Highmark’s True Performance program nears $2 billion in avoided costs
Tuesday, August 24, 2021
Highmark's True Performance program nears $2 billion in avoided costs
PITTSBURGH (August 24, 2021) — Highmark Inc.’s True Performance value-based reimbursement program for Primary Care Physicians (PCPs) has achieved nearly $2 billion in avoided cost savings since 2017 due to better health management.
In 2020, Highmark members seeing a PCP in the True Performance program had lower Emergency Department (ED) utilization than those not in the program, with potentially avoided costs of $66.7 million. Members seeing a True Performance PCP also had lower inpatient admissions than those not in the program, with potentially avoided costs of $660.4 million.
“We continue to see excellent results with our True Performance value-based reimbursement program,” said Sean Burns, vice president of provider payment for Highmark. “Value-based reimbursement means we work with and incentivize providers to deliver the right care at the right time and in the most appropriate setting.”
That collaboration also helps ensure that PCPs are meeting nationally-recognized quality measures such as giving recommended immunizations, appropriate drug therapy for patients with chronic diseases, cancer screenings and annual wellness exams.
“This helps to ensure that our members are engaged in preventive care and care coordination to stay healthy and avoid more costly care later,” said Burns.
The True Performance program also aligns with Highmark’s strategy of high performance networks and health insurance products that, together, help lower customers’ total cost of care, said Burns.
Approximately 85 percent of all eligible PCPs in Highmark’s service areas participate in True Performance – that’s more than 10,000 participating physicians from more than 2,000 practices.
Nearly 2 million Highmark members are currently seeing a PCP that is participating in the True Performance program.
About Highmark Inc.
One of America's leading health insurance organizations and an independent licensee of the Blue Cross Blue Shield Association, Highmark Inc. (the Health Plan) and its affiliated health plans (collectively, the Health Plans) work passionately to deliver high-quality, accessible, understandable, and affordable experiences, outcomes, and solutions to customers. As the fourth-largest overall Blue Cross Blue Shield-affiliated organization, Highmark Inc. and its Blue-branded affiliates proudly cover the insurance needs of more than 6 million members in Pennsylvania, Delaware, New York and West Virginia. Its diversified businesses serve group customer and individual needs across the United States through dental insurance and other related businesses. For more information, visit www.highmark.com.
All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies. This website is operated by Highmark, Inc. and is not the Health Insurance Marketplace website. It also does not display all Qualified Health Plans available through the Health Insurance Marketplace website. To see all available Qualified Health Plan options, go to the Health Insurance Marketplace website at HealthCare.gov.
Highmark Blue Cross Blue Shield or Highmark Blue Shield are Medicare Advantage HMO, PPO, and/or Part D plans with a Medicare contract. Enrollment in these plans depends on contract renewal. ®Blue Cross, Blue Shield and the Cross and Shield symbols are registered service marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Benefits and/or benefit administration may be provided by or through the following entities, which are independent licensees of the Blue Cross Blue Shield Association: Western and Northeastern PA: Highmark Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage Inc., Highmark Benefits Group Inc., First Priority Health, First Priority Life or Highmark Senior Health Company. Central and Southeastern PA: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company. PA: Your plan may not cover all your health care expenses. Read your plan materials carefully to determine which health care services are covered. For more information, call the number on the back of your member ID card or, if not a member, call 866-459-4418. Delaware: Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield. West Virginia: Highmark West Virginia Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Health Insurance Company or Highmark Senior Solutions Company. Visit our website to view the Access Plan required by the Health Benefit Plan Network Access and Adequacy Act. You may also request a copy by contacting us at the number on the back of your ID card. Western NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield. Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.
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