Gold Carding Programs Are Meant to Improve Prior Authorization. Are They Working?
Several states and insurers have gold carding programs to streamline prior authorization. However, some say they're falling short.
Why This Health Plan Moved Away from Exclusive Relationships with Specialty Pharmacies
Several years ago, Highmark began questioning its exclusive relationships with specialty pharmacies and started working with Free Market Health, which matches patients to the pharmacy that best fits their needs.
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Navina’s AI Copilot Eases the Value-Based Burden, Study Shows
A new independent study from Phyx Primary Care’s Innovation Lab points to measurable improvements in physician burnout, documentation efficiency, and key VBC metrics among primary care practices.
Highmark Launches Virtual Pelvic Health Offering Powered by Sword Health
Highmark and Sword Health launched a new virtual pelvic health offering on Monday. The program connects members with a pelvic health specialist.
Highmark Covers AppliedVR’s Product for Chronic Low Back Pain
More than 4 million Highmark commercial members now have access to AppliedVR's RelieVRx as a covered therapeutic.
Highmark Taps Laguna for Conversational AI
Through a new collaboration, Highmark’s care managers will be piloting Laguna's conversational AI technology when speaking with members.
Who Should Be Responsible for Rationing GLP-1s?
There is a shortage of GLP-1s in the U.S. But experts have differing opinions on whose responsibility it is to be rationing the drugs.
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The 5 Best Medical Billing Outsourcing Companies
Medical billing is a tedious administrative task, but outsourcing it may be the key to increased revenue. Explore the top medical billing outsourcing companies and the benefits of partnering with one.
Highmark partners with Ria Health to offer alcohol use disorder-specific telehealth services
Through the partnership, Highmark members will gain access to a personalized digital program that aims to reduce harmful drinking. The program includes virtual visits, medication-assisted treatment and coaching support.
5 Blues plans launch pharmacy solutions startup Evio
Five Blue Cross Blue Shield plans provided funding to establish Evio, which aims to improve clinical outcomes and cut drug costs. It will initially only offer services to the founding health plans, including data analytics to determine drug performance and enhancing outcomes-based contracting.
Highmark expands access to device that helps manage panic, PTSD symptoms
The payer is expanding access to telehealth coaching for Freespria's digital device, which aims to eliminate or reduce symptoms of panic disorders and post-traumatic stress disorder.
Highmark, Lark Health extend collaboration
The expanded partnership increases the number of Highmark health plan members eligible for enrollment in Lark Health's AI-driven health coaching programs aimed at managing and preventing chronic diseases.
Solving Healthcare’s Provider Data Problem Starts with Interoperability
Break down the silos. Take control of your provider data.
How are payers advancing innovation?
A new eBook explores the different ways public and private insurers are moving the needle forward to integrate and cover innovative technologies.
Can Highmark successfully commercialize the healthcare innovation process?
Highmark Health is turning its internal VITAL Innovation program into a commercial offering meant to help startups test their products in real-world clinical environments.
How value-based care and oncology come together in the healthcare ecosystem
At the MedCity CONVERGE conference in Philadelphia on July 11, experts from Harvard Business School, payer Highmark and tech company Integra Connect explored how their organizations are approaching the intersection of cancer and value-based care.
Telemedicine gets a commercial payer with Iagnosis, Highmark collaboration
One of the biggest barriers to wide-spread adoption of telemedicine is whether it’s covered by insurance. This is particularly true for consumers who might embrace it more readily if it’s not cost prohibitive but also for employers looking to contain health plan costs. So it’s not without warrant that Iagnosis, the parent company of DermatologistOnCall, […]
Two Pittsburgh healthcare giants are breaking up, and it could get messy for the patients
Pittsburgh’s dominant health insurance company and its largest healthcare provider are, essentially, getting a divorce. For decades, Highmark Blue Cross/Blue Shield and University of Pittsburgh Medical Center worked together. But as the line between insurance companies and health care providers across the country blurs, these longtime allies are venturing into each other’s business and becoming […]