2027 BestPractice Program Changes

As previously announced, starting Jan. 1, 2027, BestPractice will be renamed ValueBlue as Highmark expands the program into our other markets. The program’s overall structure will remain the same.

Highmark is updating 2027 base rates and the performance adjustment factor (PAF). These changes may affect your total capitation payment.

What You Need to Do

• Review the 2027 base capitation rate and PAF updates below.
• View your 2027 PAF Report in the Static Reports Application in Provider Facing Analytics (PFA).
• Review ValueBlue Connect incentive program (if applicable to your organization) before True Performance/True Performance Lite sunsets.

2027 Base Rate, Member Adjustment Factor (MAF), and Performance Adjustment Factor (PAF)

• Base Rate: The 2027 base capitation rates by line of business (LOB) are shown below:

• No Change to MAF: The MAF will remain the same in 2027. MAF is designed to reflect the anticipated healthcare needs of your attributed member population. Your member roster will be available in Value Insight Center (VIC) starting in 2027. Please continue to access your 2026 member roster via the Static Reports Application through Dec. 31, 2026.
• PAF: Highmark uses the PAF to adjust payments to primary care providers (PCPs) based on their performance. Your 2027 PAF Report is available in the Static Reports application in PFA.
  • What’s changing:
    • Quality: Updated quality metrics are included in the ValueBlue User Guide.
    • Efficiency: The Emergency Department (ED) Utilization metric will replace the Avoidable ED Visits metric previously used.

For complete details on 2027 base rate, MAF, PAF, and other program components, refer to the 2027 ValueBlue User Guide. To access the user guide, go to the ValueBlue and ValueBlue Connect page of the Provider Resource Center (PRC) and click on the "ValueBlue FAQs" button. (Note: You must be logged into the Availity Essentials portal to view the user guide on the ValueBlue Frequently Asked Questions page.)

Explore ValueBlue Connect

Highmark is also introducing a new complementary program, ValueBlue Connect, offering additional opportunities to earn incentive payments while supporting your efforts to deliver high-quality, preventive care.

As a result of this change, your current True Performance/True Performance Lite program will sunset at the end of 2026.

Review benefits of ValueBlue Connect and additional program information on the PRC's ValueBlue and ValueBlue Connect page.