The Dallas-based Southwestern Health Resources (SWHR) and in-home medical care provider Landmark Health—and its affiliated medical groups—have announced a strategic partnership to provide longitudinal care to seniors with complex medical needs by bringing interdisciplinary medical care into patients’ homes.
The value-based care arrangement is the largest of its kind between two medical organizations based on the number of patients included in this initiative, according to officials, who noted that by focusing on the long-term needs of patients living with multiple chronic conditions, there is greater emphasis on routine preventive care and on-demand urgent care delivered by doctors and nurses in the home to reduce avoidable hospital visits.
At a time when many patients are finding it difficult to see their doctors, patients with complex medical needs who are often the most challenged will greatly benefit from receiving care in their homes. Eligible patients will also have access to in-home palliative care, behavioral health evaluations and social services, the announcement noted.
SWHR is the clinically integrated network for University of Texas Southwestern Medical Center (UT Southwestern), Texas Health Resources, and nearly 5,500 physicians and other clinicians across North Texas. SWHR has been one of the nation’s leading Next Generation ACO (NGACO) three years in a row for shared savings having, reducing Medicare expenses by more than $120 million during that period, according to the organization’s officials.
For Landmark, which bears risk for more than 100,000 patients, this collaboration extends their in-home medical care model into their 17th state. In a recent interview with Healthcare Innovation, the company’s CEO, Nick Loporcaro, explained that the organization’s model focuses on the elderly, frail, and [those with] complex chronic conditions. “It’s a longitudinal, comprehensive, in-home medical home platform, but this is not home care or urgent care; it’s truly longitudinal primary care. Think of us as a mobile geriatrics practice as the 40,000-foot version,” he said.
Landmark’s mobile, physician-led teams will work with SWHR network physicians, aiming to amplify access to care and improve outcomes and experience for thousands of complex patients in Medicare Advantage plans. With 24/7 availability, Landmark helps to ensure that patients can always reach a clinician who knows their unique health history, regardless of the hour. In the home, Landmark’s team holistically addresses patients’ needs through extended appointments that allow clinicians to treat and manage illness, educate patients to better control medical conditions, and assess and address social determinants of health, which are more easily identified in a home environment, officials stated.
Sanjay Doddamani, M.D., chief physician executive and COO of SWHR, said in a statement, “Landmark will reach those patients who need greater support with in-home medical visits – these can augment the already excellent care our community of physicians provide. He added, “This kind of innovative care delivery extends our mission to ensure that people living with chronic conditions have an opportunity to receive the best medical care in the comfort of their homes.”
Prior to arriving at SWHR, Doddamani previously was at Geisinger where he was the chief medical officer for the health system’s “at-home program.” In an interview last year with Healthcare Innovation, Doddamani noted that during the pandemic, SWHR helped 400 practices stand up telehealth into their offices, while also working with partners to get urgent visits to the home, and collaborating with home health agencies.
“SWHR has an exemplary reputation for quality health care and improving patient outcomes,” said Michael Le, M.D., Landmark’s co-founder and chief medical officer. “We are pleased to combine our expertise to drive meaningful outcomes for their frailest patients – which not only means extending life but working to improve the quality of life for patients so they can live fully and independently for as long as possible.”
