Blue Cross Blue Shield Financial News Roundup: April 2023

Elevance Health, Inc. (Elevance) reported first quarter 2023 results reflecting strong financial performance, including double-digit growth in revenue, operating earnings, and adjusted earnings per share. The benefit expense ratio was 85.8 percent in the first quarter of 2023, a decrease of 30 basis points year-over-year. The decrease was driven by the commercial risk-based health plans.

  • Medical membership totaled approximately 48.1 million as of March 31, 2023, an increase of 1.3 million, or 2.9 percent year-over-year, driven primarily by growth in Medicaid, commercial fee-based, Medicare Advantage and ACA health plan members, partially offset by attrition in the employer group risk-based business.
  • Operating revenue was $41.9 billion in the first quarter of 2023, an increase of $4.0 billion, or 10.6 percent year-over-year. CarelonRx growth in pharmacy product revenue driven by growth in members served and script volume contributed to the increase.
  • Operating gain in the Health Benefits segment totaled $2,159 million in the first quarter of 2023, an increase of $308 million from $1,851 million in the first quarter of 2022.
  • Operating gain in the Carelon segment was $721 million in the first quarter of 2023, an increase of $123 million from $598 million in the first quarter of 2022. The increase was primarily driven by higher prescription volumes associated with growth in integrated medical and standalone pharmacy customers, improved performance in the care delivery business, and the expansion of the post-acute care business.

Independence Health Group, Inc., the parent company of Independence Blue Cross, LLC, released its financial results for 2022, a preview of the organization’s annual report. Independence reported total revenue of $27.4 billion, up $2.65 billion or 10.7 percent over 2021. When revenues are combined with claims paid on behalf of self-funded employers, Independence had health care funds under management of $37.7 billion in 2022, up from $34.5 billion in 2021.

The company had net income of $156 million, due in part to an investment loss of $72 million (after-tax) driven by unrealized losses on equity securities and offset by normal recurring investment earnings within the portfolio. In 2022, Independence saw a net income margin of 0.6 percent of total revenue, down from 3.3 percent in 2021. Independence committed 87 cents of each premium dollar to pay medical costs for its members’ health care.

Highmark Health announced consolidated financial results for the 2022 fiscal year, reporting $26 billion in revenue, an operating gain of $440 million, and a net loss of $346 million. Excluding unrealized investment impact, the organization reported net earnings of roughly $47 million for 2022.

These results are due to the positive performance of the insurance business units, notably Highmark Health Plans, United Concordia Dental and HM Insurance Group, driven by increased membership, more affordable options, and better health outcomes. Highmark Health’s provider network, Allegheny Health Network (AHN), experienced overall increased patient volumes year-over-year but faced continued cost pressures due to supply chain challenges, inflation, and higher labor costs and shortages.

The Highmark Health Plans reported an operating gain of more than $500 million for full year 2022, as well as an increase in membership enrollment of 2.5% year-over-year as more customers sought Highmark’s affordable options and improved health outcomes.


Takeaway: Comprehensive business intelligence available on Blue Cross Blue Shield plans in AMI’s 2023-2024 Report