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Highmark & VITAL

Highmark & VITAL

Accelerating Innovation That’s Vital to Health and Wellness

While medicine has identified nearly 10,000 diseases, there currently are treatments or cures for only 500 of them. The number of patients waiting for cures is also high –currently one in three Americans live with a debilitating condition ­– but it takes 20–25 years to bring a new therapy to market, let alone to patients.

As a result. healthcare’s challenge is two-fold: how to best accelerate innovation to combat disease while also deploying these new ideas to drive toward a lower overall healthcare cost.

VITAL’s mission at Highmark Health is to the leverage our position as one of the largest integrated healthcare delivery and financing systems in the nation to accelerate the pace with which novel technologies and services are made available to our patients.

In doing so:

  • Members and patients will be afforded access to safe new technologies without undue financial burden.
  • Payers will be able to better understand the full impact of new technologies on their members without changing insurance medical policy prematurely.
  • Providers will gain early access to new technologies and a first-hand understanding of their impact on patients.
  • Technology vendors will have the opportunity to prove the benefits of their new innovations to patients, providers and payers.

 

The VITAL innovation program at Highmark Health is a test bed designed to facilitate early use of technologies that have received regulatory approval.

While these technologies are being used for their intended purpose, within the approved patient population, most commercial insurers typically do not yet cover them. VITAL is designed to provide the missing link between FDA approval of an innovative technology and its full reimbursement.

To support a comprehensive, rigorous and patient-centered approach to innovation, the VITAL innovation program encourages proposals submitted by Allegheny Health Network clinicians in collaboration with external innovators such as:

  • Technology vendors
  • Clinicians from other aligned providers
  • Partners from the not-for-profit sector, government and others.

 

Innovators have the opportunity to describe their ideas in depth to the VITAL Review Board, support them with existing knowledge, identify knowledge gaps, and submit a proposal for a pilot project or a clinical trial seeking to close those gaps.

The VITAL Committee makes a final determination based on a formal, rigorous review to cover the costs of an item or service in the context of an approved project and for the duration of that project.