We would like to educate you on the new national Blue High Performance Network (HPN) utilizing the Nevada Pathway HMO Network to support new product offerings available to starting in January 20201.  These Blue High Performance Network plan offerings will only be available for Pathway HMO Providers.

 

What is Blue High Performance Network (HPN)?

  • The Blue High Performance Network is part of a cost and quality solution. It is a tailored network of providers aimed at reducing quality variation and improving cost savings. 
  • Blue High Performance Network is part of a Blue Cross and Blue Shield Association (BCBSA) mandate (supported by Anthem) to develop a national network solution aimed at achieving improved cost savings and providing access to high performing providers. ​
  • Blue High Performance Network is a next evolution of Anthem’s network strategy that mobilizes every player in healthcare to champion the best in careexperiencesand cost. ​
  • On the local side, we are pairing our local high performance network, Pathway HMO, with a medical product and digital product capabilities to create a holistic offering that would empower consumers to make informed healthcare decisions and drive a differentiated member experience.​
  • Blue High Performance Network is a national network designed from our local market expertise, deep data and strong provider relationships. These local networks (e.g. Pathway HMO) are then connected to the national chassis to form a national Blue High Performance Network.
  • Blue High Performance Network includes in-network coverage from all participating Pathway HMO providers. The only coverage available outside of a Pathway HMO Blue High Performance Network service area is for urgent or emergency care. Otherwise, there is no coverage for services received outside of a high performance network service area or from non-high performing network providers.

 

The reimbursement rates for the Blue High Performance Network will be the same as the Pathway HMO reimbursement rates. 

 

Blue High Performance Network

 

Beginning January 1, 2021 Anthem Blue Cross and Blue Shield will launch Blue High Performance Network in Nevada. Blue High Performance Network is a national network available in over 54 markets across the country. This network will be used to support some Anthem fully insured health benefits plans as well as certain self-funded plans.

 

Note: the local market is referenced as Pathway HMO; and the National market is referenced as Blue High Performance Network.

 

Pathway HMO Member ID Cards

 

Pathway HMO members will be issued a new ID card to identify and access Blue High Performance Network providers.  Virtual ID cards will also be available to members through the Sydney Health and Engage Wellbeing apps.

 

All Blue High Performance Network plan ID cards will reflect Blue High Performance Network (HPN) in a suitcase on the front of the card and a disclaimer on the back of the ID card that reads “Services rendered by a non- Blue High Performance Network provider will be limited to Urgent and Emergent care”. 

 

Identifying Blue High Performance Network members accessing the Pathway HMO Network:

Three-Character Prefix

Suitcase Logo

Health Benefit Plan Option

Product Type

Network Name (On member ID cards)

H8N

HPN in suitcase

Nevada enrollee in Blue HPN

HMO

Pathway HMO

Varies*

HPN in suitcase

Out-of-state enrollee in Blue HPN

PPO/EPO

Network name on ID card will vary, but when accessing care in Nevada, members will utilize Pathway HMO

 

Blue High Performance Network sample member ID card

 

Blue High Performance Network members will be identified by an HPN in the suitcase logo on their member ID card.​


 

Note: The High Performance Network acronym HPN is not used in conjunction or affiliated with any other local organizations known by the same acronym.

 

Virtual ID Cards through the Sydney Mobile app

 

We are excited about collaborating with our Nevada Pathway HMO providers to keep health care affordable. If you have any questions about this network please feel free to contact Network Relations at nvproviderrelations@anthem.com

 

 

932-0121-PN-NV

 

 



Featured In:
January 2021 Anthem Provider News and Important Updates -- Nevada