Improving care for chronically ill starts at home

An insurance provider and home health provider are partnering to offer in-home care for chronically ill seniors.

Blue Cross Blue Shield of Massachusetts, the largest health plan in the Commonwealth, is working with Landmark Health on a new program for seniors with multiple chronic conditions. Landmark Health offers round-the-clock, home-based medical care with an interdisciplinary team who can incorporate medical, behavioral, social and palliative care into the care plan.

As part of this new program, the first of its kind in New England, Landmark clinicians will provide care that complements but does not replace what members receive from their regular doctors. This model has been shown to increase patient satisfaction, improve quality of care and reduce healthcare spending for emergency room, inpatient and skilled nursing facility visits.

“This innovative program reinforces our commitment to improving access to high quality, affordable healthcare for our members by allowing us to provide care where seniors are often most comfortable—in their homes,” said Bruce Nash, M.D., Blue Cross Chief Physician Executive, in a press release.

Letters have been sent to Blue Cross Medicare Advantage members with serious chronic or acute conditions—including cancer, heart disease, depression, diabetes or kidney disease—to invite them to participate in the voluntary program.

This is one of three new programs Blue Cross formed to improve care for Medicare Advantage members in the region. The Dementia Care Coordination Program, developed with the Alzheimer’s Association Massachusetts/New Hampshire Chapter, creates an individualized care plan for members who have Alzheimer’s or dementia. The Transitions in Care Pilot Program works with Elder Services of Worchester to dispatch health coaches to members after they are discharged from the hospital.

Topics: Clinical