Highmark Inc. adds coverage for medical innovations in treatment of panic attacks and diagnosis of coronary arterial blockage
PITTSBURGH, Pa. (Sept. 17, 2018) A new, non-pharmaceutical treatment, Freespira, and non-invasive diagnostic technology, Heartflow FFRct (fractional flow reserve), were added to Highmark's medical policy in 2018 following positive results from a program that fast-tracks medical innovations to the marketplace.
Freespira, an in-home digital therapeutic device for panic disorder and panic attacks occurring with other anxiety conditions, was added to Highmark's medical policy in May 2018 and now covers the treatment option for members.
Panic attacks are primarily associated with anxiety disorders such as generalized anxiety disorder, post-traumatic stress disorder, and social anxiety. Symptoms associated with panic attacks are often misinterpreted by patients as a serious medical event such as heart attack or stroke, leading to over-utilization of medical services, such as emergency room visits, diagnostic testing, medications, primary, and behavioral health provider visits.
"Anyone suffering from anxiety or panic attack has their own unique fears," said JamieLee Kwolek, a Highmark member. "A fear of mine was relying on medication for a condition that I wanted to learn how to treat and manage holistically. I felt like I had missed so much of my life trying to determine how to cope with this diagnosis, and I was afraid that my options were limited to medications that might disrupt my life even more. Freespira gave me the tools I needed to truly understand and use the option I had all along my breathing. I am so grateful to have found a holistic, sustainable treatment that truly gives me control and understanding over my anxiety and panic attacks."
Results of a Highmark Health VITAL Innovation Program study showed that after just 4-weeks of using Freespira, more than 80 percent of the participants treated were panic attack free. Moreover, 80 percent were panic attack free and 93 percent reported overall panic symptom reduction at 12 months post-treatment.
"Freespira has shown very promising results as a viable, non-pharmaceutical option for our members," said Charles DeShazer, M.D., chief medical officer, Highmark Inc. "Our policies undergo a rigorous standard of review and evaluation to ensure that our members are covered for proven technology and treatments that are aligned with our value-based reimbursement model of care. Freespira has successfully demonstrated that it provides sustainable, positive outcomes for our members while driving down costs associated with over-utilization of medical services, making this new policy a 'win-win' for members, providers, and insurers."
Also added to Highmark's medical policy in 2018 was HeartFlow, a novel non-invasive diagnostic technology that offers physicians insight into both the extent of a patient's coronary arterial blockage and the impact the blockage has on blood flow.
Traditionally, diagnostic options for coronary artery disease included either a non-invasive stress test or an invasive heart catheterization. Heartflow is the first non-invasive technology to combine the information provided by a heart catheterization and stress test, which can reduce the need for invasive testing and aid physicians in their diagnostics and improve treatment strategy.
Both technologies were evaluated through Highmark Health's VITAL Innovation Program, a test-and-learn platform for early-stage health innovations that produces evidence in patient experience, care, and cost outcomes that may accelerate coverage by health plans and care delivery systems.
The VITAL program provides an additional layer to Highmark Inc.'s policy review, enabling a greater understanding of the full impact of new technologies on members without changing insurance medical policy prematurely. Once a study is completed, Highmark Inc. evaluates the results as part of an extensive medical policy review process to determine coverage for the treatment or diagnostic tool.
Other "VITAL-graduated" programs which resulted in medical policy changes within the past year were LINX, a non-invasive treatment to help manage symptoms and risks for patients with acid reflux, and Bronchial Thermoplasty, a non-pharmaceutical option for managing the symptoms of asthma.
About Highmark Inc.
Highmark Inc. and its health insurance subsidiaries and affiliates collectively are one of America's largest health insurance organizations and together with its Blue-branded affiliates, collectively comprise the third-largest overall Blue Cross and Blue Shield-affiliated organization in the country based on capital. Highmark Inc. and its affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve approximately 4.6 million members and hundreds of thousands of additional individuals through the BlueCard® program. Its diversified businesses serve group customer and individual needs across the United States through dental insurance, vision care and other related businesses. Highmark Inc. is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit www.highmark.com.