Highmark reaps $260M in savings from value-based payment program

A stethoscope and paper money.
Highmark says it saved $260 million last year off of its new primary care focused value-based payment arrangement. (Getty/utah778)

Highmark's value-based payment program saved the insurer more than $260 million within its first year, continuing an industry trend. 

The nonprofit insurer announced on Tuesday its payment arrangement program for primary care physicians reduced hospital readmissions by 16% last year, which potentially saved $224 million.

Additionally, an increased focus on prevention and wellness, including screenings and vaccinations, helped saved an estimated $38 million in avoidable emergency room visits. 

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Across-the-Board Impact of an OB-GYN Hospitalist Program

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RELATED: UnitedHealth: Bundled payments led to $18M savings, major drops in readmissions

The potential savings were generated through claims data from members who saw a physician in the True Performance Program versus those that did not participate. Members that saw physicians int he program had 11% fewer ED visits. 

Primary care physicians "have an enormous influence on our members' health—from routine visits, to prescribing medications to referrals to specialists," Dr. Charles DeShazer, senior vice president and chief medical officer at Highmark said in a statement.  "We have seen great success in the first year."

Highmark isn't the only insurer who's seen major savings under value-based arrangements. UnitedHealthcare expanded its bundled payment program in May after it netted $18 million in savings from 115 employers in the program since 2016.

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