After the pandemic, Highmark members are still utilizing virtual care

Behavioral Health and Primary Care are most used services

PITTSBURGH (January 29, 2024) — During the height of the pandemic in 2020, Highmark processed nearly 5 million claims for virtual care as members were unable to access in-person care or were apprehensive about being around other sick people. These virtual claims included members accessing care from home over the phone or through video on their phone, tablet or computer.

As more health care facilities reopened in 2021, Highmark members continued to access care virtually, with more than 4.4 million claims processed for virtual care. By 2022, virtual care claims dropped slightly to 3.8 million, and with the Public Health Emergency related to the pandemic ending earlier this year, Highmark is on track to process approximately 4 million claims again.  

“This data shows that our members saw real value in virtual care during the pandemic and have adapted to using virtual care even now that the pandemic has ended,” said Dr. Timothy Law, chief medical officer for Highmark Inc. “We are also happy to report that since 2020, 95 percent or more of our virtual care claims have been for local providers. This means that members are still using local doctors and we are reimbursing local doctors for both in-person and virtual care.”  

Highmark says that its most utilized virtual care services have been for behavioral health. In fact, 58 percent of all virtual health claims have been for behavioral health, followed by primary care at 23 percent of all virtual claims.

“Virtual care is really important for behavioral health,” said Dr. Anil Singh, senior vice president and executive medical director, population and curated health for Highmark Health. “In addition to removing barriers such as distance and cost, we are finding that virtual care is also helping to remove some of the stigma associated with behavioral health, which means more people are getting the treatment they need at a time when we are seeing dramatic increases in depression and anxiety.”

Improving access to virtual care

Dr. Singh said that Highmark Health recently announced a collaboration with Spring Health to expand the number of access points to behavioral health care by 40 percent for Highmark members — including children and teens — that will offer multiple levels of support: digital capabilities for daily wellness, one-on-one care navigation, deeper clinical care through in-person or virtual therapy, medication management, and 24/7 crisis support.

Highmark recently rolled out a new solution where members can have an urgent care visit or talk to a primary care physician (PCP) on camera. The solution — offered with certain plans in 2024 — can also provide services such as vital signs, temperature, and ear, nose, and throat examinations while on the video call for a more detailed diagnoses from the physician. 

These new programs solutions join Highmark’s existing suite of virtual care solutions, including a diabetes management program and another that addresses muscle and joint pain.

Highmark’s Virtual Physical Care program is delivered through Sword.  It is designed to treat all major joints and helps with preventive, chronic, and post-surgical pain.

With Virtual Physical Care, members receive a digital kit that includes motion sensor technology and a tablet for flexible and convenient guided exercise sessions. program. Members also receive ongoing support, including virtual visits, digitally guided exercise sessions, and plus a phone-based app with a chat function and educational content.

The Diabetes Management powered by Onduo program offers a whole-person approach to reach members where they are in their journey to managing their type 2 diabetes.  It offers virtual care through their mobile application that members download and utilize as a part of the program. Members receive a free glucose meter and unlimited test strips, access to a personal health coach and other experts through their smartphone via the Onduo app.

All of these solutions are helping Highmark better integrate virtual and in-person care with aligned providers, said Dr. Singh.

“These are just some of the solutions that are helping us to remove barriers to care, simplify care and promote better health outcomes for members, no matter where they are geographically or in their health journey,” said Dr. Singh.