Clinical Solutions for 2026: Noom, SUD Specialty Care, and Additional Offerings

Highmark is launching new clinical solutions for members in 2026, designed to enhance patient health and support your care delivery.

Noom: Weight Management Solution

Beginning Jan. 1, 2026, Highmark will offer the Noom: Weight Management Solution at no additional cost to eligible members aged 18 and older. This digital tool leverages behavioral science to help individuals achieve weight loss and holistic health goals.

Noom: Weight Management provides personalized coaching, education, and digital tools for habit modification through three main tracks:

• Noom Weight: Focuses on sustainable weight loss for members aged 18+ with a BMI ≥ 25.

• Noom Diabetes Prevention Program (DPP): A CDC-recognized program for members 18+, with a BMI ≥ 25, who screened positive for prediabetes on a CDC questionnaire.

• Noom Diabetes Lifestyle: Supports members 18+ with Type 2 diabetes in weight loss, glycemic control, and medication adherence.

While Noom won’t prescribe medications or manage GLP-1 prescriptions, it includes a GLP-1 companion component for members already on these medications, offering educational content and support.

Mental Well-Being: Specialty Care – Substance Use Disorder (SUD) Expansion

Also launching Jan. 1, Highmark's Mental Well-Being program, powered by Spring Health, will introduce a Specialty Care – Substance Use Disorder (SUD) program. All members who are eligible for the Mental Well-Being solution have access to this program. Members already enrolled in the core Mental Well-Being program can move or be referred into Specialty Care – SUD based on self-reported assessments/routine screenings from Spring Health or on the advisement of their Spring Health clinical care team, care navigator, therapist, or prescriber. Specialty Care – SUD services are available virtually, giving members convenient access when needed.

Key Features

• Specialty Care Navigators (SCN): SCNs provide proactive outreach, ongoing assessment, and long-term engagement for members who screen positive for SUD risk or express interest in behavior change.

• Comprehensive Support: Includes Medication-Assisted Treatment (MAT), Peer Recovery Coaching, and a Vetted Center of Excellence Network for in-network in-patient, detoxification, and residential programs.

• Eligibility: Highmark members aged 18+ covered under a Highmark commercial, MA, ACA, or ASO opt-in plan presenting with symptoms related to alcohol, cannabis, stimulant, opioid, or benzodiazepine dependence, and expressing interest in change. Assessments like DAST, AUDIT, and BAM are used to screen and monitor members’ condition.

You can refer your eligible patients into Mental Well-Being through the Availity Essentials portal.

Additional Solution Offerings and Expansions for 2026

• Virtual Joint Care – Thrive by Sword: Medicare Advantage (MA) members will be eligible for the solution Jan. 1.

• Kidney Health Management Powered by Healthmap: Expanding eligibility into the New York market.

• Fertility and Family-Building Management Solution (limited ASO-only): The program provides members with access to resources, guidance, and assistance with family building and navigating fertility treatment options through WIN Fertility. For more information about WIN’s network, providers can reach out to their team at providerrelations@winfertility.com. 

For additional information about Highmark’s clinical solutions for members, visit the Conditions Management Programs page of the Provider Resource Center (PRC).