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Medicare Advantage Member and Provider Programs

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Medicare Advantage Primary Care Incentive Program

The Highmark Medicare Advantage Primary Care Incentive Program recognizes and financially rewards Primary Care Physicians (PCPs) who work collaboratively with Highmark to improve quality for Medicare Advantage members.

Provider Programs and Materials

In addition to timely and actionable data reporting from Highmark, this section includes many helpful guides to assist our network providers and to help provide guidance for participation in Highmark’s Value Based Reimbursement programs.

General References & Resources

The links below apply to many resources that are available to assist providers with other pertinent information that may be reflected in Highmark’s Value Based Reimbursement Programs.

Last updated on 9/15/2023 3:38:05 PM

 

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Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.