Value-Based Reimbursement Programs

Medicare Advantage Stars

CMS Star Ratings reflect care quality and directly impact plan reimbursements. Strong performance leads to higher reimbursements.

Quality Blue Hospital

A value-based outcome strategy that reinforces and incentivizes quality, safety, efficiency, and hospital/physician collaboration across the care continuum.

True Performance

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

Guide patients to high-value providers with transparent insight into specialist performance and cost data.

Best Practice

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Streamline payments for complex care beyond office visits with predictable costs tied to quality and efficiency.