Add Row
Add Element
Glytain Logo
update
Glytain.com
update
Add Element
  • Home
  • Categories
    • Healthcare
    • Innovation
    • Digital
    • Marketing
    • Analysis
    • Insights
    • Trends
    • Empowerment
    • Providers
    • Tech News
    • Extra News
March 18.2025
3 Minutes Read

Highmark’s Shift from Exclusive Specialty Pharmacies to Tailored Solutions

Highmark Specialty Pharmacies partnership handshake in pharmacy setting.

Why Highmark is Rethinking Specialty Pharmacy Partnerships

Highmark, a significant player in the health insurance space, is reimagining its approach to specialty pharmacies. Historically tied to exclusive relationships with specific pharmacies, Highmark found this model increasingly limiting. According to Sarah Marche, senior vice president of pharmacy services, the traditional method aimed to consolidate patient drug utilization to achieve cost efficiencies. Instead, it may have compromised the quality of care available to patients with specialized needs.

Marche's epiphany came as she engaged with multiple specialty pharmacies that specialized in treating intricate conditions such as cystic fibrosis and cancer. She recognized a disparity in care; by confining patients to a singular pharmacy under an exclusivity agreement, Highmark was not only hampering patient outcomes but also potentially inflating costs. "I was receiving regular inquiries from various specialty pharmacies showcasing their unique capabilities to care for specific conditions," Marche recounted, leading her to eventually reevaluate the benefits of Highmark's exclusive contracts.

A New Collaborative Approach

As a solution, Highmark initiated a collaboration with Free Market Health around five years ago. This innovative partnership moves away from exclusivity, allowing members to connect with pharmacies tailored to their unique healthcare needs. Instead of mandating that all patients use a single provider, Highmark enables patients to choose pharmacies that specialize in managing their particular conditions. This bespoke approach not only better serves the patients but sets the stage for improved outcomes. Marche noted that patients suffering from specific ailments, like cancer, often perform better when treated by specialized oncological pharmacies.

This shift aligns with trends in healthcare towards patient-centered initiatives, where personalization is paramount. According to Marche, implementing this model means more than just financial savings; it also aims to enhance the healthcare experience, something that aligns with a broader movement in digital healthcare innovations.

The Impact of Technology on Healthcare

The partnership with Free Market Health, a tech-driven solution, aims to streamline how patients are matched with pharmacies. This model reflects emerging trends within the healthcare IT landscape, where digital solutions are becoming indispensable. The platform not only matches patients with appropriate pharmacies but also collects data to assess patient outcomes effectively. For instance, collecting information on patient journey and satisfaction could lead to long-term innovations in how healthcare benefits are administered in the future.

Looking Ahead: A Market-Driven Model

As more health providers recognize the limitations of traditional pharmacy agreements, a market-driven model emerges as a compelling alternative. By adopting this approach, healthcare stakeholders can find a balance between cost containment and patient satisfaction—an essential goal in today’s healthcare landscape. Mark Conklin, president of Free Market Health, emphasizes this transformation: “This model captures more value in a better-orchestrated ecosystem,” providing enhanced patient experiences alongside improved financial outcomes.

Conclusion

As Highmark continues to evaluate the implications of its new partnerships, it stands at the forefront of essential change within the industry. Embracing a more flexible, patient-centric approach can lead to improved outcomes and even cost reductions in the long term. Embracing innovative partnerships as healthcare trends evolve is critical for organizations seeking to stay competitive and effective in providing care.

Healthcare

Write A Comment

*
*
Related Posts All Posts

Why Trust in Organ Donation Is Critical Following Federal Report

Update Trust in Organ Donation: A Breakdown in ConfidenceThe U.S. organ transplant system has found itself under scrutiny following a shocking report from the Health Resources and Services Administration (HRSA). As revealed in a recent congressional hearing, an organ procurement organization neglected vital signs in patients before performing organ removals, raising alarm about practices that endanger lives rather than save them.Congressional committee members voiced their concerns about the impact of such actions on public trust. Rep. John Joyce highlighted the core principle of medical ethics, stating, "Above all, do no harm," which underscores the betrayal felt within the physician-patient relationship when patients endure unnecessary suffering.Understanding the Implications for Public HealthThe findings spotlight not merely individual cases of negligence but also a broader systemic issue. The transparency and safety of the organ donation process are critical for maintaining the confidence of potential donors and their families. If the public feels that the process is flawed, it risks a downturn in organ donations. This could worsen the already critical organ shortage faced by many who rely on transplants for survival.Future of Organ Donation: From Crisis to Reform?As Congress moves toward reforming the organ donation system, there’s potential for enhancing regulations and increasing oversight. By rigorously addressing the problems highlighted in the HRSA report, lawmakers can aim for improved protocols that ensure ethical practices are at the forefront of organ procurement.This pivotal moment calls for more than just policy changes; it urges a collective societal acknowledgment of the importance of organ donation. By fostering discussions and promoting awareness, we can gradually rebuild trust in a system that is so crucial for countless families.

Myeloma Treatment: Navigating Life with a Manageable Cancer

Update Opening the Door to Improved Myeloma Treatment In recent years, significant advancements have been made in the treatment of myeloma, a complex and often misunderstood cancer. Unlike many cancers that remain static in terms of prognosis, the outlook for myeloma patients has dramatically improved. Gone are the days when a diagnosis may have led to a life expectancy of just three years. Today, patients can expect to live a decade or more, thanks to innovative treatments continually emerging from research.In Treatment for Myeloma, the discussion dives into the leaps being made in myeloma care, exploring key insights that sparked deeper analysis on our end. Why Expertise Matters for Myeloma Care The Mayo Clinic is at the forefront of these advancements, providing a vital resource for patients seeking specialized care. The clinic’s rapid diagnosis capabilities and comprehensive treatment options are bolstered by a team of experts who focus solely on myeloma and similar disorders. Unlike community oncologists who may see myeloma cases occasionally, specialists at the Mayo Clinic handle multiple myeloma cases daily, ensuring they are well-versed in the latest techniques and therapies. Living Well Beyond Diagnosis One of the central messages from experts in the field is the importance of viewing cancer not just as a terminal illness, but as a manageable condition. With the right support and treatment, those diagnosed with myeloma can lead fulfilling lives. This shift in perspective encourages patients to thrive while effectively managing their conditions. By focusing on comprehensive care involving various specialists, patients receive tailored treatment plans that enhance their quality of life. The Future of Myeloma Treatment As new therapies are developed, the goal is to drive the disease into deep remission, allowing patients to return to their daily routines more quickly. The future shines brighter for those living with this condition, and the Mayo Clinic aims to remain a leader in research and treatment options. This commitment not only helps optimize existing therapies but also paves the way for even more breakthroughs. In light of all this progress, it is essential for patients and caregivers to stay informed about new developments in myeloma treatment. Whether through consultations with healthcare professionals or engaging in support networks, being proactive can lead to impactful choices in managing one's health.

Why Data Risk Management Is Essential for AI in Healthcare

Update The Growing Importance of Data Risk Management In today’s digital healthcare landscape, where reliance on artificial intelligence (AI) for clinical decision-making and patient engagement is growing, the stakes for data security cannot be overstated. As healthcare organizations accelerate their AI strategies, they face intensified scrutiny regarding data management practices. Sensitive patient information is increasingly targeted by cybercriminals, underscoring the necessity for structured, proactive data risk management that can adapt to evolving technologies. Embedding Data Protection Throughout Healthcare Systems For CIOs and IT leaders, maintaining patient data security involves integrating data protection mechanisms at all levels of their infrastructure. This approach not only protects sensitive information but also facilitates compliance with regulatory requirements. According to experts like Shannon Murphy from Trend Micro, reliable, high-quality datasets are essential for effective AI operations. However, every new data input heightens the risk of exposure, necessitating advanced risk management solutions. Challenges in Data Management for Healthcare Healthcare organizations must navigate a series of critical data challenges, particularly while implementing AI across various clinical workflows. Some of these challenges include complex interoperability demands and the need for flexible remote access. As Henry Vernov from Citrix highlights, the way data is transferred across devices and applications introduces various risks that require constant vigilance. Securing the Future of Healthcare Innovation Ultimately, embedding robust data risk management practices is vital not only for patient safety but also for the future of healthcare innovation. Organizations must recognize that data security can serve as an enabler rather than a hindrance to technological advancements. As we look ahead, healthcare sectors that prioritize data protection are likely to lead the way in successfully leveraging AI and other digital health solutions. Call to Action Healthcare stakeholders need to assess their current data risk management strategies and ensure they are equipped to meet the challenges posed by advanced AI tools. Implementing comprehensive data protections today will pave the way for safer, more effective healthcare tomorrow.

Terms of Service

Privacy Policy

Core Modal Title

Sorry, no results found

You Might Find These Articles Interesting

T
Please Check Your Email
We Will Be Following Up Shortly
*
*
*