By Leslie Small
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.
From Health Plan Weekly
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