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Thursday 24 August 2017
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Highmark

Whether it’s caring for an elderly family member, a disabled relative or a sick child, the cost of caregiving for employees and their employers can be substantial.

According to a survey by Gallup-Healthways, caregiver absenteeism costs the U.S. economy an estimated $25.2 billion in lost productivity. Additional research shows these caregiving employees also are more likely to report health problems like depression, diabetes, hypertension or heart disease, costing employers an estimated additional health-care cost of 8 percent per year, or roughly $13.4 billion annually.

Experts agree that employers should be prepared to manage the impact of caregiving responsibilities on their workforce. Today, one of the most impactful ways is through a quality-based approach to health-care and prescription coverage.

Highmark Inc., one of America’s leading health insurers, is finding new ways to enhance its benefits model. The insurer has implemented innovative programs and initiatives to ensure its members — including their caregiving employees and covered family members — are getting access to even better quality health coverage. Among these initiatives is Highmark’s new, value-based True Performance reimbursement program, as well as a more coordinated approach to care, and its integrated Pharmacy benefits, which are helping to control costs and improve outcomes.

True Performance – Quality Not Quantity
Introduced in January 2017, True Performance is an incentive payment program for primary care physicians (PCPs) that is part of the movement toward reimbursement for high-quality, cost-effective care, not volume. Participating physicians are rewarded for the right care, at the right price, instead of the number of patient visits. True Performance’s goal is to help patients — and, consequently, employers — avoid costly care — in the future.

“In our view, True Performance is one of the more forward-looking programs in the country,” explains Sean Burns , vice president, Provider Reimbursement & Network Infrastructure at Highmark. “It’s not just about the volume of visits. We want our providers to be thinking more broadly from a population health standpoint about patients, and the journey of those patients when they’re not in front of physicians.”

Read more in the August 2017 edition of the Business Magazine.