Thomas Fitzpatrick
Senior Vice President and Commercial Business Segment President
Thomas Fitzpatrick is currently the Commercial Business Segment President for Highmark Inc., the fifth largest overall Blue Cross Blue Shield-affiliated organization in the country with approximately 7 million members in Pennsylvania, Delaware, West Virginia and western and northeastern New York.
He is directly responsible for leading a team of over 450 Sales Professionals and Sales Support staff in PA, DE, WV and NY who are responsible for new sales and business retention for more than 20,000 customers, representing 4.1M members nationwide and a reported operating margin of approximately $400 million.
Mr. Fitzpatrick is responsible for motivating, coaching, setting strategy and providing direction to the staff of professionals who sell, solicit and negotiate products and services to employer groups.
Tom has been at Highmark for 25 years and has served in a number of Leadership roles including Provider Contracting, Broker Relations and Highmark's Third Party Administrative business.
Mr. Fitzpatrick is a graduate of the University of Delaware with a Bachelor of Science Degree in Human Resources.
He is also a graduate of The University of Pennsylvania's Wharton Leadership Development Program, Leadership Pittsburgh and Harvard University’s School of Negotiation.
Prior to this role, Tom served as President, HealthNow Administrative Services and Senior Vice President, Small Group Sales and Joint Administration Solutions for Highmark Inc., a part of Highmark Health. Mr. Fitzpatrick was ultimately responsible for growing membership and maintaining positive operating margin for 3 different blocks of business. The Small Group business segment represents employers with 2-50 employees who are looking for affordability and innovative products & solutions. Joint Administration Solutions was a new venture for Highmark in 2021 and produced over 95,000 members in its first 2 years. HealthNow Administrative Services is a fully functional Third Party Administrator (TPA) with over 130K members and annual revenue of over $22M.
Prior to this position, he was the Senior Vice President of Provider Contracting, Partnerships and Shared Services, where he had responsibility for managing Highmark's Provider Network. Mr. Fitzpatrick was responsible for creating and managing solid working relationships with Highmark's network of providers (hospitals and physicians) and for negotiating the reimbursement rates which Highmark pays to hospitals and physicians in Highmark's service area, which includes Pennsylvania, West Virginia and Delaware. Tom was also responsible for many of the payment transformation initiatives that Highmark continues to implement, including, Highmark's version of the Patient Centered Medical Home, called True Performance. He is also responsible for other value based reimbursement designs, including episodic and bundled payment as well as gain share and risk share models. In this role Mr. Fitzpatrick was responsible for an organizational re-design that included a new field-deployment model that enabled providers to better manage large populations of patients and to better understand and succeed in their Pay for Value programs. A large part of his strategy work consisted of finding the right providers to partner with as well as to align the most appropriate alternative reimbursement methodology.
Prior to that role, Mr. Fitzpatrick was the Vice President of Strategic Markets (Sales) at Highmark where he had ultimate accountability for 117 large group customers, primarily high profile accounts and 34 hospital accounts. His book of business represented over 200,000 members and over $400M in premium revenue. In this role, Mr. Fitzpatrick was responsible for sales, implementation and overall administration of activities related to his clients, primarily health and wellness plans. His other responsibilities included developing and maintaining relationships with clients, motivating, coaching, and developing sales personnel to achieve and exceed retention goals and for overall market profitability for the Strategic Markets division of Highmark.
Mr. Fitzpatrick is very familiar with Highmark's main distribution channel, the Producer/Broker network. He managed these relationships for 5 years as the Director of Small Group Sales and as the Director of Producer Affairs. He directed this division through a significant financial turn around that ultimately led to the creation of a for-profit, medically underwritten book of business for Highmark. He also introduced and implemented a tiered broker compensation and successfully migrated Highmark's commission structure from a percentage of premium to per member per month.
He has 30 years of experience in the insurance industry — eighteen years specializing in insurance sales, seven years in provider contracting and relations and 5 years investigating worker's compensation fraud.
His successful sales experience at Highmark demonstrates his ability to create and develop many long-term client relationships. He firmly believes in corporate teamwork and is a valuable contributor to Highmark's Strategic Planning process.
He is very active in his community and served as a youth football and basketball coach in the Upper St. Clair Athletic Association.
Thought Leadership Topics:
- Leading through Challenging Times
- Negotiation
- Self-Insured Health Plans through the use of a TPA
- Small Group Products & Services
- UPMC Contract
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