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

Casey Means' Nomination as Surgeon General Marks a Shift Towards Holistic Health

Update Trump's New Nomination: Casey Means for Surgeon General President Trump has recently nominated Dr. Casey Means as the next U.S. Surgeon General, a significant shift in leadership following the abrupt withdrawal of his previous appointee just a day before her Senate committee hearing. This change underlines the increasing influence of alternative health perspectives in American healthcare policy. The Holistic Approach to Health Dr. Means, a physician and the co-founder of Levels, a health technology company, champions holistic health principles that emphasize preventive care and lifestyle choices. Her advocacy for a more integrative approach differentiates her from traditional medical norms, aligning with modern trends that prioritize personal wellness and preventive measures. This approach resonates with a growing segment of the population seeking alternatives to conventional medication, particularly in the aftermath of the pandemic. A Shift in Political Health Narratives Trump’s choice of Means reflects a broader ideological shift in health leadership toward those who critique pharmaceutical companies and advocate for alternative solutions. Her nomination comes at a pivotal moment when the public is increasingly questioning the efficacy of traditional healthcare systems. This nomination could redefine not just the role of the surgeon general but the larger discourse surrounding health policy in the U.S. Contextualizing the Change The background and credentials of Means offer insight into this evolving health landscape. With close ties to Health Secretary Robert F. Kennedy Jr., who himself has been a controversial figure in health discussions, Means embodies a new generation of leaders challenging conventional wisdom on health. As the country grapples with issues like chronic disease and the stabilization of public health, her perspective could influence how policies are shaped. The Future of Health Leadership As Dr. Means prepares to step into this notable role, her vision for a holistic approach may herald changes in how Americans view their own health and wellness. With many seeking alternatives to standard medical practices, her leadership potentially paves the way for innovative health solutions that prioritize personal empowerment and self-care, making healthy living more accessible and effective for everyone.

Understanding The Impact of Mayo Clinic Nurses Through Their Stories

Update Celebrating the Heart of HealthcareIn the touching video titled In their own words: Mayo Clinic nurses share what their work means to them, we hear firsthand from nurses who dedicate their lives to caring for others. Their stories highlight not only the challenges they face but also the profound impacts they make on their patients’ lives. Through their words, we discover that nursing is more than a job; it’s a calling filled with purpose and compassion.In In their own words: Mayo Clinic nurses share what their work means to them, we explore the heartfelt stories of nurses, reflecting on their vital contributions to the healthcare field. Emotional Rewards of NursingEvery nurse featured in the video spoke passionately about the emotional rewards of their work. It's about being a source of comfort during some of the patients’ toughest times. From listening to fears to celebrating recovery milestones, these nurses serve as pillars of support. This human connection is at the core of nursing and, without a doubt, contributes to the healing process.The Impact of StoriesWhat's particularly inspiring is how sharing their experiences encourages a deeper understanding of the healthcare profession. Nurses are often seen only in their professional roles, but in this video, we get a glimpse into the emotional depths of their experiences. This deeper insight can build a stronger appreciation in the community for the dedication these healthcare heroes offer every day.Building Community TrustAs the healthcare landscape evolves, the stories these nurses share serve as a bridge to enhance community trust in healthcare systems. Transparency through storytelling allows communities to engage with healthcare providers more effectively, fostering relationships built on compassion and understanding.

How SMC Telogorejo Hospital Achieved EMRAM Stage 6 and Improved Patient Satisfaction

Update Transforming Healthcare with Technology At the SMC Telogorejo Hospital in Central Java, the commitment to improving patient experiences has reached new heights. Recently recognized with a HIMSS EMRAM Stage 6 validation, this 285-bed hospital demonstrates the remarkable impact of technological integration on patient satisfaction. With an impressive 4.9 rating on Google reviews, the hospital's digital transformation journey showcases how adopting modern health IT solutions can lead to improved healthcare delivery. The Journey to Digital Excellence The hospital began its digital journey in 2017, launching the MySMC mobile app that connected patients to health services and essential information. This initiative paved the way to a more comprehensive Electronic Medical Record (EMR) system established in 2019, consolidating critical data from medical records to treatment history. Enhancing Patient Care Through Innovation The COVID-19 pandemic reshaped healthcare practices, prompting SMC Telogorejo to adopt teleconsultation and a 24/7 multichannel contact center. These innovations proved especially beneficial for senior patients, who often face technology challenges. By streamlining appointment scheduling and payments through MySMC, the hospital succeeded in reducing wait times and alleviating physical crowds in their facilities. Integrating Smart Technology and Data In 2021, the integration of artificial intelligence and IoT devices took the hospital’s EMR system to a whole new level, significantly boosting efficiency in clinical decision-making. Real-time data entry improved patient safety in medication administration and laboratory processing, proving the necessity of smart healthcare solutions in the contemporary medical landscape. Future-Ready Hospital Standards As healthcare continues to evolve, SMC Telogorejo's integration with Indonesia's national health database represents a vital step towards enhancing public health. Their recent subscription to clinical decision support and drug reference resources showcases their commitment to staying at the forefront of health technology. The success of SMC Telogorejo Hospital demonstrates the transformative power of EMR systems on patient satisfaction and care delivery. As healthcare IT professionals and providers, embracing these technological advancements will be crucial for improving health outcomes and operational efficiency.

Add Row
Add Element
Glytain Logo
update
WorldPulse News
cropper
update

Glytain empowers healthcare professionals and businesses to navigate the evolving digital landscape, driving innovation and improving patient outcomes. 🚀

  • update
  • update
  • update
  • update
  • update
  • update
  • update
Add Element

COMPANY

  • Privacy Policy
  • Terms of Use
  • Advertise
  • Contact Us
  • Menu 5
  • Menu 6
Add Element

+639220000000

AVAILABLE FROM 8AM - 5PM

City, State

, ,

Add Element

ABOUT US

At Glytain, we bridge the gap between healthcare and technology by delivering expert insights, cutting-edge trends, and in-depth analysis of digital health innovations. Our platform is designed for healthcare professionals, tech innovators, and forward-thinking businesses looking to stay ahead in the rapidly evolving healthcare landscape.

Add Element

© 2025 CompanyName All Rights Reserved. Address . Contact Us . Terms of Service . Privacy Policy

Terms of Service

Privacy Policy

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