New Clinical Support Programs for 2024

New Clinical Support Programs for 2024

In support of our Living Health strategy, we’re providing a preview of our new and expanded clinical support programs for eligible Highmark members in 2024.

These programs are intended to address unmet need, help with self-management, and offer timely access to care for specific conditions and in-demand specialties, so your patients can get high-quality, convenient care after hours and in between office visits.

New programs for 2024 include:

Highmark Mental Well-Being Powered by Spring Health

Highmark Mental Well-Being, powered by Spring Health, is a high-quality mental and behavioral health care solution. The program offers expanded and timely access through customized interventions for eligible Highmark members (and their dependents ages 6+) from low-acuity wellness needs to high-acuity conditions.

Highmark Mental Well-Being provides access to an expanded network of over 6,000 behavioral health providers who use evidence- and measurement-based care to develop a customized care plan for each member based on a digital assessment. Appointments for therapy and medication management are typically available within three business days. Members will also have access to a 24/7 crisis line. A digital referral form to the program will be available by January 1 on the Provider Resource Center.

CHF and COPD Management Powered by Vida

CHF and COPD Management, powered by Vida, is a virtual, personalized health program for patients with congestive heart failure (CHF) and/or chronic obstructive pulmonary disorder (COPD). The program is designed to support patients between office visits through self-management and prioritizes medication adherence and improving health outcomes. Eligible Highmark members can engage through a smartphone, tablet, or computer to receive self-guided education and virtual one-on-one health coaching when it’s convenient for them. The program may also provide your eligible patients with monitored, no-cost devices.

Virtual Physical Care Program Powered by Sword Health

Highmark’s Virtual Physical Care Program, powered by Sword Health, helps your patients manage musculoskeletal pain. Patient care is provided by licensed physical therapists and members receive wearable sensors and personalized exercise program. The program applies to all major joints including lower back, shoulder, neck, elbow, hip, knee, ankle, and wrist and can address acute, chronic, pre- and post-surgery pain and rehabilitation needs at no cost to members. This program will expand eligibility to fully insured commercial patients starting January 1.

Well360 Virtual Health Powered by Amwell – Dermatology Clinic

In addition to our current Well360 Virtual Health Urgent, Behavioral Health and (new for 2024) Primary Care clinics, Well360 Virtual Health Dermatology clinic provides eligible patients with expanded access to high-quality providers for dermatological care. The virtual dermatology clinic lets patients share skin, hair, and nail concerns with one of more than 160 certified dermatologists with multi-state licensures and coverage in all 50 states, including Washington, D.C. Your Highmark patients can seek treatment for chronic conditions, new diagnoses, or follow-ups with a Well360 dermatologist (up to 30 days) for nearly 3,000 skin, hair, and nail conditions.

Well360 Virtual Health Powered by Amwell – Women’s Health Clinic

Well360 Virtual Women’s Health clinic allows patients to seek treatment, prescriptions, and consultations for a variety of acute and chronic conditions from endometriosis to urinary tract infections and sexually transmitted infections. Your patients can also seek therapy services (ages 10+) for pregnancy and postpartum needs as well as lactation counseling (ages 16+).

Diabetes Management – Expansion to Include Type 1 Diabetes

To complement our existing program for Type 2 Diabetes, we will be adding an option for members with Type 1 Diabetes to “bring your own device” for self-management and virtual support and remote monitoring between office visits. Please be sure to carefully code your patients with diabetes as either Type 2 or Type 1, so we can offer the appropriate program to our members.

More details will be provided around these new programs in 2024, as they begin to roll out to our eligible members.

Additional information about these programs can be found on the Provider Resource Center by clicking Education/Manuals > Clinical Support Programs.