Highmark Health is on a mission to create a remarkable health experience, freeing people to be their best. Its strategy, known as Living Health, integrates health, coverage and care, leveraging purposeful collaboration between payers, providers, tech innovators and community-based organizations. The bold, long-term goal: design a new health ecosystem that delivers a simpler, more personalized and proactive health experience for individuals and clinicians.
Highmark Health’s chief medical and clinical transformation officer, Dr. Tony Farah, and Dr. Anil Singh, executive medical director of clinical solutions, design and implementation, are two of the “clinical architects” building Living Health. They share their insights in the video below, including how the new model will use data, analytics and digital technology to improve health at scale.
Dr. Anil Singh: The most exciting thing right now is around Living Health, which is really putting payer and provider together to solve the fragmentation that is occurring currently in healthcare. The ability to move things that can be digital to digital to create efficiencies for patients and physicians to make the experience better for both.
Dr. Tony Farah: Doubled down on how we take care of people, but really take care of more of them, knowing all those barriers, whether it's social determinants that are problematic, whether it's lack of affordability, whether it's lack of interoperability, in improving the health of the populations we serve, not just one by one, but really at a much larger scale.
Dr. Anil Singh: I also believe that it started with the fact that Highmark Health took a chance on a provider system, and because of that, they really began to think how do you start to work together in a unique way — that not a lot of other places in the country are doing — to really kind of solve and sit down and solve healthcare.
Dr. Tony Farah: We don't want to tell physicians how to practice medicine. What we need to do is reduce the administrative burden and give them the most actionable information without them having to ask for it that allows them to then do what they do best. It has to be that combination between the clinicians and artificial intelligence and analytics.
Dr. Anil Singh: Leveraging our data from the insurance side, coupled that with the clinical data that will eventually be pulled together so that we can then be provided as clinicians that the next best action is the right digital solution that somebody would engage in.
Dr. Tony Farah: Through this digital technology, and through enabling access in ways that weren't available before, more and more of our members and patients now will have access virtually and through apps and other means to be able to see their own results — sometimes in real time. So now the patient is self-engaged with their with their health.
Dr. Anil Singh: So one of the ways we’re doing that right now is with a diabetes solution. And what that does is goes back to that predictive and proactive way instead of waiting for somebody to get sick, the app is able to continuously monitor somebody's blood sugar. And so, if on a Tuesday when I'm not seeing that patient, their blood sugar drops, there's an immediate phone call or a tickler if you will, to the patient that says what's going on, a health coach reaches out to that patient and begins to manage that patient right then in there. Now we can interpret the data for the patient and potentially modify behavior. And that is the I think the precipice and the genesis for better health is the ability to be aware of what's actually happening and why maybe a certain behavior is leading to a potentially poor outcome.
Dr. Tony Farah: We do have data that's allowed us to demonstrate that if you take diabetic patients who let's say have a high, we say a A1C level that's a blood test that allows you to see the three month average of you know how your blood sugar is, and we've taken those populations and within three months, brought the majority of those patients A1C levels down to within normal. And that's something that is not easy to do. We know how to do it one by one, but to be able to do this for large populations is pretty amazing.
If you look at the National Medicare data, about one out of four, sometimes one out of three patients have been hospitalized with heart failure within 30 days, come back to the hospital, which is crazy, and it's unacceptable. We've been able to prove through our pilots that you can reduce that to a single digit number. Just doing more of the things we know how to do. So now you start adding the digital and the virtual, analytics, artificial intelligence and the algorithms that allow us to give our clinicians and clinical teams that information and therefore move care upstream.
You can see how those early proof points allow us to do much better by the populations we serve. Same with high blood pressure. We know that we can bring anyone's uncontrolled blood pressure down to normal. We just need to do it at scale. We need to do it for more people.
Dr. Anil Singh: We're building what we call next best actions. And all those things are really kind of the beginnings of the execution of our Living Health strategy and vision.
Dr. Tony Farah: Our goal is to really improve the health of hundreds and thousands more of those members that we serve. And, you know, we're mission base, and I would tell you, it's our responsibility to do this.
Dr. Anil Singh: I'm most proud of being at an organization that really cares about health care and not just the bottom line. I'm most proud that we are working in a blended way by putting payer and provider together and really beginning to solve that problem. That's what keeps me going every day.
Originally Posted: December 15, 2022 on Highmark Health
This article was first published in Highmark Health Digital Magazine and is used with permission.
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