Highmark Inc. adds coverage for medical innovations in treatment of panic attacks and diagnosis of coronary arterial blockage

PITTSBURGH, Pa. (Sept. 17, 2018) — A new, non-​pharmaceutical treat­ment, Freespira, and non-​invasive diag­nostic tech­nology, Heartflow FFRct (frac­tional flow reserve), were added to Highmark’s medical policy in 2018 following posi­tive results from a program that fast-​tracks medical inno­va­tions to the market­place.

Freespira, an in-​home digital ther­a­peutic device for panic disorder and panic attacks occur­ring with other anxiety condi­tions, was added to Highmark’s medical policy in May 2018 and now covers the treat­ment option for members.

Panic attacks are primarily asso­ci­ated with anxiety disor­ders such as gener­al­ized anxiety disorder, post-​traumatic stress disorder, and social anxiety. Symptoms asso­ci­ated with panic attacks are often misin­ter­preted by patients as a serious medical event such as heart attack or stroke, leading to over-​utilization of medical services, such as emer­gency room visits, diag­nostic testing, medica­tions, primary, and behav­ioral health provider visits.

Anyone suffering from anxiety or panic attack has their own unique fears,” said JamieLee Kwolek, a Highmark member. A fear of mine was relying on medica­tion for a condi­tion that I wanted to learn how to treat and manage holis­ti­cally. I felt like I had missed so much of my life trying to deter­mine how to cope with this diag­nosis, and I was afraid that my options were limited to medica­tions that might disrupt my life even more. Freespira gave me the tools I needed to truly under­stand and use the option I had all along — my breathing. I am so grateful to have found a holistic, sustain­able treat­ment that truly gives me control and under­standing over my anxiety and panic attacks.”

Results of a Highmark Health VITAL Innovation Program study showed that after just 4-​weeks of using Freespira, more than 80 percent of the partic­i­pants treated were panic attack free. Moreover, 80 percent were panic attack free and 93 percent reported overall panic symptom reduc­tion at 12 months post-​treatment.

Freespira has shown very promising results as a viable, non-​pharmaceutical option for our members,” said Charles DeShazer, M.D., chief medical officer, Highmark Inc. Our poli­cies undergo a rigorous stan­dard of review and eval­u­a­tion to ensure that our members are covered for proven tech­nology and treat­ments that are aligned with our value-​based reim­burse­ment model of care. Freespira has success­fully demon­strated that it provides sustain­able, posi­tive outcomes for our members while driving down costs asso­ci­ated with over-​utilization of medical services, making this new policy a win-​win’ for members, providers, and insurers.”

Also added to Highmark’s medical policy in 2018 was HeartFlow, a novel non-​invasive diag­nostic tech­nology that offers physi­cians insight into both the extent of a patient’s coro­nary arte­rial blockage and the impact the blockage has on blood flow.

Traditionally, diag­nostic options for coro­nary artery disease included either a non-​invasive stress test or an inva­sive heart catheter­i­za­tion. Heartflow is the first non-​invasive tech­nology to combine the infor­ma­tion provided by a heart catheter­i­za­tion and stress test, which can reduce the need for inva­sive testing and aid physi­cians in their diag­nos­tics and improve treat­ment strategy.

Both tech­nolo­gies were eval­u­ated through Highmark Health’s VITAL Innovation Program, a test-​and-​learn plat­form for early-​stage health inno­va­tions that produces evidence in patient expe­ri­ence, care, and cost outcomes that may accel­erate coverage by health plans and care delivery systems.

The VITAL program provides an addi­tional layer to Highmark Inc.‘s policy review, enabling a greater under­standing of the full impact of new tech­nolo­gies on members without changing insur­ance medical policy prema­turely. Once a study is completed, Highmark Inc. eval­u­ates the results as part of an exten­sive medical policy review process to deter­mine coverage for the treat­ment or diag­nostic tool. Other VITAL-​graduated” programs which resulted in medical policy changes within the past year were LINX, a non-​invasive treat­ment to help manage symp­toms and risks for patients with acid reflux, and Bronchial Thermoplasty, a non-​pharmaceutical option for managing the symp­toms of asthma.

ABOUT HIGHMARK INC.

Highmark Inc. and its health insur­ance subsidiaries and affil­i­ates collec­tively are one of America’s largest health insur­ance orga­ni­za­tions and together with its Blue-​branded affil­i­ates, collec­tively comprise the third-​largest overall Blue Cross and Blue Shield-​affiliated orga­ni­za­tion in the country based on capital. Highmark Inc. and its affil­i­ates operate health insur­ance plans in Pennsylvania, Delaware and West Virginia that serve approx­i­mately 4.6 million members and hundreds of thou­sands of addi­tional indi­vid­uals through the BlueCard program. Its diver­si­fied busi­nesses serve group customer and indi­vidual needs across the United States through dental insur­ance, vision care and other related busi­nesses. Highmark Inc. is an inde­pen­dent licensee of the Blue Cross and Blue Shield Association, an asso­ci­a­tion of inde­pen­dent Blue Cross and Blue Shield compa­nies. For more infor­ma­tion, visit www​.high​mark​.com.

For more information, contact:

Leilyn Perri
Highmark Health
717−302−4243
leilyn.​perri@​highmarkhealth.​org