$27.1 billion operating revenue in 2023
In 2023, Highmark Health and its subsidiaries and affiliates made capital investments of more than $825 million to advance the mission of creating a remarkable health experience, freeing people to be their best.
An independent licensee of the Blue Cross Blue Shield Association, Highmark Inc., together with its Blue-branded affiliates, collectively comprise the fifth largest overall Blue Cross Blue Shield-affiliated organization in the country with approximately 7 million members in Pennsylvania, Delaware, West Virginia and western and northeastern New York.
Star ratings for Highmark and its affiliated health plans: For 2023, Community Blue, Security Blue, and Together Blue Health Maintenance Organization (HMO) plans in Pennsylvania achieved the highest possible quality rating from CMS for the third year in a row, 5 out of 5 Stars. In West Virginia, Highmark’s Freedom Blue plans received 4.5 out of 5 Stars. In western and northeastern New York, Highmark’s HMO and PPO plans all scored 4 out of 5 Stars despite facing numerous member and provider experience disruptions as part of migrating the Medicare Advantage business from HealthNow to the Highmark platform for 2023 coverage. In Delaware, Highmark’s new Medicare Advantage Freedom Blue PPO plans were scored for the first time by CMS and received a very respectable 4 out of 5 stars. Historical industry Star results indicate that it is very difficult for new, small plans to achieve a 4-Star rating in their first year.
As of January 2024, Highmark Health Plans had 376,000 Medicare Advantage members across Pennsylvania, West Virginia, Delaware and parts of New York, an increase of 31,000 members year over year.
As of February 2024, Highmark Health Plans have 205,000 Affordable Care Act members, an increase of nearly 40,000 members year over year.
The Health Plans are supported by more than 168,000 in-network physicians; in 2023, the Health Plans processed more than 220 million claims on behalf of customers.
AHN Forbes Hospital unveiled the new PNC Healthy Food Garden, which provides fresh produce for patients facing food insecurity in eastern suburbs of Pittsburgh.
AHN and the Humane Animal Rescue of Pittsburgh launched the "Humane Health Coalition" mobile clinic and its new M.O.V.E.S (Medical – Outreach – Veterinary – Essential – Support) vehicle, which is thought to be the first mobile clinic in the U.S. that cares for pets and people together in the same venue.
In 2023, AHN's no-cost cancer screenings evaluated almost 1,000 patients at locations across western Pennsylvania a 61% increase in participants from 2022.
2023 enterprise giving total: Highmark Health and its affiliates and subsidiaries totaled nearly $50 million in corporate and foundation giving in Pennsylvania, Delaware, West Virginia and New York.
Highmark Inc. and its Blue-branded affiliates provided more than $20 million in grants and sponsorships. Additionally, Highmark Health contributed more than $6 million in corporate giving through its non-Blue-branded affiliates and subsidiaries.
The Highmark Foundation, its restricted funds, the Caring Foundation and Delaware BluePrints for the Community committed nearly $23 million in funding to support community health, grieving children and other initiatives.
enGen serviced more than 11 million members of separate health plans via the Enterprise Health Solution.
enGen supports all lines of health care business: national, large/small group, individual, ACA, Medicaid and Medicare Advantage.
Over 90% of home health agencies in the networks Helion serves are in a value-based arrangement.
Approximately 87% of home health episodes and 80% of skilled nursing facility episodes are driven to high-performing networks.
Earned annual gross revenues of about $1.2 billion
Insured more than 1,500 self-funded plans
Paid more than $825 million in claims in 2023
United Concordia Dental's network includes over 132,000 unique dentists across more than 461,000 access points. The dental solutions partner has more than 10 million members and over 21,300 commercial clients.
United Concordia Dental works collaboratively with 16 Blues partners in 27 service areas and 10 national insurance carriers, providing a wide variety of dental solutions from network leasing to Third Party Administrator (TPA) services, etc.
In 2023, United Concordia Dental and its charitable fund supported more than 100 community-based organizations and committed over $2.1 million in funding to help improve the oral and overall health needs of people and communities across the country.