One of the biggest challenges for provider organizations is the shift from fee-for-service to value-based care. Landmark was built for this payment model and has been successful financially but more importantly it allows us to consider the long-term outcomes of our interactions with patients. This outlook is exceptionally rewarding for doctors and providers, but shifting a traditional model to these new payment models has proven challenging for many. Partnering with existing value-based provider groups is one avenue to making that shift.
2. What has you most optimistic about the future of health care?
The COVID pandemic is not something I would have hoped for, but as an industry we are taking lessons learned from that experience and making change. In particular, site of care. The home is now being seen as a clinical site of care – this shift is incredibly important for frail, homebound, and polychronic patients who struggle to access the traditional facility-based medical system. Improved access through telemedicine and in-home care also creates opportunities to provide better longitudinal care and care coordination for more rural populations.
3. How has your organization adapted during Covid times?
We were very concerned about the COVID pandemic for our patients as our average patient is 77 years old with 9 chronic conditions – this is the population absolutely hardest hit by the virus. We knew we had to stay close to our patients to ensure they received the care they needed to control their chronic conditions at home, avoiding unnecessary exposure to the virus in clinics or hospitals. We pivoted most visits to telemedicine (phone and video) for the first couple months of the pandemic due to a lack of PPE but shifted very quickly back into the home after aggressive PPE procurement efforts. Our patients have sight and hearing issues, dementia and other needs that make in-person, hands-on care necessary. Ultimately, our efforts worked as our patients had significantly less exposure to the virus – and a lower mortality from the virus – versus people who did not have access to ongoing in-home care.
4. What motivates you to keep doing the work that you do?
Our patients. As a young child growing up in Massachusetts, I watched my father practice medicine. He often grabbed his black doctor’s bag to head out and see one of his patients in the home. This type of care resonated with me even then and I have focused much of my career on home-based medical care, specifically for the sickest and frailest. This is the right delivery model for these high-needs patients and I’m excited to see the tremendous growth in this area of healthcare.