East Pennsboro-based Highmark Blue Shield is introducing a new plan in which members receive enhanced value benefits or pay less if they choose a less expensive hospital or doctor.
The plan is called Community Blue Premier Flex, and Steven Nelson, Highmark senior vice president of product, marketing and strategy, estimated it could save employers up to 20 percent on their premium costs, depending on the group's current utilization.
"The number one question from businesses is how can we lower our health care costs; this kind of product helps give them cost savings choices," Nelson said.
Kelly Lieblein, vice president of sales and client management for Highmark Blue Shield, said the plan draws on the cost transparency work Highmark has been doing, which now lets members look at costs and compare providers on 150 procedures.
"Essentially there are two levels of in-network benefits," Lieblein said, with the member's percentage of cost-sharing higher for standard providers and lower for enhanced providers. "When the employees use the benefit, based upon any service that they might look for, they have a choice to go between a standard or an enhanced provider. They can go online and look at the choices. It's not that they're choosing a network, they're choosing a provider."
The plan will be offered starting July 1 in Northcentral Pennsylvania — Centre, Columbia, Juanita, Mifflin, Montour, Northumberland, Schuylkill, Snyder and Union counties — with possibilities for future expansion.
Lieblein said Geisinger Health System and Berwick Hospital Center will be considered standard-level providers. Enhanced-level providers, with lower costs to members choosing them, include Evangelical Community Hospital, Health South Rehabilitation Center, Lewistown Hospital, Mount Nittany Medical Center, Schuylkill Medical Center, St Luke's Miners Memorial Hospital and Sunbury Community Hospital.
"I do think it will be the trend of the future, as people are looking for more solutions on the cost side," Leiblein said of the tiered-benefit approach.
Strategy details for this new benefit are under review by the Pennsylvania Department of Health, according to Highmark's news release.