Blue Cross Blue Shield Plan Financial & Activities News: March 2024


The following Blue Cross Blue Shield announcements are just a few of the company activities from this month.

AMI offers continuing market research services to clients on Blue Cross Blue Shield Plans as well as publishing an annual Blue Cross Blue Shield Plans Report that provides comprehensive profiles on each of the 33 BSBS plans as well as the BCBSA organization.


Anthem Blue Cross Blue Shield

Anthem Blue Cross and Blue Shield in Virginia announced that the WiseChoice Healthcare Alliance had secured its first contract for the state’s healthcare solution for small businesses. Appalachian Foundation Services of Roanoke, Virginia enrolled its employees for healthcare coverage after hearing of the state’s new option allowing small businesses to pool together as one large self-funded group. The WiseChoice Healthcare Alliance allows its participants to spread claims risk and lower administrative costs resulting in savings for employees and their families.


Blue Cross and Blue Shield of Massachusetts

Blue Cross and Blue Shield of Massachusetts, Inc. and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. reported a combined after-tax fourth quarter net loss of $12.3 million on revenue of $2.4 billion. These results reflect an operating and other loss of $1.8 million (-0.4% operating margin), and an investment loss of $10.5 million. For the full year 2023, Blue Cross reported a combined net gain of $146.6 million on revenue of $9.3 billion (1.6% net margin). These results reflect an operating and other gain of $47.8 million (0.4% operating margin), and an investment gain of $98.8 million.


Blue Cross Blue Shield of Michigan

Despite experiencing over $3 billion in increased medical and pharmacy claims costs in 2023, Blue Cross Blue Shield of Michigan will report a marginally positive net gain of $100 million on enterprise revenue of $36.3 billion for the calendar year ending Dec. 31. BCBSM will report an underwriting loss of $544 million driven by the fast-growing cost and use of health care services. In 2023, BCBSM and its subsidiaries paid an average of $88 million per day for the care and benefits of members in Michigan and around the nation. This is $8 million more per day than 2022.The company experienced a $1.4 billion increase in claims costs for medical services, especially surgical, hospital-administered drugs, imaging, and diagnostic services. Additionally, the company experienced an increase of $1.8 billion in pharmacy claims costs, including $750 million more for specialty drugs, especially for autoimmune conditions; and $350 million more in claims for GLP-1 drugs for diabetes and weight management.


Blue Cross and Blue Shield of North Carolina

UNC Health, North Carolina’s leading public academic medical system, and Blue Cross and Blue Shield of North Carolina (Blue Cross NC), the state’s largest not-for-profit health insurer, have signed a new, long-term extension to their network agreement. The four-year agreement will enable UNC Health and Blue Cross NC to continue collaboration on new ways to improve care and access for patients across North Carolina, especially in rural areas.


Blue Cross and Blue Shield of Oklahoma

Hillcrest HealthCare System (Hillcrest) and Blue Cross and Blue Shield of Oklahoma have agreed to a new, two year agreement. This new agreement, which starts on March 1, 2024, includes Hillcrest facilities and medical provider groups and will service members in Tulsa, Owasso, Claremore, Cushing, Henryetta and Pryor.


Elevance Health

Elevance Health announced the closing of its acquisition of Paragon Healthcare, Inc., a company specializing in life-saving and life-giving infusible and injectable therapies.

Paragon Healthcare provides infusion services to patients through its omnichannel model of ambulatory infusion centers, home infusion pharmacies, and other specialty pharmacy services. The company, headquartered in Plano, Texas, currently serves more than 35,000 patients at over 40 ambulatory infusion centers across eight states, as well as patients’ homes. The acquisition of Paragon Healthcare will deepen Elevance Health’s capabilities around providing affordable, convenient access to specialty medications for those living with chronic and complex illnesses. Paragon Healthcare will now operate as part of CarelonRx, the pharmacy services segment within Carelon, Elevance Health’s health services division.

The Kroger Co. entered into a definitive agreement for the sale of its specialty pharmacy business to CarelonRx, a subsidiary of Elevance Health. The retailer’s specialty pharmacy serves patients with chronic illness that requires complex care. Skilled clinicians and superior therapy programs allow patients and prescribers to benefit from education and resources, counseling, side effect management, financial assistance, personalized care and administrative expertise. The specialty pharmacy business supports patients facing diseases including rheumatoid arthritis, growth hormone deficiencies, multiple sclerosis and bleeding disorders.


Excellus BlueCross BlueShield

Excellus BlueCross BlueShield finished last year with a net loss of $23 million — the first time since 2008 that the region’s largest insurer closed out a year in the red. The health plan attributed its losses to continued increases in medical benefits being paid out. This marked the second straight year of significant declines in the company’s net income. Company profits dropped 50% in 2022, from $117.6 million down to $58.9 million.


Highmark Health

Highmark Health announced consolidated financial results for 2023, reporting $27.1 billion in revenue, an operating gain of $338 million, and a net income of $533 million. Highmark Health maintained a strong balance sheet with $11 billion in cash and investments and net assets of $10 billion as of December 31, 2023. The Highmark Health Plans reported an operating gain of approximately $400 million in 2023, driven by steady year-over-year membership, as enrollees sought the organization’s more affordable options and experience improved health care outcomes.

Highmark Health introduced Alloyed Works, unifying its Diversified Business solutions and other market-leading capabilities that drive growth, reduce costs and improve outcomes for health organization customers across the country.

The Alloyed Works portfolio includes the capabilities of nationally-recognized Highmark companies, including: United Concordia Dental, Helion, enGen, HM Insurance Group, and HealthNow Administrative Services.

Highmark Health has laid off 182 employees throughout the enterprise, including 15 people from its New York state operations, five in Delaware and four in West Virginia.


Independence Blue Cross

Independence Blue Cross (IBX) and Rothman Orthopaedic Institute (Rothman Orthopaedics) have extended their value-based care agreement for three years. The extension allows the two organizations to continue their work to enhance the quality of care IBX members receive, to address health equity, and to reduce health care costs. Rothman Orthopaedics was the first physician-owned group to work with IBX on an approach that brings health insurers, hospitals, and doctors together to improve the quality and lower the costs of health care in the region.