Community Providers

Collaborative care for complex patients.

Learn how Landmark works with you and what services are available to you and your patients.

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Landmark partners with care delivery systems, including health plans, health systems, and risk-based provider groups, to bring additional care to high-need patients. Patients qualify for the Landmark program based on their current health state, number of chronic conditions and complex health needs.

Coordinated in-home care.

You continue to serve as your patients’ primary care provider. Landmark is a provider group that supports your care plan. We go to patients where they reside. Landmark provides interdisciplinary care and coordination for your highest acuity patients, updating you after each home visit. We also provide urgent home visits and post-acute care visits to treat in place and help patients avoid unnecessary emergency trips to the hospital.

Coordinated in-home care.  Image
We target care gaps. image

We target care gaps.

As a value-based provider, we focus on long-term outcomes of patients. We facilitate health care that is not easily addressed in a clinical appointment, such as condition education, caregiver stress, medication adherence, root-cause perspective, post-acute follow-up, goals of care conversations, and beyond. Landmark providers are experienced in thorough documentation and identifying ways to positively impact your quality measures.

Our interdisciplinary care team.

Landmark’s care is based on treating your whole patient with a dynamic team of Complexivist® and Urgentivist™ providers, as well as an interdisciplinary team, who are also available at your request. The local Landmark team may include:

Our interdisciplinary care team.
  1. Providers (doctors, nurse practitioners, physician assistants)
  2. Behavioral health specialists
  3. Social workers
  4. Pharmacists
  5. Nurse care managers
  6. Dietitians
  7. Care coordinators
  8. Healthcare ambassadors

Landmark’s care team supports the individual needs of the whole patient. Our patients have access to a range of specialized roles.

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Proven results.


of Landmark patients stated that we have helped them stay out of the hospital or emergency room.


decrease in hospitalizations in the portion of Landmark’s patient cohort that has actively engaged with its services.*


reduction in mortality for patients engaged in the Landmark program, compared to those non-engaged.

* For Landmark patients in the first six months of engagement compared to the trend in utilization for statistically matched non-engaged patients. Chu, Lihao. A House-Call program that reduces unnecessary variation in utilization and spending among patients with poly chronic conditions. Academy Health Annual Research Meeting, June 25 2018, Seattle, WA. Unpublished conference paper. Landmark Health, LLC, Huntington Beach, 2018. Print.

What our community partners said.

"Landmark providers do an exemplary job communicating with the patient, the family and the patient’s personal physician which contributes to their ability to help patients comfortably remain in their homes."

Dr. Friedmann Polyclinic

"As a PCP for the most challenging members of our community, I felt such relief to know that there is a program that is able to attend to their urgent care needs in lieu of having to send them in to an ER. Landmark is one of the first organizations in my area to understand that is takes a village to keep our elders safe at home and out of the hospital."

Dr. O'Brien Visiting Practitioners

"Landmark proactively identifies and addresses problems and needs that would otherwise go unnoticed and unmanaged, making timely additions and adjustments to treatment plans with primary care providers that better support patients and caregivers. I have found Landmark Health to be an invaluable partner in the care of my most complex home care patients."

Dr. Costello Albany Medical

“I welcome Landmark evaluations and appreciate the collaboration because they are done by providers similar to my skills that I can trust. It's like I went to the patient's home. There are insights to patient care that Landmark can find at a home visit that are easily missed in a brief office visit.“

Dr. Armstrong Riverbend Medical

"MH struggles to leave her home so it’s been great that Landmark is able to make meaningful contact with the patient and help take care of her in her home because she is so challenging. I appreciate the collaboration by Landmark."

Dr. Casey Swedish

Looking to talk with your Landmark care team? Reach out!