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Company type | Non-profit |
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Industry | Healthcare, Insurance |
Founded | June 22, 1977 |
Headquarters | Fifth Avenue Place Pittsburgh, Pennsylvania |
Key people | Deborah L. Rice-Johnson, President |
Products | Health insurance |
Revenue | $18.2 billion USD (2016) [1] |
Number of employees | 40,000+ (2017) [2] |
Website | 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.
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]
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.[ citation needed ] 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]
In 2014, a gay couple criticized Highmark for not providing family coverage to same-sex couples under the Affordable Care Act. [11] Highmark later reversed their policy. [12]
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. [13]
In 2021, Highmark acquired HealthNow, which operated BlueCross BlueShield in Western New York and Northeastern New York. [14]
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. [15]
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.
William Winkenwerder Jr. is an American business and health care industry executive. He served as Assistant Secretary of Defense for Health Affairs from 2001 to 2007. He also has served in other executive positions within the health industry.
The University of Pittsburgh Medical Center (UPMC) is an American integrated global nonprofit health enterprise that has 92,000 employees, 40 hospitals with more than 8,000 licensed beds, 800 clinical locations including outpatient sites and doctors' offices, a 3.8 million-member health insurance division, as well as commercial and international ventures. It is closely affiliated with its academic partner, the University of Pittsburgh. It is considered a leading American health care provider, as its flagship facilities have ranked in U.S. News & World Report "Honor Roll" of the approximately 15 to 20 best hospitals in America for over 15 years. As of 2016, its flagship hospital UPMC Presbyterian was ranked 12th nationally among the best hospitals by U.S. News & World Report and ranked in 15 of 16 specialty areas when including UPMC Magee-Womens Hospital. This does not include UPMC Children's Hospital of Pittsburgh which ranked in the top 10 of pediatric centers in a separate US News ranking.
Blue Cross Blue Shield Association, also known as BCBS, BCBSA, or The Blues, is a United States-based federation with 34 independent and locally-operated BCBSA companies that provide health insurance in the United States to more than 115 million people as of 2022.
Allegheny General Hospital is a large urban hospital located at 320 East North Avenue in Pittsburgh, Pennsylvania. It is part of the larger Allegheny Health Network.
Allegheny Health Network (AHN), based in Pittsburgh, is a non-profit, 14-hospital academic medical system with facilities located in Western Pennsylvania and one hospital in Western New York. AHN was formed in 2013 when Highmark Inc., a Pennsylvania-based Blue Cross Blue Shield insurance carrier, purchased the assets of the West Penn Allegheny Health System (WPAHS) and added three more hospitals to its provider division. Allegheny Health Network was formed to act as the parent company to the WPAHS hospitals and its affiliate hospitals. Highmark Health today serves as the ultimate parent of AHN.
STAT MedEvac is a service of the Center for Emergency Medicine of Western Pennsylvania in Pittsburgh, Pennsylvania. The primary function of STAT MedEvac is to provide emergency medevac and air medical transport of critically wounded or sick civilians, either from emergency scenes or between hospitals. As of July of 2017, the organization also operates two ground ambulances for patients with severe injury or critical illness. STAT MedEvac is directed by a consortium of hospitals of the University of Pittsburgh Medical Center (UPMC) that include UPMC Children's Hospital of Pittsburgh, UPMC Altoona, UPMC Hamot, UPMC Mercy and UPMC Presbyterian Shadyside. STAT MedEvac's base of operations is in West Mifflin, Pennsylvania, at the Allegheny County Airport. With 18 air bases across Pennsylvania, Maryland, New York, Ohio, and the District of Columbia, it is one of the largest single operated and dispatched air-medical service organizations in the United States.
UPMC Children's Hospital of Pittsburgh (CHP), popularly known simply as Children's, is part of the University of Pittsburgh Medical Center and the only hospital in Greater Pittsburgh dedicated solely to the care of infants, children, teens and young adults through around age 26. UPMC Children's also sometimes treats older adults that require pediatric care. The hospital is affiliated with the University of Pittsburgh School of Medicine and features a state-verified level 1 pediatric trauma center, one of four in the state. CHP also has a rooftop helipad for emergent transport of pediatric patients.
An integrated delivery system (IDS), also known as integrated delivery network (IDN), is a health system with a goal of logical integration of the delivery (provision) of health care as opposed to a fragmented system or a disorganized lack of system.
Independence Blue Cross (Independence) is a health insurer based in Philadelphia, Pennsylvania, in the United States. Independence is the largest health insurer in the Philadelphia area, serving people in the region and seven million nationwide.
The Western Pennsylvania Hospital, commonly referred to as "West Penn Hospital", is located at 4800 Friendship Avenue in the Bloomfield neighborhood of Pittsburgh, Pennsylvania. The 317-bed hospital is part of the Allegheny Health Network. It serves as a clinical campus of the Drexel and LECOM schools of medicine, and also educates physicians through its large number of residency and fellowship programs. It is also the primary clinical setting of the West Penn Hospital School of Nursing.
Kenneth R. Melani is the former president and chief executive officer of Highmark, a health insurance company based in Pittsburgh and the largest health insurer in Pennsylvania. Before his abrupt departure from Highmark in 2012, he was one of the most powerful health insurance executives in the country. At his peak in 2012, Melani was in charge of a Highmark that was $14.6 billion company and had millions of policyholders, for which he was paid $4 million annually.
Elevance Health, Inc. is an American health insurance provider. Prior to June 2022, Elevance Health was named Anthem, Inc. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Anthem Blue Cross in California, Wellpoint, and Carelon. It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2022, the company had 46.8 million members within its affiliated companies' health plans.
UPMC Western Maryland is a hospital and health system located in Cumberland, Maryland, in Allegany County. The facility, which opened on November 21, 2009, is part of the University of Pittsburgh Medical Center (UPMC) system as of February 3, 2020. UPMC Western Maryland was originally established as a combination of Memorial Hospital (Cumberland) and Sacred Heart Hospital (Cumberland), both of which are now closed. It is sometimes confused with Western Maryland Hospital Center, a state-run rehabilitation hospital located in Hagerstown, Maryland.
The Pennsylvania Health Care Quality Alliance (PHCQA) is a nonprofit group of healthcare organizations, including the Hospital and Healthsystem Association of Pennsylvania, which represents more than 225 hospitals and health systems across Pennsylvania in the United States.
Wellmark Blue Cross Blue Shield is a mutual insurance in the United States with more than two million members in Iowa and South Dakota. It is the dominant health insurance in Iowa. It is an independent licensee of the Blue Cross Blue Shield Association. Founded in 1939, Wellmark offers dental and health insurance as well as life insurance. It began participating in the health care exchange for 2017.
CareFirst BlueCross BlueShield is a health insurance provider serving 3.5 million individuals and groups in Maryland and the Washington metropolitan area. It has dual headquarters in Baltimore, Maryland and Washington, D.C. It is a nonprofit organization and an independent licensee of the Blue Cross Blue Shield Association.
UPMC Magee-Women's Hospital, known simply as Magee-Womens Hospital, is a nationally ranked, 335-bed non-profit, full service specialty hospital located in the South Oakland neighborhood of Pittsburgh, Pennsylvania, United States. Magee-Womens is a part of the University of Pittsburgh Medical Center (UPMC). The hospital is near UPMC's flagship campus which houses Presbyterian and Montefiore. While the hospital is UPMC's primary facility for women's health, the hospital is a full service hospital that also serves men. As the hospital is a teaching hospital, it is affiliated with University of Pittsburgh School of Medicine.