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UPMC Health Plan grows individual exchange market in western Pennsylvania to 87%


Pittsburgh-based UPMC’s insurance division grew its membership from about 2.9 million to 3.1 million policyholders in the first half of fiscal year 2017, representing a year-over-year increase of nearly 7 percent.

Here are four things to know.

1. UPMC Health Plan stated it has surpassed other state insurers to become the largest medical insurer in western Pennslyvania. UPMC Health Plan’s individual exchange market share in 29 counties of western Pennslyvania grew to 87 percent in 2017, up from 58 percent last year.

2. While UPMC Health Plan trails Pittsburgh-based Highmark in Medicare Advantage membership, UPMC Health Plan saw its Medicare Advantage membership grow 32.4 percent between February 2014 and February 2017, while Highmark saw membership decrease 18.6 percent in the same period. 

3. President and CEO of UPMC Health Plan Diane Holder said 35 percent of insured residents in the state’s western region are covered under UPMC Health Plan, according to a TribLive report. In addition, Ms. Holder said approximately 1,000 more businesses began offering the health plan’s coverage to employees in the last year compared with the year prior. 

4. Officials said growth in UPMC’s insurance division largely contributed to its 9 percent revenue growth during the six-month period, which ended Dec. 31. However, the system ended the period with a lower operating income than it had maintained during the last six months of 2015.  

More articles on payer issues:
Prime Healthcare Services rescinds plans to terminate Anthem contract
Bon Secours St. Francis Health System, UnitedHealthcare resolve contract impasse
3 ways to harness data in payer and provider collaborations

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