UPMC is off to a strong financial start in 2025, with both its health care and insurance services in the black last quarter for a total operating income of $237 million.
The health care network made $142 million, while the insurance side — a drag on many recent quarterly reports — took in $95 million, according to financial information released last week.
Revenue between the two divisions came in just over $8.2 billion.
Positive margins have been elusive for UPMC as of late, with the organization taking a $339 million loss last year. UPMC Health Plan was the culprit, posting a $506 million loss because of higher medical utilization, ballooning pharmacy costs and declining enrollment.
These most recent results signal a turnaround may be in the works.
Insurance gains were primarily attributed to Medicare, Medicaid, Community HealthChoices and Community Care Behavioral Health premium rate increases.
UPMC Health Plan membership, however, declined by 2% compared to the first quarter of 2024, from about 4.24 million to 4.16 million.
Health care income was bolstered by higher patient volumes and the sale of assets for more than they were listed on the organization’s balance sheet, the report said.
Admissions and observation visits increased 8% compared to the first three months of 2024, as did physician revenue. Outpatient revenue rose 16%, driven in part by a trend toward shorter postsurgery hospital stays.
The organization had $22.8 billion in assets as of the report.
UPMC is Pennsylvania’s largest non-governmental employer, with about 100,000 employees, including more than 5,000 physicians and more than 21,000 nurses and support staff.
It runs in excess of 40 hospitals and 800 other medical facilities, making it one of the nation’s most expansive nonprofit health systems.
Highmark Health, UPMC’s main competitor, posted $15 million in operating income last quarter. Allegheny Health Network and Highmark’s diversified businesses had positive margins, while the health plan took a slight loss.
