Health Insurance
8:44 am
Sun April 14, 2013

New Highmark Insurance Plan Channels Patients to Specific Hospitals

A new insurance plan from Highmark allows employers to nudge their employees toward particular hospitals when they need risky surgeries.

Employers using the "Blue Distinction" program can give incentives, such as waived deductibles and co-pays, to employees who choose hospitals that have proven track records for certain surgeries.

The company can also choose to increase co-pays or even “carve out” coverage for any other hospital when the specialty surgery is needed, according to Highmark Vice President of Regional Sales Eric Hays.

He said the six specialty surgery areas in the Blue Distinction program are among the most risky for insurance companies. They are: bariatric surgery, cardiac care, complex and rare cancers, knee and hip replacement, spine surgery, and transplants.

Hospitals must have a track record of few errors and complications in order to earn the Blue Distinction mark in any category.