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Highmark CEO discusses the great battle of Pittsburgh



In this video, David Holmberg, CEO of Pittsburgh-based health insurer and integrated delivery system Highmark Health, discusses its long and fierce battle with the University of Pittsburgh Medical Center for the region’s healthcare market. Among other things, the says the intense competition has helped build innovation at Highmark.

‘Risk-corridor’ woes threaten more than co-ops


It looked safe but wasn’t.

Shortfalls in the Feds’ “risk-corridor” program, meant to cut the financial risk of health plans on Affordable Care Act insurance exchanges by collecting funds from insurers doing a better exchange business and sharing the money with less successful ones, is not only famously hurting co-ops created under the ACA.

The government has said that it could pay  only a small portion of what it owed in risk-corridor program payments.

But while co-ops have received most of the publicity about risk-corridor woes, small  plans of all types are likely to face losses, Colorado HealthOP CEO Julia Hutchins told LifeHealthPro, linked here.

An example is a provider-owned health maintenance organization WINhealth, which has said it will  quit Wyoming’s exchange in 2016 in part because of the uncertain status of its risk-corridor payments, LifeHealthPro reported.

Another example: When Pittsburgh-based Highmark Health announced losses in April, it cited negative results from selling Affordable Care Act health plans and uncertainty about the collectability of risk-corridor payments. So — not being confident about  recouping the $155 million it was owed through the program — it took an “appropriately conservative accounting approach” concerning the payments.


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