Value-Based Reimbursement Programs
Our innovative value-based care programs enable providers to deliver high-quality outcomes for our members.
Value-Based Reimbursement Programs
ValueBlue and ValueBlue Connect
- wpa/ nepa
- cpa/ sepa
- wv
- wny
- neny
We’re launching ValueBlue and ValueBlue Connect, new and innovative partial capitation plus incentive models, set to begin in 2027.
Medicare Advantage Stars
- all
CMS Star Ratings reflect care quality and directly impact plan reimbursements. Strong performance leads to higher reimbursements.
Quality Blue Hospital
- all
A value-based outcome strategy that reinforces and incentivizes quality, safety, efficiency, and hospital/physician collaboration across the care continuum.
True Performance
- all
Highmark’s foundational value-based reimbursement program for PCPs - focused on improving care quality and reducing costs across home health, physical and occupational therapy, skilled nursing facilities, and more.
Specialist Performance Initiative
- all
Guide patients to high-value providers with transparent insight into specialist performance and cost data.
Best Practice
- wny
Streamline payments for complex care beyond office visits with predictable costs tied to quality and efficiency.
Additional Guidance
Provider Service Center
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Clinical Services
Call us: 8:30 a.m. to 7 p.m. Monday through Friday, 8:30 a.m. to 4:30 p.m. Saturday and Sunday.
