Integrated Care by Highmark likely to be more Cost-Effective

An analysis of data from 2017 to 2019 by HealthScape Advisors showed that group customers who used Highmark for both medical and pharmacy benefits experienced 3.9 percent shorter inpatient hospital stays compared to those without integrated benefits. Group members of Highmark saved an average of $150 to $230 per member, per year and had better health outcomes compared to those who used separate vendors.

1. Lower costs: According to an independent study conducted by HealthScape Advisors, Highmark group customers who combine medical and pharmacy benefits can significantly lower medical costs while improving health outcomes and member engagement.
2. Optimized care: Jeff Bernhard, the company’s Senior Vice President of commercial markets, said, “With a unified model, employers and individual members both enjoy a seamless experience that provides optimized care because clinicians have access to real-time medical and pharmacy data that offers a comprehensive view of a member’s health status”.
3. In-depth analysis: HealthScape Advisors conducted a three-year analysis of cost and health outcomes data for the Highmark group customers with integrated medical and pharmacy benefits compared to group customers with carved-out pharmacy benefits, adjusting for member demographics and health risk score.
4. Risk score: The study also stratified Highmark group customers by the health risk score of their members. The higher the risk score, the higher the average medical savings experienced by group customers with integrated medical and pharmacy benefits compared to those who carved out pharmacy benefits. Group customers with a lower risk score enjoyed medical costs savings of five percent on average with integrated benefits.
5.  Coordinated care access: “With integrated medical and pharmacy benefits, members with complex health needs receive the kind of coordinated care required to manage and improve their health,” says Sarah Marche, Senior Vice President of pharmacy services for Highmark Inc. “Members have access to the most clinically and cost-effective medications, benefit designs that can lower out-of-pocket costs, and the support of Highmark pharmacists, case managers and health coaches who leverage medical and pharmacy data to provide customized care. Integrated benefits are a win for employers and individual members alike.”