Highmark expands virtual opioid treatment into Pennsylvania

Pittsburgh — Highmark recently announced that its commercial, Affordable Care Act and Medicare Advantage members in Pennsylvania and Delaware now have access to a comprehensive, technology-enabled opioid use disorder (OUD) program, according to a recent press release.

The program, which was first rolled out to Highmark’s West Virginia members in January, will help preserve treatment access and promote recovery during the COVID-19 pandemic and beyond, the press release said.

“In the communities that we serve and across the country, patients face extremely limited access to opioid use disorder treatment and medication-assisted treatment (MAT) therapy,” Dr. Caesar DeLeo, vice president and executive medical director of strategic initiatives for Highmark, said in the press release.

“The COVID-19 crisis has created even more treatment access challenges, while also fueling feelings of isolation and despair. By expanding this program, we’re harnessing technology to support our members on their path to recovery during this period of social distancing,” he said.

The OUD treatment program is offered in partnership with Bright Heart Health, an organization that offers nationally-recognized teleaddiction services. More than 90 percent of patients are retained in OUD treatment one month after beginning services, according to Bright Heart Health, according to the press release.

More than 90 percent of patients are negative for opioids within 90 days of beginning treatment, and more than 85 percent are negative for other stimulants and sedatives, the press release said.

Health related costs are reduced by $20,000 annually when opioid dependent patients are on MAT.

Highmark members can access services and meet on-demand with medical staff and counselors through a smart phone, tablet or computer.

Members may access Bright Heart Health services via self-referral or through a warm hand-off, a process of transitioning a patient with a substance use disorder from an intercept point, such as an emergency department, to a treatment provider once the patient is stable, according to the press release.

Following an initial intake and assessment process, members are connected to a multidisciplinary care team that includes a physician, therapist, case manager, care manager and a wellness coach. The program offers individualized treatment plans and MAT that allows individuals to stop abusing opioids without experiencing powerful drug cravings or severe withdrawal symptoms.

“We are proud to partner with Highmark in expanding access to high-quality opioid use disorder treatment in Pennsylvania and Delaware, in addition to West Virginia,” Jon Ciampi, president of Bright Heart Health, said in the press release.

“In this time of crisis and limited in-person treatment options, Bright Heart teleaddiction services will help ensure that individuals in need still have a supportive care team,” he said.

The expansion of technology-enabled OUD treatment is Highmark’s latest step to support the communities it serves during the COVID-19 crisis.

Highmark has also waived members’ out-of-pocket costs for telemedicine, COVID-19 testing and in-network inpatient COVID-19 treatment; provided $2 million for COVID-19 relief efforts related to food insecurity, financial stability and safety net health care in Pennsylvania, Delaware and West Virginia.

Highmark also assisted local primary care physicians by advancing more than $30 million in payments earned through Highmark’s True Performance value-based reimbursement program, according to the press release.


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