- The health plan reported an operating gain of $750 million for 2017, an increase of $508 million over the previous year.
- HM Health Solutions added five new health plan partners onto its Enterprise Health Solution platform.
The integrated provider and payer network of Highmark Health in Pittsburgh, Pennsylvania on Tuesday reported net income of $1.1 billion in 2017, an increase of a billion over the previous year.
The pre-tax $1.1 billion was driven by strong results in the system’s health plan of commercial and government business, its provider Allegheny Health Network and the sale of a portion of the vision business.
The health plan reported an operating gain of $750 million for 2017, an increase of $508 million over the previous year.
Much of this was due to strong performance in the system’s Affordable Care Act business, which reported income for the first time in 2017.
“2017 was a watershed year for Highmark Health’s financial performance, as we were able to sustain the solid performance that we reported at mid-year, driven by strong overall results in the Health Plan’s government and commercial books of business, including a substantial turnaround in the ACA business,” said CFO and Executive Vice President Karen Hanlon.
The health plan has 4.6 million members in its core markets of Pennsylvania, West Virginia and Delaware. Highmark has a 35 percent market share of Medicare Advantage members in western Pennsylvania.
Highmark Health’s HM Insurance Group reported an operating loss of $30 million, as the stop loss and managed care reinsurance industries continue to face headwinds, the company said.
Due to a decision to have more sustainable product offerings in its health plan, Highmark’s operating revenues remained relatively flat year-over-year at $18.3 billion. This was offset by growth in the provider Allegheny Health Network and in HM Health Solutions.
HM Health Solutions added five new health plan partners onto its Enterprise Health Solution platform, including Blue Cross Blue Shield of North Dakota and Blue Cross Blue Shield of Wyoming and it completed the development of the platform to expand its services to include Medicaid plans.
Allegheny Health Network grew by $217 million or nearly 8 percent over the prior year, driven by stable hospital volumes and high patient retention, greater operational efficiencies and more effective business and clinical processes such as revenue cycle operations and better coordination through Epic, Highmark said.
Physician office visits increased by more than 4 percent and ambulatory surgery center volume increased by 10 percent. Inpatient and outpatient volumes remained flat.
“We delivered a capital level of $6.5 billion in 2017, confirming that our strategy is working and that consumers are benefiting from increased access to high-quality, community-based, affordable health care,” said CEO and President David Holmberg.
Date: March 20, 2018