Highmark Health Options establishes innovative social care network in West Virginia

• Initiative ensures member health issues are addressed by local community organizations
• Full state coverage has been achieved for food insecurity
• Pennsylvania program has yielded a significant reduction in total cost of care for members

Parkersburg, WV (November 3, 2025) — A 2023 state health assessment released by the West Virginia Department of Health emphasized the adverse effects of health related social needs on West Virginians. Key findings included 14% of all residents are impacted by food insecurity, including 90% of adults who lack the recommended daily serving of fruits and vegetables; a long-term, steady decrease in the number of high school students pursuing a college degree; and social issues ranking as the top health obstacle according to residents polled in an online community survey.

To address these critical health care issues and more, Highmark Health Options West Virginia, the state’s newest managed care organization (MCO) and first-ever Blue Cross Blue Shield-branded MCO to serve West Virginians, has established an innovative social care network in collaboration with frontline nonprofits and community organizations. It aims to replicate the social care network’s remarkable success in Pennsylvania, where it has demonstrably reduced cost of care, while improving access to crucial mental health and preventative care.

“We spend a large percentage of our time and resources endorsing preventive care and empowering people to be healthy,” said Jason Landers, president, Highmark Health Options West Virginia. “We can help our members be immunized and provide them with tech-driven solutions that make it easy to schedule and keep appointments, but if they’re hungry, they’re not going to be healthy. Our challenge is to address and ideally eliminate social needs that are preventing members from achieving their best health. We think this model of a social care network gives our members the best chance at success.”

The program operates through a unique structure. The network identifies and connects individuals facing social challenges with community-based organizations (CBOs) equipped to provide vital support. Highmark Health Options provides a financial incentive to CBOs for each member who successfully receives assistance through the network. The incentives can range from $25 to $200 or more depending on the level of service and assistance the CBO provided the member.

Unlike other attempts to address social care needs, which often struggle to ‘close the loop’ and measure impact, Highmark Health Options’ innovative approach incentivizes CBO participation, ensuring accountability and measurable outcomes. In a similar network in Western Pennsylvania, members who received services saw a statistically significant 38% reduction in total cost of care as compared to those who were referred but did not receive services.

Currently, the network offers access to a broad range of services, including veteran support, home winterization programs, and food assistance, with plans to expand service offerings as the program matures. The network utilizes the findhelp system to connect individuals with appropriate organizations, enabling self-referral and improving the visibility of participating CBOs. The goal is to provide complete statewide coverage, which has already been achieved for food assistance.

The list of organizations currently in the network include Mountaineer Food Bank, Facing Hunger Food Bank, Heart and Hand Outreach Ministries, West Virginia Drug Intervention Institute, and Connecting Champions.

“What we’ve created is the next iteration of solving health related social needs,” Landers added. “It’s more than giving an organization money and saying, ‘help everyone.’ It’s a targeted approach that ensures when we find someone in need and make that referral, we confirm that a connection has been made, and the need has been solved. Without this additional touchpoint, it’s almost care by hope.”