Highmark's revenue up $500M in 2018 even as insurance business sees decline 

Pittsburgh
Pittsburgh-based Highmark Health issued its 2018 financial report on Tuesday. (Getty/Joecho-16)

Pittsburgh-based Highmark Health reported a more than $500 million in topline growth in 2018, reaching nearly $18.8 billion in revenues last year, according to its latest financial report. 

However, net incomes declined by about the same figure during that window, dropping from just over $1 billion in 2017 to $570 million last year, according to the earnings report

That's largely due to Highmark’s government insurance business—its Affordable Care Act, Medicare Advantage, Medicaid and small group plans—which decreased by $126 million from 2017, and commercial plans, which declined by $114 million. Membership was stable in 2018, Highmark said, with 4.5 million members across its plans in Pennsylvania alone. 

Conference

13th Partnering with ACOS & IDNS Summit

This two-day summit taking place on June 10–11, 2019, offers a unique opportunity to have invaluable face-to-face time with key executives from various ACOs and IDNs from the entire nation – totaling over 3.5 million patients served in 2018. Exclusively at this summit, attendees are provided with inside information and data from case studies on how to structure an ACO/IDN pitch, allowing them to gain the tools to position their organization as a “strategic partner” to ACOs and IDNs, rather than a merely a “vendor.”

Highmark also reported a more stable risk pool in its ACA plans, according to the report. Highmark said that it had 105,000 members enrolled in its ACA plans, 70% of which enrolled on the exchanges and 30% were off-exchange enrollees. 

The major bright spot on Highmark’s earnings is its provider arm, Allegheny Health Network, which posted $39 million in operating revenue, an increase of $10 million from 2017. AHN also saw 11% boost in visits to ambulatory surgical centers in 2018. 

RELATED: Penn State Health, Highmark Health sign $1B value-based care network 

“We believe it provides yet another proof of point that our strategy is working,” CEO David Holmberg said on a call with reporters on Tuesday. 

Holmberg declined to comment directly on the politics of a recent Trump administration letter calling for a federal appeals court to affirm a lower ruling that struck down the ACA, but said that Highmark is prepared for “twists and turns” as the court case plays out. 

“We’re prepared to play the hand we’ve been dealt,” Holmberg said. 

Also on the call, Holmberg weighed in on the ongoing legal battle between Pennsylvania Attorney General Josh Shapiro and Highmark’s rival the University of Pittsburgh Medical Center. He reaffirmed Highmark’s support for the AG’s requested modifications to the consent decree between the two integrated health networks. 

RELATED: Highmark, Geisinger create joint venture community-based clinical network 

The spat between UPMC and Highmark has continued for the better part of the last decade and began in earnest when Highmark acquired what is now Allegheny Health System in 2011. The state sought to mitigate the dispute with a consent decree, but that agreement is set to expire this summer. 

The AG sued UPMC after it declined to agree to its modified extension to the consent decree, launching a back-and-forth volley of court filings on both sides

The attorney general’s lawsuit aligns with Highmark’s pro-consumer, pro-competition goals, Holmberg said. 

“[Shapiro’s] actions last month affirm what we’ve been seeking for the last 6 years: a level playing field that fosters competition,” he said. 

Suggested Articles

An artificial intelligence tool can help diagnose post-traumatic stress disorder in veterans by analyzing their voices, a new study found.

The country will see a shortage of up to nearly 122,000 physicians by 2032, according to a report from the Association of American Medical Colleges.

Dr. Asaf Bitton has been tapped as the executive director at Ariadne Labs.