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Highmark posts operating gain of $ 490m in 2020 – better than before pandemic




When covid-19 hit western Pennsylvania last March, Highmark Health CEO and Chairman David Holmberg said he and his colleagues were bracing for the worst.

They didn’t know how overwhelmed their suppliers could be, or how much money and other resources it would take to keep operations going as epidemics proliferated.

A year after the start of the pandemic, however, Holmberg says Highmark Health maintains a strong financial position and remains poised for growth.

The non-profit system reported total 2020 revenue of $ 18 billion on Monday, including an operating gain of $ 490 million – more than double the gain of $ 241 million reported in 2019.

“We have been curled up for a brutal year, and certainly from a clinical point of view there have been extraordinary successes and extraordinary losses, but we are pleased with the overall financial performance of the organization,” said Holmberg . “Highmark was designed to withstand a pandemic.”

Increase in patient volume, decrease in covid cases

After dropping 50% in March and April, when elective procedures were postponed, patient volumes have returned to near pre-pandemic levels in recent weeks.

At its peak in early December, Highmark’s Allegheny Health Network facilities were treating more than 395 people with coronavirus disease – nearly 100 of whom were in intensive care unit beds. This week, the 13-hospital system’s covid patient count stands at 68.

The network has treated more than 5,600 hospitalized covid-19 patients and 650 patients have died of the disease at AHN facilities.

Highmark continued with major construction projects last year, including four new mini-hospitals in Harmar, Hempfield, Brentwood and McCandless. In June, he inked a affiliation with HealthNow New York Inc., which, upon regulatory approval, will add approximately 1 million New York members to the insurance role.

Holmberg credits Highmark’s diverse business branches – including its insurance enrollment as well as its investments in dental care, medical technology and stop loss coverage – for stabilizing the organization’s financial results amid so much of uncertainty.

Insurance gains offset hospital slowdowns

Like UPMC, a Pittsburgh-based competitor, Highmark controls both providers and insurers. The setup aims to align incentives and allows organizations to offset losses on the hospital side with gains on the insurance side; when people receive less treatment, insurers have to make fewer payments.

After three years in the dark, Highmark’s provider arm, Allegheny Health Network, reported an operating loss of $ 136 million, a decrease of $ 180 million from 2019. AHN has more than 2,500 physicians in its hospitals and outpatient, outpatient and health and well-being centers across the Region.

Hospitals in the system saw sharp declines in the spring, with appointments resuming in the second half of the year and in recent weeks. At the end of 2020, the AHN reported an overall drop of 9% in inpatient discharges and observations, a 7% drop in physician visits, and a 2% drop in outpatient enrollments.

But during the same period, Highmark Health Plan reported an operating gain of $ 400 million.

Highmark’s insurance listings have grown to over 5.6 million members and the organization has a retention rate of 95% in western Pennsylvania. Business plans dipped slightly amid layoffs during the pandemic, but gained momentum, officials said. The same goes for Medicare and Medicaid memberships not only in this region, but also in West Virginia and Delaware.

“We are very fortunate that Highmark Health is a national company and that we have several companies in different segments. We are able to take these resources and success and bring it back to the four states in which we operate, ”said Holmberg.

“Telehealth is here to stay”

More than 500,000 telehealth appointments were scheduled in the Allegheny Health Network last year – a 5,000% increase from 2019, Highmark reports.

“Telehealth is here to stay,” said Holmberg.

The network has waived many copay and shared or additional costs associated with telehealth appointments at least this summer.

Even as vaccinations ramp up and covid becomes less of a threat to public health, officials expect virtual dates to continue to be part of the new normal, a major change in the industry. . Goals include the expansion of virtual appointments offered by specialist care providers.

“We were forced to do this last year and luckily it has worked very well for patients and providers. Providers have embraced it, ”said Cynthia Hundorfean, CEO and President of Allegheny Health Network.

Highmark’s net assets now stand at $ 9 billion, up from $ 7.6 billion in 2019.

Natasha Lindstrom is the editor of Tribune-Review. You can contact Natasha at 412-380-8514, [email protected] or via Twitter .

Allegheny | Health | Local | Best Stories

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