Narrower exchange losses puts Highmark Health in black in 2016

Highmark Health, a Pittsburgh-based health plan that owns eight-hospital Allegheny Health Network, returned to the black in 2016 after staunching losses that plagued it in 2015.

The Blues-affiliated plan in 2016 narrowed its losses on the Affordable Care Act individual insurance exchanges to $180 million 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 its 2016 fiscal year ended Dec. 31, compared with an operating loss of $565 million in 2015, the company said in a release.

Revenue increased to $18.2 billion in 2016 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, the company said.

Inpatient and outpatient volumes increased in 2016 over 2015, 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. The ACA established risk corridors and two other risk-mitigation programs to help insurers weather the uncertain environment in the first few years of expanded health coverage.

Dave Barkholz

Dave Barkholz is Modern Healthcare’s Southern Bureau Chief stationed in Nashville. He covers hospitals, doctors, suppliers and governance across the Southeast. A winner of numerous national journalism awards, Barkholz started his career at Modern Healthcare in 1984 covering the investor-owned hospital companies. He spent the past 10 years in Detroit at Automotive News, a sister Crain publication.

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