Highmark's value-based payment program saved $260 million

Value-based care is getting popular amongst patients and healthcare providers. Highmark a non-profit insurer has saved more than $260 million with its first year as a result of this value-based payment program.

Its payment arrangement program for primary care physicians led to the reduction in hospital readmissions by 16% last year. This saved $224 million. Also, focus on prevention and wellness, like screenings and vaccinations have led to saving of an estimated $38 million in avoidable emergency room visits.

download (3).jpeg

These potential savings came from claims data from members who saw a physician in the True Performance Program versus those who didn’t participate. Members that saw the physicians in the program had 11% fewer emergency department visits.

Primary care physicians influence the member’s health in a significant way – may it be routine visits, referral to specialists, or prescribing medications says Dr. Charles DeShazer, senior vice president and chief medical officer at Highmark. 

Highmark is not the only insurer who managed to save under the value-based arrangements. UnitedHealthcare has, in fact, expanded its bundled payment program after it saved $18 million from 115 employers in the program since 2016.