Best Doctors will provide virtual expert second opinions for Highmark members and their physicians dealing with rare or complex medical conditions. While Best Doctors provides access to more than 53,000 physicians in over 450 medical specialties, Highmark is the nation's fourth largest Blue Cross and Blue Shield-affiliated organization.
Data from Best Doctors show that consultation with its experts results in corrected or refined diagnosis in 37 percent of its U.S.-based cases, and corrects or improves treatment in nearly 75 percent of cases.
"Highmark chose to partner with Best Doctors on second opinions because their process is patient-centric and clinically collaborative," Charles DeShazer, M.D., chief medical officer at Highmark, said in a statement. "We like that medical decision-making remains at the local level with the treating physician because this fosters continuity of care."
With the member's permission, their Highmark case manager will collaborate with a case manager at Best Doctors. Together they gather the member's complete medical record to help provide a clearer view of the patient's entire history with the Best Doctors expert. These experts are clinically and academically accomplished, affiliated with national and global centers of excellence, and elected by their peers to the top five percent of U.S. physicians. They then undertake a structured and comprehensive review, devoting many clinical hours to each case, analyzing it from multiple angles in a criterion-based review before preparing their report which is shared with the Highmark member and their doctor.
Highmark members with complex conditions and multiple comorbidities, elusive diagnosis, multiple hospitalizations and ER visits, and facing decision points in care are the best candidates for the program. Best Doctors will be available for Highmark's fully-insured customers as well as to Highmark's Affordable Care Act (ACA) members.
"The uncertainty of not knowing your diagnosis or receiving an incorrect one comes with a tremendous physical, emotional, and financial toll," Peter McClennen, CEO of Best Doctors, said in a statement. "This partnership between Highmark and Best Doctors represents an opportunity to reverse that negative impact and bring peace of mind to many patients simply looking for the right answers."