A Conversation With: Brian Rinker, market president for Highmark’s Eastern Pennsylvania Region

Brian Rinker is the market president for the Eastern Pennsylvania Region for Highmark Blue Cross Blue Shield, based in Camp Hill & Wilkes-Barre.

He is responsible for coordination and support of Highmark’s business objectives and advocacy with key stakeholders.

LVB: Covid-19 has brought about changes in health care insurance. What are some of the big changes?

Rinker: One of the biggest changes we saw during the pandemic was the increase in usage and adoption of telemedicine.

At the beginning of the pandemic last year, Highmark expanded coverage for telehealth services to all members and waived cost-sharing (deductibles, coinsurance and copayments) on all covered telehealth services from contracted vendors and providers.

However, as restrictions are being lifted and more and more members are able to schedule in-person medical appointments, the cost-sharing waiver for in-network telehealth visits will expire as planned on June 30.

Throughout the pandemic, our members have really taken to telemedicine and the option to receive care virtually.

In fact, utilization of telehealth services by Highmark members during the pandemic increased by more than 3,400 percent and more than 3.4 million telehealth services were accessed by the end of 2020 alone.

LVB:  What are some of the other trends in health care insurance?

Rinker: One trend we are seeing now is insurers working to help get not just their members, but everyone, vaccinated.

At Highmark, we are working with many partners to ensure that vulnerable populations are being vaccinating and learning that they should not be hesitant about getting the vaccine.

Highmark has joined with other Blue Plans for the Rally for Recovery Commitment to protect employees, encourage COVID-19 vaccinations and educate staff and local communities on ways to mitigate the spread of the virus. The pledge was launched in March 2021 by the federal government and business leaders.

We also joined the Vaccine Community Connects pilot program with AHIP, BCBSA and the White House to vaccinate 2 million seniors, with a focus on people living in the most at-risk vulnerable and underserved areas, including African American and Hispanic communities.

And we are a main sponsor with Latino Connection on several ongoing vaccination events serving minority and vulnerable populations across Pennsylvania.

And we have also partnered with Rite Aid to deliver 3,000 COVID vaccines to vulnerable populations (mostly seniors) in western and central PA at our Highmark Direct stores.

LVB:· How do you help employers navigate the changing health insurance landscape?

Rinker: Most employers utilize brokers who know health care and who can use their expertise to help the employer navigate the complexities of the health care landscape.

As an insurer, we can help customers by helping their employees better understand their bills, their benefits, and the cost of their care. Our transparency tools provide members with the information they need to make smart decisions about their health care and health care spending. This makes cost and quality not only transparent but meaningful; helping customers and their employees make educated choices when deciding on medical care.

These tools include:

• A care cost estimator tool that allows members to shop and compare costs on common surgeries, diagnostic procedures, and office visits. The tool calculates what portion members will have to pay for medical care or procedures based on their plan and benefits.
• A “Find a Doctor” tool that allows members to search for a local provider. Members can view a physician’s medical training, board certifications, professional recognitions, and practice details and compare up to three physicians side by side.
• A Doctor Match tool also allows members to search for a doctor that meets their personal preferences, such as a doctor who likes to spend more time with patients or a doctor sensitive to cultural differences.

LVB:  What are some developments in health care insurance that you see on the horizon?

Rinker: What we are focused on at Highmark is creating real value for our customers and members. This means working for customers and members to manage costs, manage quality of care as well as quality of health, and to create a remarkable member experience.

As an example, for the last several years we have been moving toward value-based reimbursement, which pays providers more when our members are healthier and have better outcomes.

And we are seeing results through our True Performance program. Our claims data for years 2017, 2018 and 2019 (2020 is not yet available) has shown that the program has helped to avoid a total of $1.09 billion in health care costs from Emergency Department (ED) visits and hospital admissions.

We are also implementing high-performance networks and products with like-minded providers that offer our customers and members the highest value.

Together, these initiatives are helping to lower our customers’ total cost of care.