Across America, people are looking for solutions to address the ongoing challenges that our health care system faces. Everyone is looking for ways to solve the ultimate health care question: How do you get the highest quality care, the best outcomes, through the most convenient location and at an affordable cost?
In the quest to solve this dilemma, it’s becoming evident that there’s not a one-size fits all solution. At Highmark, we firmly believe – and are fervently pursing – solutions that are based on our collaborations with doctors, hospitals and consumers.
When employers look to the health insurance industry for answers, many health plans talk about partnerships with doctors and hospitals as being an important part of the answer to their problem. But, few in the industry are actually partnering effectively and fewer are focusing on the most important piece of the puzzle – the customer.
Highmark Blue Shield, is uniquely positioned to focus on the customer. We serve approximately 1.3 million members and significantly leads our competitors in commercial market share,
Through our affiliated Blue companies, Highmark is the largest and highest-rated Medicare Advantage program in Pennsylvania, and all Medicare Advantage plans have received a Centers for Medicare & Medicaid Services STARS quality rating of 4+ out of 5.0 STARS. Highmark Blue Shield employs approximately 4,000 people in central Pennsylvania and the Lehigh Valley.
When we talk about hospital and health system partnerships, we are focused on a multi-faceted approach with like-minded organizations. These are hospitals and health systems that are driven to offer high-quality, affordable care in the community and close to home – approaches that drive the best outcomes for our customers.
Here in Schuylkill County we have been working with the Lehigh Valley Health Network to create long-term health improvements in the community that will lower future health care cost trends for both employers and individuals. Together, we launched a new health insurance product – Lehigh Valley Flex Blue – in Lehigh, Northampton and Schuylkill counties, enabling Lehigh Valley Health Network and other aligned physicians and clinicians to better manage the care our customers receive, ultimately leading to lower costs and better outcomes.
Since 2016, our claims data shows that members in Lehigh Valley Flex Blue are more likely to get preventive services such as immunizations and physical exams than members in other products. This keeps these members healthier and is another benefit of the coordinated care efforts that this partnership creates. Our claims data also shows that members in Lehigh Valley Flex Blue have had 39 percent fewer emergency room visits and 20 percent fewer surgeries than members in standard PPO products. These results tell us that these members are more engaged and are healthier. Employers that have purchased the Lehigh Valley Flex Blue product have also seen a six percent savings on overall medical and prescription costs.
Highmark Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit www.highmark.com.