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From Our Chair and Our Chief Executive Officer

Welcome to Our 2023 Annual Report

Joseph C. Guyaux and David L. Holmberg

Joseph C. Guyaux, Chair, Board of Directors, Highmark Health

David L. Holmberg, President & Chief Executive Officer, Highmark Health

Our 2023 financial overview tells a story of strong financial performance across a diversified business model that supports ongoing growth and innovation. We saw 5% growth in annual revenue to $27.1 billion, net income of $533 million, and an operating margin of $338 million.

However, our financial strength takes on more significant meaning in what it enables us to do for the people and communities we serve. In 2023, we invested more than $825 million in the solutions, technology and facilities that are transforming the health experience for our consumers and customers. We also provided more than $225 million in community support, including charity care, uncompensated care, and nearly $50 million in enterprise-wide corporate and foundation giving. Highmark Bright Blue Futures, the unifying program for much of our corporate giving, brings the impact of those community investments to life in our annual Community Report. And you will find stories of how our businesses invest in making every day better throughout this annual report.

Investing in better health and stronger communities

2023 completed a decade of organizational transformation since we stood up Allegheny Health Network and formed Highmark Health as an enterprise to strategically align our health insurance, provider, and diversified businesses. By all measures, our business model has demonstrated strength and resilience. During the decade, Highmark Health's annual revenue grew 72%, AHN's annual revenue more than doubled, and Highmark's health plan membership rose 32%.

As a purpose-driven nonprofit, growth alone is not enough. Our measure of success always comes back to how we are improving health — including economic health — for the people and communities we serve.

That is true across our four-state health insurance footprint and for a nationwide customer base. But our story in western Pennsylvania bears special mention. In 2013, our financial strength enabled us to take on what others considered too daunting. We stepped up to save struggling community hospitals and providers, and thousands of jobs, and we created AHN, an economically viable regional health system that gives people access to high-quality care closer to where they live.

Since 2013, we have invested more than $3 billion in AHN. That investment has helped make our Living Health model in western Pennsylvania one of the nation's leading examples of payer-provider integration. But to gauge return on investment, also consider the value provided to the region: new hospitals, health and wellness pavilions, facilities, medical technology, and programs that offer exceptional access, choice and value for health and care. AHN’s outstanding patient experience, quality, and safety have earned recognition from Press Ganey and others.

On the health plan side, that investment in closer payer-provider collaboration and better integration of health, coverage and care has delivered high member satisfaction, better care coordination, and operational efficiency. Comparing multi-year data, we also see evidence that our model can bend the cost curve. For example, Highmark's cost trends for commercial and Medicare Advantage members have been several percentage points lower in western Pennsylvania than in other markets.

Our legacy of investing to benefit our communities goes back 80 years with some of our regional Blues plans, and 175 years in the case of AHN West Penn Hospital. The corporate giving mentioned at the start of this letter is just part of that legacy. Our organization's purpose, and investments, are about improving people's health — and healthier communities are stronger communities.

We also contribute to economic health in our communities as an employer of more than 44,000 people across multiple businesses. A 2021 economic impact study conservatively estimated that Highmark Health and its subsidiaries and affiliates contribute at least $20.6 billion annually to the national economy, including our core business regions in Pennsylvania, West Virginia, Delaware, and western and northeastern New York.

Every day better: Continuing to invest, innovate, and improve

Our theme — every day better — evokes the continuous improvement mindset that exists throughout our enterprise. Every day we look for opportunities to improve our operations, increase the value we deliver to customers, and take on the hard challenges and good work that will drive positive change for the people and communities we serve. We remain confident that, despite economic and other challenges, our fundamental financial strength and stability will allow us to continue that work for years to come.

Similarly, to fulfil our vision of a world where everyone embraces health, we will continue to focus on giving people the resources and opportunities to make every day better for themselves, their families, and their communities. Working together with providers, technology collaborators and community organizations, we strive to do that for everyone we serve, in every interaction, every day.


"As a purpose-driven nonprofit, growth alone is not enough. Our measure of success always comes back to how we are improving health — including economic health — for the people and communities we serve."

Financial Results

Highmark Health's strong financial performance in 2023, including revenue of $27.1 billion and net income of $533 million, enabled the organization to continue investing in its Living Health model and transformation strategy. In addition to more than $825 million in capital investments, the organization provided more than $225 million in enterprise-wide community support, including corporate giving, charity, and uncompensated care.