Better Value Care

Highmark transforms your employees’ health care experience in several ways, including:

• Excellent care at a better cost through in-network primary care providers (PCPs) who participate in our True Performance program
• Flexible network designs that give employees affordable access to high-value care in their communities and to 95% of doctors and 96% of hospitals across the country
• Access to new best practices in cancer care that have been shown to cost 35% less
• A health management program to help at-risk and high-cost patients get the right care where and when they need it
• Wellness tools to help your employees take the right steps to stay healthy and avoid unnecessary doctors’ visits or hospitalizations

Our True Performance program encourages PCPs to provide better preventive care.  We do this by:

• Providing member data to PCPs that helps them create effective preventive care plans tailored to each patient’s individual needs
• Raising quality standards by rewarding PCPs for improving the value of the care they provide, so your employees receive excellent, evidence-based care
• Keeping your employees healthy and out of the hospital or ER by providing bonuses to participating PCPs who follow best practice guidelines

Since we reward PCPs based on quality and affordability, you know every dollar you spend goes toward effective, cost-efficient care. In fact, 75% of our members visit in-network PCPs who are paid for the value of care they provide, saving up to $50 million per year. ¹

The Highmark Cancer Collaborative provides access to high-quality cancer care that can reduce costs by up to 35%. We offer:

• Access to care informed by cutting-edge research and new clinical trials, through our collaboration with Johns Hopkins Kimmel Cancer Center and other world-class doctors and hospitals
• Care models that follow national “gold standard” best practices 
• Access to streamlined care that eliminates unnecessary red tape and prior authorizations for proven treatment plans, so there’s no delay while claims are authorized

Our approach to health insurance has proven results, which means more savings and better value for you. Here are some examples:

• True Performance patients visit the ER 13% less than patients of providers who are not in the program. 
• Patients of True Performance PCPs have fewer hospital stays. In fact, hospital admission rates for True Performance doctors are 16% lower than those who aren't in the program. 
• Because of these results, Highmark has helped avoid $180 million in hospital costs to date. ³