Pennsylvania Insurance Department moves to create level playing field in health care marketplace; Acknowledges Highmark Health's, Highmark's and AHN's steady and significant progress
Independent Economist Report Affirms Value of Investments in Allegheny Health Network (AHN) for the benefit of the community
Decision provides Highmark with needed flexibility to continue to make timely, strategic investments in AHN and in Highmark Health's supporting strategies
Highmark Health Plan President and Highmark Health Chief Financial Officer comments
PITTSBURGH (July 28, 2017)
Statement from Highmark Health Plan President Deborah Rice-Johnson
"We are pleased that the Pennsylvania Insurance Department has agreed to modify the conditions of the April 2013 Order that enabled the creation of the Allegheny Health Network (AHN) and Highmark's affiliation with the former West Penn Allegheny Health System. In the 2013 Order, the Department took the bold step of allowing the restructuring of Highmark, based on the company's commitment that the affiliation would promote health care competition in western Pennsylvania by providing meaningful choice to consumers. The Department's decision also preserved the jobs of more than 11,000 western Pennsylvania residents.
With its decision to modify the Order, the Insurance Department has acknowledged that, through the hard work and collective efforts of the Highmark Health organization, competition in health care in western Pennsylvania is alive and well, and has resulted in significant benefits to the people of western Pennsylvania, including Highmark customers and members.
The Department's decision provides us with the flexibility we need to continue to make timely, strategic investments in AHN and in Highmark Health's supporting strategies, all of which are aimed at providing ready access to high quality value-based health care. The decision also will facilitate our continued efforts to pursue new strategies to improve care through innovative actions such as AHN's recently announced collaboration with Johns Hopkins Kimmel Cancer Center.
The Department's decision also will enable Highmark to take the steps that it needs to make, including jointly investing with other leading health care providers, to develop a better health care system across Pennsylvania.
Highmark Health, Highmark and AHN appreciate the Insurance Department's acknowledgement that we have made steady and significant progress since the formation of AHN to stabilize and strengthen the AHN system and to deliver on our collective promise to create a customer-focused, value-based health care system that works better for everyone. The residents of western Pennsylvania will continue to have access to a competitive health care delivery and financing system that provides a choice of providers and access to high quality, affordable care.
Highmark's customers, AHN's patients and the entire western Pennsylvania community can feel confident that with our organization's leadership, our roadmap to the future, and our financial strength and stability, we will continue our work to get health care right in terms of access, quality and affordability."
Statement from Highmark Health Chief Financial Officer Karen Hanlon
"We are pleased that the Pennsylvania Insurance Department's independent economist's report has found that since 2013, Highmark has made investments to improve the quality of care and expand access to the community of western Pennsylvania.
We appreciate that the Compass Lexecon report finds competition in health care in western Pennsylvania alive and well, and has resulted in significant benefits to the people of western Pennsylvania, including Highmark customers and subscribers. It recognizes that the Allegheny Health Network (AHN) has proven its ability to provide patients high quality, accessible and affordable health care in a very competitive marketplace. Highmark members continue to shift to AHN and community hospitals through high-performing network products and new and innovative health plans, decreasing their reliance on other health systems.
We value the report's assessment that Highmark and AHN have not had the benefit of a level playing field and firmly believe that findings like those reported by Compass Lexecon are a positive step forward in our continued efforts to create the health care system of the future that delivers differentiated value across the full spectrum of health care needs."
Journalist Note: The April 29, 2013 Order of the Pennsylvania Insurance Department (PID) approved a transaction which allowed Highmark to consummate its affiliation with the former West Penn Allegheny Health System. The Order contained various conditions, including limitations on Highmark's ability to make certain "donations" and "financial commitments" without either notice to or approval by the Department. After nearly four years of successful operation and financial improvement, on March 27, 2017, Highmark Health filed a request that the Department modify the donations and financial commitments conditions. On July 28, 2017 the Department agreed to modify the Order to afford Highmark additional flexibility under these conditions. The remaining conditions of the Order remain in place, and Highmark will continue to be bound by all financial and other restrictions applicable to all other Pennsylvania health care insurers.
About Highmark Inc.
Highmark Inc. and its health insurance subsidiaries and affiliates collectively are among the ten largest health insurers in the United States and comprise the fourth-largest Blue Cross and Blue Shield-affiliated organization. Highmark Inc. and affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve 5 million members and hundreds of thousands of additional members through the BlueCard® program. Its diversified businesses serve group customer and individual needs across the United States through dental insurance, vision care and other related businesses. Highmark Inc. is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit www.highmark.com.
About Highmark Health
Highmark Health, a Pittsburgh based enterprise that employs more than 40,000 people nationwide and serves nearly 50 million Americans in all 50 states, is the second largest integrated health care delivery and financing network in the nation based on revenue. Highmark Health is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to nearly 5 million members in Pennsylvania, West Virginia and Delaware as well as dental insurance, vision care and related health products through a national network of diversified businesses that include United Concordia Companies, HM Insurance Group, Davis Vision and Visionworks. Allegheny Health Network is the parent company of an integrated delivery network that includes eight hospitals, more than 2,800 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions in western Pennsylvania. HM Health Solutions focuses on meeting the information technology platform and other business needs of the Highmark Health enterprise as well as unaffiliated health insurance plans by providing proven business processes, expert knowledge and integrated cloud-based platforms. To learn more, please visit www.highmarkhealth.org.