Modern Healthcare

Narrower exchange losses put Highmark Health back in black

- —Dave Barkholz

Highmark Health, a Pittsburgh­based health plan that owns eight-hospital Allegheny Health Network, returned to the black last year after stanching losses that plagued it the year before.

The Blues-affiliated plan in 2016 narrowed its losses on the Afford- able Care Act individual insurance exchanges to $180 million, down 70% compared with exchange losses of $590 million in 2015.

With other operating improvemen­ts across the system, Highmark posted an operating gain of $64 million in 2016, compared with an operating loss of $565 million the prior year. Revenue rose to $18.2 billion last year from $17.7 billion in 2015.

Highmark’s hospital and provider operations, Allegheny Health Network, reported a slightly higher operating loss of $39 million last year compared with $36 million in 2015. The wider losses were largely the result of spending on electronic health record systems and investing in physicians and key support staff.

Inpatient and outpatient volumes also increased in 2016, Highmark noted.

Highmark is suing the federal government to recover money owed under the risk-corridor program for plans sold on the ACA’s insurance exchanges. The lawsuit, filed in the U.S. Court of Federal Claims, argues Highmark is owed at least $223 million in risk-corridor payments.

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