The Future of Fee-for-Service, and Landmark Health

Center for Medicare and Medicaid Innovation (CMMI) announced last week their top four priorities: Patients, Physicians, Payment for Outcomes and Prevention. For Landmark, this announcement aligns closely with our own vision and mission.

Our vision at Landmark is to transform health care by dramatically improving the quality of lives in our communities. When we consider how we can get there, we look to our model – as a risk-bearing medical group, we only benefit when our patients stay well at home. The high-touch, in-home clinical care Landmark provides would simply not be sustainable in a fee-for-service payment world.

Our providers see around five to seven patients a day, often spending up to an hour at each visit. In addition, they have the support of a fully-employed interdisciplinary team of behavioral health specialists, pharmacists, nurses, dietitians and socials workers who can all be called on to help the patient. This ensures the right care, at the right time to help keep patients well at home. It’s only through a payment for outcomes model that this level of care can be delivered.

Our patients benefit because high-quality, coordinated care comes to them in their home, routinely to stay ahead of potential issues and urgently 24/7 if needed. This focus on prevention results in less hospital/ER admissions, and patients who live longer, more independent lives.

For our providers, the Landmark model results in lower burnout rates. Our physicians and advanced practice providers are doing the work they are passionate about. They can see fewer patients for a clinically appropriate amount of time. This longitudinal care provides them the means to truly impact patients’ health by seeing the whole patient – their homes, their lives, their families/caregivers, their other physicians. This level of coordination is too rarely seen in today’s healthcare system.

As we look to our own future priorities, we see clear alignment with CMMI’s four Ps: Patients, Physicians, Payment for Outcomes and Prevention. This focus is core to our model and enables us to bring comprehensive care to patients wherever and whenever they need it.

Read more about the work happening at CMMI.