Highmark Aims to Be ‘Center of Gravity’ for Testing Innovative Therapies

After Highmark Health expanded from an insurer to an inte­grated delivery system, the orga­ni­za­tion decided it was uniquely posi­tioned to launch a plat­form to test early-​stage, FDA-​approved medical inno­va­tions that were strug­gling to attain the evidence needed for wide­spread adop­tion — and, crit­i­cally, insur­ance reim­burse­ment.

Nearly four years later, Highmark Health Plan and its affil­iate Allegheny Health Network have changed their poli­cies and purchasing contracts to provide ther­a­peutic inno­va­tions to members after gath­ering evidence on their effec­tive­ness. Examples include HeartFlow, which can create a 3D model of coro­nary arteries and block­ages, and FreeSpira, a digital ther­a­peutic that reduces debil­i­tating panic attacks.

Highmark also opted to trans­form VITAL from an internal plat­form to a commer­cial offering — meaning compa­nies pay Highmark to test their prod­ucts, says Eileen Rodgers, director of Highmark’s VITAL Innovation Program.

Making VITAL a commer­cial offering, according to Rodgers, helps it source new inno­va­tions and make the program a recog­niz­able name out in the market­place. Our intent really is to draw new inno­va­tions to Highmark Health as kind of a center of gravity,” she says.

For the startup compa­nies that work with VITAL, the services the program offers can be the differ­ence between staying afloat or going under, Rodgers points out.

A lot of inno­va­tions are FDA approved and make it past clin­ical trials to be commer­cially avail­able, but because there’s no financing mech­a­nism, the delivery systems are unable to buy them,” she says.

But the real-​world evidence VITAL provides can help star­tups get over that hurdle faster by making payers’ deci­sion to cover their product a safer bet.

Source: AIS Health