Highmark program realizes more than $3B in avoided cost savings

Highmark Inc.’s program to reduce hospital admissions and emergency department (ED) visits has seen more than $3 billion in avoided cost savings since 2017. 

Highmark Inc. said it’s True Performance program for primary care physicians (PCPs) realizes avoided cost savings when inpatient hospital admissions and ED visits for members seeing True Performance PCPs are reduced, based on the average costs for those services. 

In 2022, avoided cost for reduced inpatient admissions totaled $632 million across Highmark’s service areas in Pennsylvania, Delaware and West Virginia. Avoided costs for ED visits totaled $106 million across Pennsylvania, Delaware and West Virginia in the same time period. 

 “The True Performance program has really shown results as we work to reduce health care costs for our customers and members and improve health outcomes,” said Dr. Timothy Law, chief medical officer for Highmark Inc. “And reducing hospital admissions and ED visits also shows that PCPs in the True Performance program are keeping our members healthier.”  

Law said through the True Performance program PCPs are keeping members healthier by giving recommended immunizations, appropriate drug therapy for patients with chronic diseases, cancer screenings and annual wellness exams. 

Close to 90% of eligible PCPs – more than 13,000 physicians from more than 2,100 practices – participate, Law said. 

There are 2.2 million Highmark members currently seeing a PCP that is participating in the True Performance program.