Highmark Explained

Highmark Inc.
Type:Non-profit
Foundation:June 22, 1977 https://www.corporations.state.pa.us/corp/soskb/Corp.asp?428808
Location:Fifth Avenue Place
Pittsburgh, Pennsylvania
Key People:Deborah L. Rice-Johnson, President
Num Employees:40,000+ (2017)[1]
Revenue:$18.2 billion USD (2016)[2]
Industry:Healthcare, Insurance
Products:Health insurance
Homepage:www.highmark.com

Highmark is an American non-profit healthcare company and Integrated Delivery Network based in Pittsburgh, Pennsylvania, United States. It is a large individual not-for-profit health insurer in the United States, which operates several for-profit subsidiaries.

Locality

It is a health insurer in Pennsylvania, and through a purchase in 1996, an insurer in West Virginia and also later Delaware. As Highmark Blue Cross Blue Shield, it is primarily available in 29 counties of western Pennsylvania. As Highmark Blue Shield, it is available in 21 counties in Central Pennsylvania and the Lehigh Valley. It also has a presence in the border areas of eastern Ohio, and all of West Virginia through its subsidiary, Highmark Blue Cross Blue Shield West Virginia.

Highmark acquired Blue Cross of Northeastern Pennsylvania, BCNEPA, in June 2015.[3] [4]

Company history

Highmark was created in 1977 and in the 1990s by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) based in suburban Harrisburg, and Blue Cross of Western Pennsylvania based in downtown Pittsburgh (now Highmark Blue Cross/Blue Shield). The consolidated group is available in 62 of the state's 67 counties.[3] In West Virginia, the company operates as Highmark Blue Cross Blue Shield West Virginia, and in Delaware, it operates as Highmark Blue Cross Blue Shield Delaware. The new company based its head offices in downtown Pittsburgh.

On March 28, 2007, Highmark announced it intended to consolidate with Independence Blue Cross of Philadelphia. The combination of the 2 insurers would have created a new company with over 18,000 employees, dual-headquarters in both Pittsburgh and Philadelphia and an economic impact of over $4 billion throughout the Commonwealth of Pennsylvania. On January 22, 2009, Highmark and Independence Blue Cross withdrew their applications to consolidate due to the unacceptability of conditions that the Pennsylvania Insurance Department was going to place upon the merger: to give up either of their well-known "Blue Cross" or "Blue Shield" trademarks.[5]

In 2011 the company announced it would buy the financially troubled West Penn Allegheny Health System (WPAHS) for about $500 million, expanding from insurance into owning hospitals.[6] This began a period of conflict between Highmark and UPMC, which had expanded from hospitals into insurance, and caused difficulties for patients to access care at the conflicting institutions.[7] The conflict included a lawsuit by Highmark against UPMC alleging that UPMC over-billed it by $300 million for cancer drugs,[8] [9] arbitrators ordered Highmark to pay $188 million.[10] [11]

In 2014, a gay couple criticized Highmark for not providing family coverage to same-sex couples under the Affordable Care Act.[12] Highmark later reversed their policy.[13]

In January 2020, the company earned distinction as "Best Place to Work for LGBTQ Equality" from the Human Rights Campaign Foundation, receiving a perfect score of 100 points in the national Corporate Equality Index.[14]

In 2021, Highmark acquired HealthNow, which operated BlueCross BlueShield in Western New York and Northeastern New York.[15]

On March 29, 2021, the Buffalo Bills football team announced that their stadium’s new name would be Highmark Stadium after reaching a 10-year agreement with Highmark Blue Cross Blue Shield of Western New York. [16]

Highmark's mission is to revolutionize healthcare by embracing disruption and evolving for the future.[17]

Organizational structure

Highmark Inc. has several wholly owned for-profit subsidiaries: United Concordia Companies, Inc., a dental insurer; Davis Vision, a provider of managed care vision benefits; Visionworks of America, a vision retail provider offering frames, lens and accessories; and HM Insurance Group, a reinsurer providing stop-loss, limited benefit medical plans, worksite, life, disability, and administrative services. Highmark Inc. sold Visionworks of America to VSP Global in 2019.

External links

Notes and References

  1. Web site: Archived copy. 2019-04-18. 2022-01-19. https://web.archive.org/web/20220119135004/https://www.highmarkhealth.org/hmk/pdf/2017HHFactSheet.pdf. dead.
  2. Web site: Highmark Health reports $18.2 billion in 2016 revenue - Pittsburgh Business Times . 2017-11-04 . live . https://web.archive.org/web/20170614180758/http://www.bizjournals.com/pittsburgh/news/2017/03/17/highmark-health-reports-18-2-billion-in-2016.html . 2017-06-14 .
  3. Web site: Blue Cross of Northeastern Pennsylvania and Highmark Inc. sign definitive merger agreement . CBS MarketWatch . 26 November 2019 . 18 February 2014.
  4. https://www.thetimes-tribune.com/news/business/highmark-blue-cross-of-nepa-deal-complete-1.1891416 The Scranton Times-Tribune, 2 June 2015
  5. News: Bill Toland. Health giants halt merger. 18 December 2014. Pittsburgh Post-Gazette. PG Publishing Co., Inc.. 22 January 2009. live. https://web.archive.org/web/20141224153348/http://www.post-gazette.com/business/businessnews/2009/01/22/Health-giants-halt-merger/stories/200901220298. 24 December 2014.
  6. News: Insurer's Cost-Cut Plan: Buy Hospitals. Mathews. Anna Wilde. 2011-06-29. Wall Street Journal. 2018-04-17. en-US. 0099-9660. live. https://web.archive.org/web/20180418092808/https://www.wsj.com/articles/SB10001424052702303627104576413580875856442. 2018-04-18.
  7. News: Two visions for the future of health care are at war in Pittsburgh. Johnson. Carolyn Y.. 2018-02-13. Washington Post. 2018-04-17. en-US. 0190-8286. live. https://web.archive.org/web/20180418161108/https://www.washingtonpost.com/business/economy/two-visions-for-the-future-of-health-care-are-at-war-in-pittsburgh/2018/02/13/d987433c-0157-11e8-9d31-d72cf78dbeee_story.html. 2018-04-18.
  8. News: Highmark sues UPMC for cancer treatment 'overbilling'. Pittsburgh Post-Gazette. 2018-04-17. en. live. https://web.archive.org/web/20180418161216/http://www.post-gazette.com/business/2014/09/03/Highmark-sues-UPMC-over-cancer-treatment-overbilling/stories/201409030202. 2018-04-18.
  9. News: Highmark sues UPMC over billing for cancer drugs. 2014-09-04. Washington Examiner. 2018-04-17. en. live. https://web.archive.org/web/20180418161258/https://www.washingtonexaminer.com/highmark-sues-upmc-over-billing-for-cancer-drugs. 2018-04-18.
  10. Web site: Arbitrators side with UPMC; Highmark must pay $188 million for cancer care. Venteicher. Wes. TribLIVE.com. en-US. 2018-04-17. live. https://web.archive.org/web/20180418161353/http://triblive.com/news/adminpage/9415408-74/upmc-highmark-panel. 2018-04-18.
  11. News: Elijah . Willie . Genialsante . 21 November 2023 . Holistic health.
  12. News: Some States Deny Same-Sex Couples Family Insurance. NPR.org. 2018-04-17. en. live. https://web.archive.org/web/20180418093134/https://www.npr.org/sections/health-shots/2014/02/11/275260366/despite-federal-rules-some-states-deny-family-policies-for-same-sex-couples. 2018-04-18.
  13. News: Highmark to insure same-sex couples in Pennsylvania. Pittsburgh Post-Gazette. 2018-04-17. en. live. https://web.archive.org/web/20180418161123/http://www.post-gazette.com/news/health/2014/02/25/Highmark-to-insure-same-sex-couples/stories/201402250106. 2018-04-18.
  14. Corporate Equality Index 2O2O. www.hrc.org/cei.
  15. Web site: Highmark finalizes deal with New York-based health plans, forming nation's 4th largest Blues plan . 2 March 2021 .
  16. Web site: Buffalo Bills' stadium to be named 'Highmark Stadium' after deal with health insurer . WBFO . 20 August 2022 . en . 31 March 2021 .
  17. Web site: Ratanjee . Vibhas . 2020-09-14 . How Highmark Health Embraces Disruption and Builds for the Future . 2024-05-18 . Gallup . en.