How Landmark can support primary care providers as they care for our most vulnerable Medicare Advantage members

On Jan. 1, 2023, all Medicare Plus Blue℠ and BCN Advantage℠ members who have multiple chronic conditions and reside in Michigan’s Lower Peninsula will be eligible for Blue Cross Blue Shield of Michigan and Blue Care Network’s high-intensity in-home care program. This program uses the services of Landmark Health L.L.C., an independent company that provides Blue Cross and BCN with in-home care services.

The Landmark program

Using a physician-led, interdisciplinary team, the Landmark program complements office-based primary care by:

• Collaborating and coordinating with each member’s primary care provider, using the primary care provider’s preferred method of communication
• Supporting frail, elderly patients who want to manage their conditions through in-home care
• Meeting patients in the comfort of their homes
• Delivering geriatric care, including medical, behavioral, urgent care, medication management and 24/7 nurse triage

The program doesn’t replace members’ primary care providers or other health care providers. Instead, the Landmark team provides supplemental support between members’ regularly scheduled medical appointments, when it’s often needed most.

The Landmark program is a member benefit. Members who are eligible for the Landmark program decide whether they want to participate in the program.

Opportunities to discuss collaboration

Blue Cross, BCN and Landmark are available to meet with primary care practices, providers and care managers to answer questions about Landmark’s care model and coordination of care.

Discussion topics include:

• Coordination of care between Landmark and an identified person in the practice
• The best method of communication with the practice and how to coordinate on urgent patient needs
• How and when practices can call on Landmark for eligible or engaged patients when the patient has an urgent need or can’t come into the office
• Feedback on Landmark communication with primary care providers

If you want to participate in an open-forum discussion, email the Care Delivery Solutions team at CareDeliverySolutionsProgramMtg@bcbsm.com.

How patients are identified for the Landmark program\

Blue Cross and BCN identify eligible members through specific criteria related to level and number of qualifying chronic conditions, age, geographic location and other factors (for example, frailty).

You can refer patients to the Landmark program. To do this, send an encrypted email message to CareDeliverySolutionsProgramMtg@bcbsm.com with the patient’s:

• First and last name
• Contract ID
• Date of birth
• Any pertinent medical information, including chronic conditions.

For the patients you refer, we’ll review the information you provide and reply to your email to let you know whether the patient will be accepted into the Landmark program.

Additional information

To learn more about our program with Landmark, see the High-intensity in-home care program: Frequently asked questions for providers document.

Note: Health care providers who are in full-risk arrangements have separate provisions for this benefit.