Highmark Projects Profits for West Penn Allegheny in 2014

Pittsburgh-based health insurer Highmark is projecting significant financial gains for potential affiliate West Penn Allegheny Health System, including a swing from a $43.6 million net loss estimated for this year to a net profit of $113.8 million in 2015, according to a Pittsburgh Tribune-Review report.

Those figures were filed with the Pennsylvania Insurance Department, which still needs to approve the deal. Highmark projects that West Penn would make its return to profitability in 2014 with an estimated net profit of $4.8 million.

That's one year earlier than what Highmark told the PA Insurance Department in its January filing, but that filing assumed Highmark would not extend in-network contracts with University of Pittsburgh Medical Center, according to the report. The latest filed projections are based on the scenario that Highmark members would be able to continue accessing UPMC hospitals and physicians after 2014, which is when the current contract expires.

Highmark executives said access to UPMC providers would increase patient volume at West Penn by 46 percent over five years, reaching 83,000 patients by 2017, according to the report. But UPMC has said it will not renew contracts with Highmark, since the payor's acquisition could "harm" UPMC if patients are steered to West Penn, according to the report.   

"Highmark believes that the data it has submitted to the [PA Insurance Department] proves that its plan for restoring WPAHS to financial health is achievable, with or without a UPMC contract, and that a UPMC contract ensures a stronger Highmark," Highmark said in its most recent filing, according to the report.

More Articles on UPMC and Highmark:

Highmark Claims UPMC is Waging "Disinformation Campaign"
UPMC, Altoona Regional Health Negotiate Affiliation Terms
Highmark Seeks Injunction Against UPMC to Stop Sharing Confidential Documents


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