Press Releases

Monday, July 25, 2022

Bridges Health Partners LLC and Highmark Blue Cross Blue Shield announce three-year value-based care agreement

Warrendale, Pa. – July 25, 2022Bridges Health Partners LLC, a Clinically Integrated Network, and Highmark Blue Cross Blue Shield (Highmark) have entered into a Value-Based Agreement for Highmark’s Medicare Advantage (MA) membership in Western Pennsylvania. The agreement is designed to improve the health of Highmark’s MA members by providing accessible, high quality, cost effective, patient centered care through member collaboration and innovation. 

“Bridges and Highmark worked closely for more than a year and a half to come to an agreement that will ensure Highmark’s MA members in western Pennsylvania have ready access to the state-of-the-art care offered by the Bridges providers,” said John Grese, Vice President of Payor Strategy and Network Management for Bridges. 

Formed in 2017 by Butler Health System, Excela Health, St. Clair Health and Washington Health System, Bridges partners with each systems’ independent and employed medical staff to provide an integrated regional network of care consisting of more than 1,000 physicians. 

“Working collaboratively, Bridges and Highmark will use insights derived from clinical, claims, and administrative data to promote a healthier community through wellness promotion and early intervention” said Bridges Health Partners LLC Interim President and Chief Medical Officer, Dr. Robert Zimmerman. “The relationship between our organizations and the use of advanced technology will optimize our ability to create evidence-based clinical pathways to provide high quality, cost-effective care as well as ensure a seamless patient experience across the healthcare continuum.” 

The agreement is also a continuation of Highmark’s strategic shift to value-based reimbursement models for providers that focus on improving outcomes for members and lower care costs. Value-based reimbursement models achieve this by incentivize providers to deliver the right care at the right time in the most appropriate setting and by focusing on preventive care.

“Highmark prioritizes providing our Medicare Advantage members with high-quality, low-cost products to meet their health needs” said Ellen Galardy, senior vice president of Highmark Medicare & ACA Strategy and Sales. “We are looking forward to working with Bridges on data sharing, closing gaps in care, population health management and more to bring lower cost, quality care to a significant portion of our membership in western Pennsylvania.”

The agreement will also create a joint care management team designed to:

  • Use data insights to proactively manage the health care needs of Highmark MA members through early care intervention, and educate all patients on the value of preventive care
  • Partner with Bridges providers to ensure any gaps in care are addressed
  • Provide patient-centered care that increases the quality of access to medical services, reduces costs, and offers an enhanced patient experience
  • Ensure a seamless integration within inpatient and outpatient care teams

“We are excited to continue to transform the medical care we provide to our patients and our communities. The Bridges care model will be augmented by this relationship with Highmark as we strive to not only help treat chronic medical problems, but to also encourage healthy lifestyles to prevent them” said Dr. Zimmerman.

About Bridges Health Partners LLC
Four independent, non-profit health systems in the Pittsburgh metropolitan market and surrounding communities are the founding members of Bridges Health Partners LLC, including Butler Health System, Excela Health, St. Clair Health and Washington Health System. Each partner system, along with their independent and employed medical staff are committed to transforming how healthcare services are delivered by implementing an integrated, regional network of care that supports all patient populations, no matter the payer. Together, Bridges Health Partners LLC serves patients through a broad geography of outpatient, community-based sites and inpatient facilities in Allegheny, Armstrong, Beaver, Butler, Clarion, Fayette, Greene, Indiana, Lawrence, Mercer, Venango, Washington and Westmoreland counties. 

Our commitment to quality has been recognized by numerous national and independent authorities including HealthGrades, The Leapfrog Group, Quantros CareChex, IBM Watson 100 Top Hospitals, and U.S. News and World Report's High Performing Hospitals and Best Regional Hospitals, to name just a few. 

Bridges Health Partners LLC network comprises eight hospital campuses with over 1,450 licensed beds, over 1,000 employed and affiliated physicians with a network of primary care and specialty group practices, ambulatory surgery centers, urgent care clinics, imaging and diagnostic centers, skilled nursing, home health and hospice care. Bridges Health Partners LLC are strong healthcare provider organizations individually; collectively dedicated to delivering the best quality of care at a lower cost to patients where they live and work.  To learn more about Bridges Health Partners LLC, visit www.bridgeshealthpartners.org.

About Highmark Blue Cross Blue Shield
Highmark Inc., doing business as Highmark Blue Cross Blue Shield, serves approximately 2.6 million members through the company’s health care benefits business and hundreds of thousands of additional members through the BlueCard® program. Highmark Blue Cross Blue Shield is the market leader in commercial market share, and through its affiliated Blue companies has strong Medicare Advantage market share as well. All of Highmark's Medicare Advantage plans in Pennsylvania achieved the highest possible quality rating from the Centers for Medicare and Medicaid Services (CMS) - 5 out of a possible 5 Stars. In western Pennsylvania, its unaided brand awareness, brand preference and overall brand rating are significantly higher than its closest competitor. Highmark Blue Cross Blue Shield employs approximately 4,500 people in western, north central and northeastern Pennsylvania. Highmark Blue Cross Blue Shield’s total economic impact throughout Pennsylvania is more than $16 billion.  Highmark Blue Cross Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit www.highmark.com.

For more information, contact:
John M. Grese
Bridges Health Partners
(724) 300-8104
John.grese@bridgeshealthpartners.org 

Anthony Matrisciano
Highmark Inc. 
Office: 570-200-6310
Cell: 570-574-0050
anthony.matrisciano@highmark.com