Highmark Partners with Welvie to improve health plan members' surgical experience

PITTSBURGH, Pa. (Oct. 30, 2017) — Highmark Inc. is partnering with Welvie to offer Highmark members an inter-active educational guide to help them understand all the steps for deciding on, preparing for and recovering from elective surgeries, including surgeries for back, knee, hip, and eyes. Welvie gives members the knowledge they need to work with their physicians to make smarter decisions leading to better outcomes. There is no cost to eligible members for Welvie.

Welvie's learning modules, to-do lists, calendars, and diaries help patients participate in decision-making with their doctors, avoid surgical complications, and reduce risks during recovery — all leading to better outcomes. Highmark is offering this benefit free of charge for each member covered under its fully-insured commercial, Medicare Advantage and Affordable Care Act (ACA) individual, and small group health plans in Pennsylvania, West Virginia, and Delaware.

"We want our members to feel comfortable and confident when discussing surgery with their doctors so they can participate in their care in a meaningful way," said Barbara Gray, R.N., senior vice president of clinical services. "For every surgery, there are typically as many as three non-surgical options, and we want our members to know what they are so they can discuss the relative merits of each option with their doctors," Gray said.

Carefully considering alternatives is particularly important in light of the fact that 25 to 33 percent of non-emergency surgeries have associated health risks that exceed potential benefits. If members proceed with surgery, Welvie helps them prepare for the procedure and plan for a successful recovery once back at home.

"Welvie is surgery neutral," explained Chip Tooke, executive chairman of Welvie. "Its information and checklists never advocate for or against surgery. All medical decision-making is left to physicians and their patients. Ninety-three percent of Welvie participants report being better prepared to speak with their physician about their health and 99 percent report that Welvie helped them understand how to prepare for surgery."

Welvie is an interactive process, not mere content. Members work their way through a six-step curriculum. These steps were designed by surgeons based on their experience of what patients need to know and be prepared for.

1. Get the right diagnosis
   Members develop a list of questions to make the most of the time with their doctor and ensure they share all the information critical to reaching the right diagnosis.
2. Choose the right doctor
   This step prepares people to interview and select the right surgeon. Members compose interview questions specific to their circumstances. Viewing mock interviews helps them overcome any nervousness or reluctance to interview the surgeons they're considering.
3. Make a decision
   Along with their doctors, members investigate all of their options, surgical and non-surgical. They evaluate the benefits and drawbacks of each and decide which option is best for them.
4. Surgery locations
   Different surgery locations, in-patient and out-patient, are discussed. Members also learn about the important role of the anesthesiologist.
5. Prepare for surgery.
   Members generate to do lists and fill in event calendars to help them track all their pre-surgery appointments and procedures. Welvie sends reminder alerts to make sure nothing falls through the cracks.
6. Recover at home
   Members prepare their homes in advance so they can safely return post-surgery when they may have limited mobility. Members and their doctors fill out an activity timeline when they can expect to return to different types of physical activity.

Highmark will mail eligible members an informational piece about Welvie and an invitation to sign up for the free service.