Highmark Members Adapting to Virtual Care

Medical nurse consulting with general practitioner via video call and recommending tablets to senior patient

At the height of the COVID-19 pandemic in 2020, many patients were unable to access care or were hesitant to go to a doctor’s office or clinic. 

As a result, Highmark members turned to virtual care, and the health insurer saw telehealth utilization increase by more than 3,600 percent from 2019, with more than 3.5 million claims processed for telehealth services. 

In 2021, even as many COVID-related restrictions were lifted and members felt more comfortable with in-person care, telehealth utilization by Highmark members remained virtually unchanged, with more than 3.3 million claims processed for telehealth services.

“What the data is telling us is that our members have really adapted well to virtual care,” said Dr. Timothy Law, vice president and executive medical director, Clinical Services, Highmark. “This is really great news because we are finding that virtual care can help to remove barriers to care such as traveling distance, scheduling difficulties and apprehension about going to a doctor’s office and being around other sick patients.”  

Dr. Law said the data also shows that Highmark paid a total of more than $307 million in telehealth claims in 2021, with more than $303 million – or 98 percent – being paid to local doctors, hospitals and clinics. 

Highmark’s claims data also shows that the most utilized service by its members was Behavioral Health, with more than 1.3 million claims, representing 42 percent of all telehealth claims. 

“Telehealth and virtual care are really important for behavioral health,” said Dr. Law. “In addition to removing barriers such as distance and cost, we are finding that virtual care is also helping to remove some of the stigma associated with behavioral health, which means more people are getting the treatment they need at a time when we are seeing dramatic increases in depression and anxiety due to the pandemic.” 

In fact, Highmark has added many new virtual behavioral care providers for members in recent months. Meru Health is a 12-week evidence-based program to treat depression, anxiety and burnout via a discreet smartphone app. To help improve diagnosis and treatment of OCD, Highmark is also now working with the provider NOCD to deliver virtual face to face therapy with therapists specializing in Exposure & Response Prevention (ERP). 

Earlier in 2021, Highmark contracted with Ria Health, a technology-enabled telehealth medical practice that focuses on treating alcohol use disorder by combining medically assisted treatment with digital tools to help members track and record progress.

Dr. Law said members have used telemedicine services for more than behavioral health. Flu, pink eye, rashes, strep throat and sinus infections have also been treated virtually through board-certified doctors 24 hours a day via phone, tablet or computer.

Highmark’s data also showed that women were more likely to utilize telehealth by a two-to-one margin, and that members age 19 and younger accounted for 21 percent of telehealth utilization in 2021, followed by members 20-29 and 20-39 at 18 percent. Members 60 or older accounted for just 13 percent of all telehealth utilization in 2021. 

For more information on accessing telehealth services, members should visit the Highmark member portal. 

About Highmark Inc. 

One of America’s leading health insurance organizations and an independent licensee of the Blue Cross Blue Shield Association, Highmark Inc. (the Health Plan) and its affiliated health plans (collectively, the Health Plans) work passionately to deliver high-quality, accessible, understandable, and affordable experiences, outcomes, and solutions to customers. As the fourth-largest overall Blue Cross Blue Shield-affiliated organization, Highmark Inc. and its Blue-branded affiliates proudly cover the insurance needs of more than 6 million members in Pennsylvania, Delaware, West Virginia and New York. Its diversified businesses serve group customer and individual needs across the United States through dental insurance and other related businesses. For more information, visit www.highmark.com.

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