Well360 Choice

Case and Care Management:

• Utilization management (UM): Comprehensive programs optimize support and costs across inpatient, outpatient, and specialized services, including advanced imaging, musculoskeletal and oncology. UM can assist with discharge planning and facilitate the correct use of benefits. It can also identify members who may benefit from additional services, including support for chronic conditions and behavioral health services.
• Case management: Members get help managing their admissions and transition of care, so they feel supported through their health care journey.
• 24/7 nurseline: Provides your members with immediate medical advice and guidance for urgent situations.
  

Condition Management:

• Mental well-being: Using in-depth patient assessments, the Mental Well-Being program screens for over 12 different mental health conditions. This helps to identify member needs and creates a customized treatment plan.
• Diabetes prevention program: Members receive virtual or in-person coaching to help prevent diabetes.
• Telemedicine: Members can connect virtually with an expert anytime, anywhere for virtual care. Members can access urgent care needs and behavioral and mental health support.

Workforce Support:

• My Highmark: Our exclusive app and online experience can simplify member health management. It provides 24/7 virtual access to experts, as well as access to obtain virtual ID cards and get help with finding resources and program suggestions.
  

Value added services:

Well360 Choice also offers employers the flexibility to add premium level services that provide extra value to their members and families.

• Premier Member Service: Your members get access to a specially trained Member Experience Specialist team with extended hours for world class phone and chat-based support.
• Seamless pharmacy integration: Integrating your pharmacy benefits through Highmark unifies the pharmacy experience between members and employers. This can result in lower costs and improved outcomes.
• Enhanced Telemedicine: In addition to your regular telemedicine benefits, members can also access primary care and schedule appointments for women’s care and even dermatology.
• Integrated Care Program: Nurse case managers coordinate care for your highest risk, highest cost members admitted to the hospital.
• Weight management: A solution using science-backed techniques to drive sustainable lifestyle changes for diabetes prevention, weight loss, and diabetes support, helping members create habits for long-term health.
• Kidney Care Management: Your members get a coordinated team for kidney care support. They can assist with appointment scheduling, medication questions, and accessing community resources.
• CHF-COPD management: Your members receive personalized, one-to-one support for managing congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD).
• Virtual Physical Care: Members can make use of in-depth treatment plans at home or on the go for muscle/joint pain and pelvic issues.
• Diabetes Management: Members get one-on-one support with individually tailored care plans and strategies for A1C reduction and management.
• Virtual Second Opinion: This service taps in to leading Cleveland Clinic specialists to give your members expert guidance for complex conditions from some of the world’s leading health care experts.
• Fertility and Family-Building: Offers a unique combination of expert clinical guidance, modern technology and inclusive family solutions. This supports your employee’s family building efforts while creating cost savings for you.
• Employee Assistance Program (EAP): This service for members offers expanded access to behavioral health providers through employer sponsored sessions. These come in addition to self-services resources available through the digital experience.
• Wellness Rewards Program: Your members can better reach their goals through tailored member experiences, positive health challenges and expert advice.
• MyHighmark Enhanced/AllMyHealth Enhanced: This digital experience can be personalized to display employer specific programs, campaigns, and benefits to further drive member engagement.