Wednesday, July 24, 2019
More than $600 million in avoided costs over two years
PITTSBURGH (July 24, 2019) — Highmark Inc.'s True Performance initiative — one of the largest risk- and value-based reimbursement programs for Primary Care Physicians (PCPs) in the country — is continuing to show results in avoiding costs and improving outcomes.
In fact, Highmark's claims data for 2017 and 2018 shows that the program focused on affordability and quality of health for Highmark members has helped to avoid a total of $611.4 million in health care costs.
"That's great news for our members and customers," said Dr. Charles DeShazer, senior vice president and chief medical officer, Highmark Health Plan. "True Performance helps PCPs deliver the right care at the right time and in the most appropriate setting, so not only are we avoiding costs, our members are receiving more coordinated and high quality care."
According to Dr. DeShazer, Highmark members who are seeing a PCP in the True Performance program had fewer Emergency Room visits in 2018 than members seeing a PCP that is not in the program.
"The True Performance value-based reimbursement model rewards PCPs for meeting nationally-recognized quality measures such as ensuring members receive appropriate screenings and vaccinations," said Dr. DeShazer. "The focus on prevention and wellness helps members avoid costly ER visits, and the avoided cost was more than $37 million in 2018."
Members seeing a PCP in the True Performance program also had fewer inpatient admissions in 2018 compared to members seeing a PCP that is not in the program — at a care cost savings of more than $311 million.
PCPs in the True Performance program recieve ongoing support and up-to-date information on best practices from Highmark to continue the transition to value-based care models.
"In the last two years, PCPs have been very receptive of the program," Dr. DeShazer said. "Approximately 85 percent of all eligible PCPs in Highmark's service areas participate in True Performance — that's more than 12,000 participating physicians from more than 1,700 practices."
Nearly 2 million Highmark members are currently seeing a PCP that is participating in the True Performance program.
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 4.5 million members in Pennsylvania, Delaware, and West Virginia. Its diversified businesses serve group customer and individual needs across the United States through dental insurance, vision care and other related businesses. For more information, visit www.highmark.com.
For more information, contact:
Highmark is a registered mark of Highmark Inc. © 2021 Highmark Inc., All Rights Reserved.
Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Blue Cross Blue Shield of Western New York serves eight counties in Western New York and Highmark Blue Shield of Northeastern New York serves 13 counties in Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.
This page is not available for this ZIP code. Please enter your ZIP code or return to highmark.com.