Well360 Complete

Case and Care Management:

• Comprehensive, proactive support: Health care providers actively work with patients to guide them to the best treatments and results. Easy to understand information helps find patients who need attention and gets them connected to the right health and wellness programs. An integrated care program engages your members who are at a higher risk to help manage admissions, claims and support when additional follow-up is needed.
• Utilization management (UM): Comprehensive programs optimize support and costs across inpatient, outpatient and specialized services, including advanced imaging, musculoskeletal and oncology. UM can assist with discharge planning and facilitate the correct use of benefits. It can also identify members who may benefit from additional services, including support for chronic conditions and behavioral health services.
• Care navigation and provider selection: Members can engage with a care navigation team for assistance finding high-quality providers and the best location for their needs.
• Wellness program: Health coaches support a member’s journey to better weight, sleep, stress management, and a smoke-free life.

Condition Management:

• Mental health support: Using in-depth patient assessments, Well360 Choice screens for over 12 different mental health conditions. This helps to identify employee needs and creates a customized treatment plan.
• Kidney care management: Your members get a coordinated team follow-up for kidney support. They can assist with appointment scheduling, medication questions and accessing community resources.
• CHF/COPD management: Your members receive personalized, one-to-one support for managing congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD).
• Telemedicine: Members can connect with an expert anytime, anywhere for virtual care. They can access virtual providers, urgent care and mental and behavioral health support.
• Virtual physical care: Members can make use of in-depth treatment plans at home or on the go for muscle/joint pain and pelvic health concerns.
• Diabetes management: Members receive individual virtual support, detailed plans and strategies for A1C reduction and management.
  

Premier Workforce Support:

• My Highmark app: Our exclusive app and online experience simplifies member health management. It provides 24/7 virtual access to experts, health content, and condition management solutions. Your members can also obtain virtual ID cards, benefit information, and get help with finding resources and program suggestions.
• Dedicated premier member support: Specially trained member advocates act as one point of contact,  providing personalized assistance to members via phone and chat. They can also identify care gaps, answer benefit and billing questions and find opportunities for care navigation and clinical support.
• Wellness rewards program: Your members can better reach their goals through tailored member experiences, positive health challenges, and expert advice.
  

Value added services:

• Integrated pharmacy benefits: We’ve streamlined the process, with less paperwork and hurdles that can delay delivery. This results in lower costs and better health outcomes for your members.
• Virtual second opinion service (Cleveland Clinic): This service taps into the Cleveland Clinic’s leading health care experts for guidance with complex medical conditions.
• Fertility & family building support: Offers a unique combination of expert clinical   guidance, modern technology and inclusive family solutions to support your member’s family building efforts while creating cost savings for you.
• Employee assistance program (EAP): This service for members offers expanded access to behavioral health providers through employer sponsored sessions. These are in addition to self-service resources available through the digital experience.