Your safety and trust are vital to us. We're aware of ongoing recruitment scams in which individuals falsely claim to represent our organization. We're actively monitoring and addressing these scams. However, because they originate outside of our systems, we cannot directly prevent all fraudulent activity. If you believe you have been targeted by a recruitment scam, reporting scams to the FBI is the most effective way to take action. In such an event, you should discontinue communication with the suspected scammer and report the incident to the FBI’s Internet Crime Complaint Center (IC3) at: https://www.ic3.gov If something feels suspicious, trust your instincts. Taking a moment to verify authenticity can protect your personal information and prevent fraud. Read more about what to look out for: https://bit.ly/4rZ8M37.
Protect Yourself from Recruitment Scams
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“Health engagement is not just a buzzword; it’s the heart of what we do,” says Judy Arrow, vice president of health engagement operations at Highmark. With her insights, this article explores how we're evolving case management to proactively address member needs and improve outcomes, all while navigating the challenges and opportunities in the current health care landscape. “Think of it like igniting a spark within our members to actively participate in their own health and well-being. We want members to be informed, empowered partners on their health journey.” Read more: https://lnkd.in/eQ2HXerD
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Highmark is proud to announce a significant enhancement to our health plans, effective January 1, 2026: all diagnostic breast studies and breast MRIs will now be covered at 100%, with no copay or deductible. This enhanced coverage applies to all Highmark health plans across Pennsylvania, New York, West Virginia and Delaware, encompassing commercial, eligible group, and individual ACA plans. By eliminating out-of-pocket costs for these critical follow-up diagnostics, we are actively removing financial barriers that can often delay or prevent access to timely, life-saving care. This new coverage is a testament to Highmark's unwavering commitment to improving health outcomes for our members. Learn more: https://lnkd.in/etZTFBi7.
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Deborah Rice-Johnson, our chief growth officer and CEO of diversified businesses, discusses how Highmark has faced the same challenges as others in the industry but has also made significant strides at the same time. "The diversification of our organization has enabled us to weather industry pressures and prepare for a stronger future,” she said. Read more: https://lnkd.in/ezWEhq6K
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Our stop loss business, HM Insurance Group, shares a helpful guide for business decision makers on what to consider with self-funded insurance as well as factors affecting the stop loss market today.
As health care costs continue to rise, a number of factors are impacting the Stop Loss market. That’s why it’s important for self-funded employers to look for a Stop Loss carrier that understands the trends and works to deliver the right coverage at the right price. Check out our latest infographic to find details on escalating claim frequency, pharmacy costs, leveraged trend, and what the right Stop Loss carrier provides to clients: https://lnkd.in/eBKUiSKn
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At Highmark, we're not just talking about the future of health care; we're building it. By strategically integrating AI into our case management practices, we're transforming how our dedicated team members work. This isn't just about efficiency; it's about empowering our clinicians to deliver an even better experience for our members. Learn more: https://lnkd.in/eQN_v2iQ
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Hear from Kurt Spear, our vice president of financial investigation and provider review, on how modern tools like generative AI are being exploited by bad actors to defraud the health care system. He also discusses what health plans need to do in response. Read more in Becker's Healthcare: https://bit.ly/4tyD8Zb.
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Delayed prior authorizations frustrate patients and physicians, and they can also delay needed care. We're changing that, and others are taking notice. Our Gold Card program streamlines the process, saving time for patients and providers, while driving down costs of clinical documentation and appeals. With nearly 25,000 doctors having qualified for Gold Card status, this program continues to drive change in the health care industry. Read Pittsburgh Post-Gazette’s article on our Gold Card program: https://lnkd.in/eKtvsyQU
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We take enormous pride in being an organization that steps up when our communities need us most. Highmark will be donating $20 million to further support the public safety bureaus that provide first-response emergency medical care. The $4 million a year over five years will be invested in resources that medical first responders need with a primary initial focus on Pittsburgh Bureau of Fire vehicles. Hear more from Highmark Health CEO David Holmberg below in the mayor's video!
Thank you Highmark and UPMC for stepping up for Pittsburgh Public Safety with a new, five-year, $55 million partnership! This investment will ensure our first responders have the resources needed to keep Pittsburghers safe and healthy for years to come. Read more about this new partnership: https://lnkd.in/e-jPFv5g
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Trust is built, or broken, in the moments that matter most to the people we serve. Highmark Health President Karen Hanlon shares that in order to redefine consumer experiences in healthcare, industry leaders have a responsibility to create one that is transparent, personalized and easy to navigate. By being reliable and guiding people through their care journeys, we can help them feel confident and more engaged in their health. She says, "My vision for the healthcare industry is to offer an experience so seamless and intuitive that it doesn't feel like a healthcare experience at all. It feels different." Read the Forbes Business Council article: https://bit.ly/4fyX5di.
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Our data-driven gold carding program has been successfully removing prior authorization roadblocks for doctors across specialties, including Dr. mike darowish, an orthopaedic surgeon from Penn State Health. Immediate approvals help to reduce last-minute denials and allow providers to focus on patient care instead of redundant administrative tasks. Read more about our program in HealthLeaders’ recent article: https://bit.ly/4v0torD
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