Highmark's True Performance program nears $2 billion in avoided costs

PITTSBURGH (August 24, 2021) — Highmark Inc.’s True Performance value-based reimbursement program for Primary Care Physicians (PCPs) has achieved nearly $2 billion in avoided cost savings since 2017 due to better health management.

In 2020, Highmark members seeing a PCP in the True Performance program had lower Emergency Department (ED) utilization than those not in the program, with potentially avoided costs of $66.7 million. Members seeing a True Performance PCP also had lower inpatient admissions than those not in the program, with potentially avoided costs of $660.4 million.

“We continue to see excellent results with our True Performance value-based reimbursement program,” said Sean Burns, vice president of provider payment for Highmark. “Value-based reimbursement means we work with and incentivize providers to deliver the right care at the right time and in the most appropriate setting.” 

That collaboration also helps ensure that PCPs are meeting nationally-recognized quality measures such as giving recommended immunizations, appropriate drug therapy for patients with chronic diseases, cancer screenings and annual wellness exams.

“This helps to ensure that our members are engaged in preventive care and care coordination to stay healthy and avoid more costly care later,” said Burns.

The True Performance program also aligns with Highmark’s strategy of high performance networks and health insurance products that, together, help lower customers’ total cost of care, said Burns.

Approximately 85 percent of all eligible PCPs in Highmark’s service areas participate in True Performance – that’s more than 10,000 participating physicians from more than 2,000 practices.

Nearly 2 million Highmark members are currently seeing a PCP that is participating in the True Performance program.