Highmark: Physician reimbursement program saved $1B+


Highmark has avoided more than $1 billion in costs through its value-based reimbursement program for primary care physicians, the integrated health insurer and provider said Oct. 5.

Claims data from Highmark indicates that its True Performance value-based reimbursement program saved $1.1 billion in healthcare costs. The savings were related to emergency department visits and hospitalizations, and were generated from 2017-19. 

Under the program, primary care physicians are rewarded for ensuring Highmark members receive recommended vaccines, drug therapies, screenings and wellness exams. The focus on prevention helped curb ED costs by $40 million in 2019 alone, Highmark said. 

About 2 million Highmark members currently see a primary care physician in the True Performance program.

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