Well360 Complete

Case and Care Management:

• Comprehensive, proactive support: Clinicians proactively engage members, navigating them toward optimal care and outcomes. Actionable data identifies and prioritizes at-risk members, connecting them with the most appropriate care and wellness programs. An integrated care program engages your members who are at a higher risk to help manage admissions, claims, and support when additional follow-up is needed.
• 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.
• Care navigation team and provider selection: : Members can engage with the care navigation team for assistance finding high-quality providers and the best location for their needs.
• Wellness Program: Coaches and clinicians support a member’s journey to better weight, sleep, stress management, and a smoke-free life.

Condition Management:

• Mental health support: Using in-depth patient assessments, the Mental Well-Being program screens for over 12 different mental health conditions. This helps to identify employee needs and creates a customized treatment plan.
• 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).
• Telemedicine: Members can connect with an expert anytime, anywhere for virtual care. Members can access virtual providers for urgent care and mental and behavioral health support. They can even access primary care and schedule appointments with providers such as dermatologists and women’s care.
• Virtual Physical Care: Members can make use of in-depth treatment plans at home or on the go for muscle/joint pain and pelvic health concerns.
• Diabetes Management: Members receive individual virtual support, detailed plans and strategies for A1C reduction and management.
  
• 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.

Premier Workforce Support:

• My Highmark app: Our exclusive app and online experience simplifies member health management. It provides 24/7 virtual access to experts, health content, and condition management solutions. Your members can also obtain virtual ID cards, benefit information, and get help with finding resources and program suggestions.
• Dedicated Premier Member Service: Our specially trained member advocates are held to the highest standard of customer service to provide an exceptional member experience. They act as the single point of contact and offer personalized help by phone and chat, identifying gaps in care, answering questions about benefits and billing, providing guidance on navigating care options, and offering clinical support.
• Wellness Rewards Program: Your members can better reach their goals through tailored member experiences, positive health challenges, and expert advice.

Value added services:

• Integrated pharmacy benefits: We’ve streamlined the process, with less paperwork and hurdles that can delay delivery. This results in lower costs and better health outcomes for your members.
• Virtual Second Opinion Service: This service taps into 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 to support your member’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 are in addition to self-service resources available through the digital experience.