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Highlights: Highmark Health Plans

Highmark Health Plans titlebar

One of America's leading health insurance organizations and an independent licensee of the Blue Cross Blue Shield Association, Highmark Inc. (the Health Plan) and its affiliated health plans (collectively, the Health Plans) work passionately to deliver high-quality, accessible, understandable, and affordable experiences, outcomes, and solutions to customers.

As the fourth-largest overall Blue Cross Blue Shield-affiliated organization, Highmark Inc. and its Blue-branded affiliates proudly cover the insurance needs of approximately 6.8 million members in Pennsylvania, Delaware, and West Virginia, along with western and northeastern New York. Its diversified businesses serve group customer and individual needs across the U.S. through dental insurance and other related businesses.

Sitting at the diner

Highmark Inc. is committed to creating the Living Health model, an innovative system of health, coverage, and care that will deliver a simpler, more personalized, and proactive health experience for members. Growth is essential to building Living Health, and in 2021 Highmark Inc. grew in a variety of ways, from organic growth in membership, to strategic affiliations, to provider partnerships and joint ventures, to digital solutions.

Highlights include:

  • Completed its affiliation with HealthNow, adding nearly one million new members in western and northeastern New York.
  • Significantly expanded access to high-quality, community-based care in central Pennsylvania, including opening two new hospitals with Penn State Health.
  • Acquired full ownership of Gateway Health (now Highmark Wholecare), a leading managed care organization Highmark co-founded with more than 355,000 Medicaid and Medicare members across Pennsylvania.
  • Worked with other leading Blues organizations to tackle prescription drug costs and accessibility, through the CivicaScript and Evio pharmacy initiatives.

CATE mobile unit

Highmark partnered with Latino Connection mobile unit to help educate and vaccinate people across Pennsylvania. Kathy McKenzie, vice president of community affairs for Highmark Blue Shield, speaks at the one-year anniversary event. More than 8,000 people have been vaccinated against COVID-19 through these efforts.

Throughout 2021, and as the pandemic continued, Highmark Health Plans worked with many partners to ensure that vulnerable populations were being vaccinated and made aware that they should not be hesitant about getting the vaccine.

One example is the CATE mobile unit initiative in Pennsylvania, which has administered more than 8,000 COVID-19 vaccinations and 5,000 COVID-19 tests, and has reached more than 20,000 people across the commonwealth, especially in areas where access to resources and education were not readily available.

The Health Plans also joined with other Blue Plans for the Rally for Recovery Commitment to protect employees, encourage COVID-19 vaccinations, and educate staff and local communities on ways to mitigate the spread of the virus. The pledge was launched in March 2021 by the federal government and business leaders to encourage companies to take action to defeat the coronavirus.

The Health Plans also maintained the historic commitment to improve the quality of life in the communities they serve throughout the pandemic. In 2021, the Health Plans' corporate giving benefited hundreds of organizations, donating nearly $16 million in western, central, and northeastern Pennsylvania, West Virginia, and Delaware, as well as more than $7 million in western and northeastern New York. A signature program, Highmark Walk for a Healthy Community, was once again virtual in 2021 and raised more than $813,000 for 249 organizations. In addition, a company-wide virtual holiday program helped provide gifts to over 1,100 children, seniors, and veterans across the organization's communities.

Successful growth strategy translates to lower costs, better care [PDF]

Other Highlights

An independent licensee of the Blue Cross Blue Shield Association, Highmark Inc., together with its Blue-branded affiliates, collectively comprise the fourth-largest overall Blue Cross Blue Shield-affiliated organization in the country with approximately 6.8 million members in Pennsylvania, Delaware, West Virginia, and western and northeastern New York.

Star ratings for Highmark and its affiliated health plans: For 2022, Community Blue, Complete Blue, Freedom Blue and Security Blue Medicare Advantage plans in Pennsylvania, and Medicare Advantage PPO plans in western and northeastern New York, achieved the highest possible quality rating from the Centers for Medicare and Medicaid Services: 5 Stars. Medicare Advantage plans in West Virginia and New York Medicare Advantage HMO plans achieved ratings of 4.5 stars.

As of January 2022, Highmark Health Plans had more than 320,000 Medicare Advantage members across Pennsylvania, West Virginia, Delaware, and parts of New York.

With innovative products and lower costs, Highmark has expanded its Affordable Care Act membership to more than 140,000 members — nearly doubling its total ACA membership over the past three years.

The Health Plans are supported by more than 145,000 in-network physicians; in 2021, the Health Plans processed more than 149 million claims on behalf of customers.

Spotlight: Membership Growth

Through affiliation and acquisition, Highmark Inc. added nearly one million new members in western and northeastern New York, and another 355,000 Medicaid and Medicare members in Pennsylvania.