Highlights: Highmark Health Plans

As the fifth largest overall Blue Cross Blue Shield-affiliated organization, Highmark Inc. and its Blue-branded affiliates proudly cover the insurance needs of approximately 7 million members in Pennsylvania, Delaware, New York and West Virginia. Its diversified businesses serve group customer and individual needs across the U.S. through dental insurance and other related businesses.

In 2022, Highmark Inc. and its affiliate health plans:

• Helped keep patients healthier and generated nearly $700 million in health cost savings through its signature True Performance value-based program.
• Improved prescription drug affordability and accessibility, including by partnering with other leading Blue Cross Blue Shield organizations to lower the cost of generic prescription medications.
• Marked the five-year milestone in a joint venture with Penn State Health. Through the joint venture, Highmark and Penn State Health have created and expanded health care access points throughout central Pennsylvania; partnered with private practice clinicians to improve patients’ health outcomes and lower costs; worked with community-based organizations to combat COVID-19 and improve health equity; invested in leading-edge cancer research; and launched novel health insurance products.

Highmark Health Plans proudly serve more than 345,000 seniors through Medicare Advantage plans. Each year, the Centers for Medicare and Medicaid Services (CMS) evaluates the quality of MA plans using a 1- to 5-star rating scale, taking into account factors such as keeping members healthy and up to date on preventive care measures, managing chronic health conditions, member responsiveness, handling problems and complaints, and customer service. Seniors in Pennsylvania, West Virginia and New York all had the option of choosing Highmark insurance plans that achieved a five-star rating — the highest possible quality score.

Through the work of Highmark Wholecare, Highmark Health Plans' federal-program footprint in Pennsylvania extends beyond Medicare Advantage to include traditional Medicaid and individuals who are dually eligible for Medicare and Medicaid. Total year-over-year membership grew by more than 55,000 in 2022 to nearly 376,000 members. With its 4-star plans, Highmark Wholecare focuses on whole-person wellness with a special dedication to social determinants of health, which are factors like housing, nutrition, transportation, and financial stability that collectively influence up to 80% of a person’s health outcomes. Highmark Health Options, a Delaware Medicaid managed care program, helps more than 164,000 members get the care and services they need to live healthier and more independent lives. In addition, Highmark Western New York provides Medicaid enrollment to 58,000 members in the 8 counties of western New York.

With innovative products and lower costs, the Highmark Health Plans have expanded their Affordable Care Act membership to more than 171,000 members — growing total ACA membership by 65% over the past three years. A signature ACA offering in western Pennsylvania, Together Blue, connects the world-class care of Allegheny Health Network (AHN) with an innovative service and experience model from the health plan.

Highmark Healthy Kids, a CHIP program, serves nearly 16,000 children and continues the organization's legacy of putting kids, families and communities first. When the steel industry collapsed in the 1980s, the company partnered with stakeholders from across Pennsylvania to create a program ensuring that all children, regardless of their family's financial status, have quality health coverage. The program went statewide, and then became a model for the national CHIP program.

With a commitment to put customers first, Highmark, Inc. earned a Brand Excellence Award from the national Blue Cross Blue Shield Association (BCBSA). The annual Brand Excellence Awards honor Blue Cross and Blue Shield plans and are given in recognition of the efforts of Blue Cross Blue Shield plans in building brand strength and providing superior customer service, solid financial performance, and enrollment growth.

Collectively, Highmark Health Plans now proudly serve more than one million customers through federal health insurance programs. With more than 80 years of experience serving members and locally based customer service teams across the region, Highmark remains a trusted name in health care.