts counties: Middlesex, Worcester, Suffolk, Norfolk, Essex, Bristol, and Plymouth.
About Harvard Pilgrim Health Care
Harvard Pilgrim and its family of companies provide health benefit plans, programs and services to more than 3 million customers in New England and beyond. A leading not-for-profit health services company, we guide our members – and the communities we serve – to better health.
Founded by doctors 50 years ago, we’re building on our legacy. In partnership with our expansive network of doctors and hospitals, we’re improving health outcomes and lowering costs through clinical quality and innovative care management.
Our commitment to the communities we serve is driven by the passion of the Harvard Pilgrim Health Care Foundation. Through its work, low- and moderate-income families are gaining greater access to fresh, affordable food — a cornerstone to better health and well-being.
It would work politically – but again – without an impeccable population registry and control over who is who on a national level, this is unlikely to succeed. The system would be predestined to fail because of lack of funds. If you design a system to provide the health care needs for a population and then increase that population without any additional funds – then naturally it would lead to a lower level of service, declined quality, and waiting lists for complex procedures. In real terms, American health care goes from being a first world system to a third world system.
Thousands, if not a million, American residents live as any other American citizen but they are still not in good standing with their immigration even if they have been here for ten or fifteen years. A universal health care system will raise issues about who is entitled and who is not.
The alternative is for an American universal health care system to surrender to the fact that there is no order in the population registry and just provide health care for everyone who shows up. If that is done, costs will dramatically increase at some level depending on who will pick up the bill – the state government, the federal government, or the public health care system.
Illegal immigrants that have arrived within the last years and make up a significant population would create an enormous pressure on a universal health care, if implemented, in states like Texas and California. If they are given universal health care, it would be a pure loss for the system as they mostly work for cash. They will never be payees into the universal health care system as it is based on salary taxes, and they do not file taxes.
The difference is that Sweden has almost no illegal immigrants compared to the United States. The Swedes do not provide health care services for illegal immigrants and the illegal immigrants can be arrested and deported if they require public service without good legal standing.