(Wellesley, MA) – Harvard Pilgrim Health Care today reported a net loss of $4.7 million and an operating loss of $5.5 million on revenue of $788.3 million for the first quarter of 2017. For the same period in 2016, the health plan reported a net loss of $34.9 million and an operating loss of $36.6 million on revenue of $749.7 million. 

 

Harvard Pilgrim’s total membership for the first quarter stands at 1,273,552 down from 1,316,016 in the first quarter of 2016.

 

“In the first quarter of this year, we performed better than expected,” said Harvard Pilgrim Chief Financial Officer Charley Goheen. “We had a planned loss due to investments in our expansion markets. We are growing in those markets, which include Medicare Advantage and the state of Connecticut. While we are reporting an operating loss for the first quarter of 2017, we are seeing that our medical management initiatives are positively impacting medical trend. We continue our work to negotiate pharmacy contracts that are based on real life patient outcomes and help to drive better medical outcomes for our patients while working to hold down the escalation in pharmacy costs. Overall, we are optimistic that this year will be a better one financially than 2016.”

 

In 2016, the health plan experienced sharply increasing medical utilization, soaring pharmacy costs and continuing challenges related to the Affordable Care Act (ACA), including the impact of the special enrollment period and the risk corridor and risk adjustment programs.  

 

                   

About Harvard Pilgrim Health Care
Harvard Pilgrim is a not-for-profit health services company that, along with its subsidiaries, is improving the well-being of its 2.7 million customers.  Harvard Pilgrim’s flagship health plans in New England provide health coverage to 1.3 million members, while another 1.4 million individuals are served through Health Plans, Inc., a subsidiary that provides integrated care management, health coaching and plan administration solutions to self-funded employers nationwide.  Founded in 1969, Harvard Pilgrim has built its reputation on innovation and collaboration with a goal of lowering health care costs, improving care and enhancing the overall member experience. It is known for its excellent clinical programs, customer service, health improvement strategies and innovative tools that offer consumers greater transparency and empower them to make better decisions about their health care. Harvard Pilgrim is home to the Harvard Pilgrim Health Care Institute, a unique collaboration with Harvard Medical School. As Harvard Medical School’s Department of Population Medicine, the Institute is the only appointing department of a U.S. medical school housed within a health plan.   Funded primarily through external government and private sources, it provides critical information to all levels of our health care system on issues affecting population health and health care delivery. Harvard Pilgrim is consistently among America’s highest-rated health plans according to an annual ranking of the nation’s best health plans by the National Committee for Quality Assurance (NCQA)*.