Citing Soleo Health’s clinical expertise and data-reporting capabilities, U.S. national insurer Highmark has tapped the specialty pharmacy and infusion services provider to help care for its members who have hemophilia.
An independent licensee of the Blue Cross Blue Shield Association, Highmark covers about 190 hemophilia patients. The agreement with Soleo, one of three Highmark providers, begins Jan. 1, 2020. The insurer spends roughly $80 million each year on care for hemophiliacs, some 90% in pharmacy costs.
The pact calls for Soleo Health to care for these members through its 20 therapeutic care management centers across the nation that are dedicated to bleeding disorders. Each center is staffed with trained interdisciplinary teams consisting of specially taught pharmacists, registered nurses, clinical nurse educators, local resource advocates, and reimbursement specialists. These staffers treat and manage both hemophilia types, A and B, as well as Von Willebrand disease and other bleeding disorders.
Highmark will use SoleMetrics — Soleo Health’s proprietary, evidence-based, data-driven clinical outcomes program, which is designed to enhance the care of those with complex or chronic conditions such as hemophilia. The interdisciplinary program provides customized detail reporting by patient therapy, disease state, physician, payor, pharmaceutical manufacturer, and accountable care organization. The insurer can use the program’s hemophilia-specific data to gauge clinical and economic value to Highmark, providers, and patients.
“Soleo Health was selected as a preferred provider partner to manage our hemophilia patients, based on the exemplary care it delivers as well as its extraordinary outcomes and data capabilities,” Sean Burke, manager, Highmark specialty pharmacy services, said in a press release. “Highmark wanted to develop a program that delivered exceptional value-based care to our patients, and recognized the best way to do this was to partner with physician specialists and infusion providers.”
Burke said Highmark sought to link members with providers experienced in hemophilia management.
“Our priority lies in taking a highly personalized and therapeutic focused approach to providing superior patient management and clinical care,” said Drew Walk, Soleo Health’s CEO. “We continue to garner preferred relationships with payors and health systems as well as pharmaceutical manufacturers based on our clinical expertise and distinctive, real-world evidence data reporting.”
“We are positively affecting the quality of care we bring the patients, payors, and providers with whom we care for and work,” Walk added.
According to the Centers for Disease Control and Prevention, hemophilia occurs in about one of every 5,000 male births.