CALENDAR YEAR 2017 FINANCIAL RESULTS AND SYSTEM HIGHLIGHTS. February 28, 2018
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1 CALENDAR YEAR 2017 FINANCIAL RESULTS AND SYSTEM HIGHLIGHTS February 28, 2018
2 Strong balance sheet allows UPMC to thrive as the region s most preferred provider, best serving needs of patients and businesses Expand top-ranked clinical care to meet increasing demand from more patients while operating efficiently Provide affordable insurance choices and competition for the region, among the lowest costs in the nation $1.3 billion net income UPMC S FINANCIAL PICTURE The largest medical insurer in western PA with 3.4 million members Substantial reinvestment in the region and beyond $736 million in capital spending and business investments to enhance quality and care $118 million pension contribution protects employees retirement plans Fully funded based on ERISA funding rules RESULTS IN BRIEF: $245M operating income / $1.3B net income / $7.5B investment reserve portfolio 2
3 UPMC S FINANCIAL PICTURE Operations Investment Reserve Portfolio Operating income of $245 million needed to run operations, fund capital expenditures and create new programs UPMC Insurance Plan membership 8% Outpatient revenue 28% $7.5 billion cash and investments provides for long-term sustainability Value rises and falls based on market conditions Calendar year return for UPMC 13.6% Admissions & observations 14% Physician revenue 11% 3
4 UPMC OPERATING RESULTS Calendar Years Ended December 31 (Dollars in Millions) OPERATING REVENUE $15,643 OPERATING INCOME $245 OPERATING EBIDA $789 $13,427 $215 $
5 UPMC INSURANCE SERVICES GROWTH % Annual Growth in Membership; 15.3% Annual Growth in Revenue Membership line 3,500,000 3,000,000 2,500,000 2,000,000 1,500,000 1,000,000 Revenue (in billions) Membership $8.8B 3.5M $9 $8 $7 $6 $5 $4 $3 $2 Revenue - bars (in billions) 500,000 $ Proj. $0 5 Acquired Best Care UPMC Plan Community Care Behavioral UPMC Benefits UPMC Network UPMC For You E-Benefits Benefits Management Services UPMC Center For High- Value Evolent UPMC Work Alliance UPMC Options UPMC Coverage HCMS Community Choices
6 WESTERN PENNSYLVANIA S HEALTH INSURANCE MARKET UPMC largest medical insurer in western PA 21% (813K) UPMC 31% (1,198K) 385K Shift from one of nation s most highly concentrated insurance markets to highly competitive, proconsumer Among the lowest cost Top 30 cities nationwide Most large companies offering employees choice of insurers 36% (1,419K) Highmark 23% (895K) 524K Seniors choosing Medicare Advantage have more options than ever, including $0 premium/$0 deductible plans UPMC s individual plans among the lowest prices nationwide June 30, 2019 expiration of the Consent Decrees 24% (952K) All Other Insurers 31% (1,220K) 268K UPMC Immune Transplant & Therapy Center (ITTC) Investing $2B to create 3 new specialty hospitals 18% (716K) Medicare FFS & Uninsured 15% (607K) 109K 8% (319K) UPMC Hillman Cancer Hospital UPMC Heart and Transplant Hospital UPMC Vision and Rehabilitation Hospital 6 Total population = 3.9M in 29-county western PA region Sources: CMS / PA DHS & DPW / Leaders / US Census & Penn State Data Center / UPMC Enrollment
7 UPMC MEDICARE ADVANTAGE ENROLLMENT GROWTH Change in Medicare Advantage Market Share 0.7% 17.3% February 2014 February % 7.9% 7.7% 27.6% 35.4% 19.8 Medicare Advantage Membership Feb Feb Gain/(Loss) % UPMC 123, ,136 50, % Highmark 207, ,222 (46,319) -22.3% 46.5% 32.8% Aetna 77,296 97,275 19, % United 3,273 21,612 18, % Other Insurers 35,200 38,009 2, % Total 446, ,254 45, % UPMC Highmark Aetna United Other Insurers 7 Source: CMS. February Medicare Advantage Monthly Enrollment by Contract/Plan/State/County county western Pennsylvania region. includes the following counties: Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Fayette, Forest, Fulton, Greene, Huntingdon, Indiana, Jefferson, Lawrence, McKean, Mercer, Potter, Somerset, Venango, Warren, Washington, and Westmoreland.
8 ADDITIONAL UPMC INSURANCE SERVICES MARKETS PA Community Choices 28.8% PA Choices Behavioral February 2018 January 2018 UPMC Community Choices has in excess of 42,200 members in the 14- county PA Southwest Zone. 13.0% UPMC Community Care Behavioral is the largest behavioral health MCO in PA with over a million members statewide. 53.0% 22.0% 50.0% 19.2% 15.0% N=78,556 N=2,019,022 UPMC Amerihealth Caritas PA & Wellness UPMC Value BH Magellan PerformCare 8 Source: DHS February 2018 ARMS Report PA SW Zone: Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington and Westmoreland Source: DHS January 2018 ARM587 Report All PA Counties except Philadelphia
9 UPMC INSURANCE SERVICES BENCHMARKS: Among The Highest Nationally NCQA Rating Commercial PPO Achieved 4.5 out of 5 Rating Top-rated PPO in Pennsylvania Commercial HMO Achieved 4.5 out of 5 Rating One of the top-rated HMOs in Pennsylvania Medicare HMO and PPO and Medicaid Achieved 4 out of 5 Rating 2018 CMS Star Scoring Medicare Advantage HMO and PPO Achieved a 4 Star out of a possible 5 star score Most Current NCQA Ratings 2017 Rating Accreditation Status Product Line 4.5 Excellent Commercial PPO 4.5 Excellent Commercial HMO 4 Commendable Medicare HMO 4 Commendable Medicare PPO 4 Commendable Medicaid Medicare Special Needs Plan Achieved a 4 Star out of a possible 5 star score 9
10 Member Services Awards 2017 Contact Center of the Year (Over 100 seats) #1 In Member Satisfaction - PA Region Overall 2 Consecutive Years 2017 Customer Experience Best Practice Award CSR Advancement 2017 Most Improved First Call Resolution Best Large Contact Center Customer Service Team of the Year Recovery Situation Business Services, Financial Services & Insurance Back-Office Customer Service Team of the Year Other Service Industries (Enrollment Services Team) Marketing Awards 2017 Landy Award by SearchEngineLand.com for B2B Search Engine Marketing; judges from Google and Bing; national award that bested other finalists including Macy s and Comcast 10
11 UNIQUE POSITION OF EXCELLENCE IN EVERY HEALTH CARE SECTOR Top Quality Clinical Care Provider U.S. News & World Report - Honor Roll of Best Hospitals in the U.S. #14 Best Hospital #9 Best Children s Hospital More than 4,000 employed physicians Highly Evolved Integrated Delivery & Finance System (IDFS) Cutting-Edge Academic Medical Center #5 in NIH grants with $513M for research with Pitt One of largest programs in U.S. with 1,800 residents and fellows Fastest Growing Insurance Services 2 nd largest provider-owned Plan nationally Largest medical insurer in western PA 3.4 million members #1 in commercial member satisfaction in Pennsylvania J.D. Power NCQA Excellent rating Entrepreneurial & Business Enterprises TRANSLATIONAL SCIENCE Immune Transplant & Therapy Center attracting world-class talent DIGITAL INNOVATION Microsoft partnership A.I. and cloud computing to empower physicians and patients IT Most Wired Evolent IPO valued >$1 billion Large International Footprint Exporting clinical excellence 20-year anniversary of ISMETT transplant hospital in Italy Unmatched network of cancer centers overseas 11
12 FINANCIAL RESULTS BRIEFING SCHEDULE Q1 CY2018: May 3, 2018 Q2 CY2018: August 8, 2018 Q3 CY2018: November 8, 2018 Q4 CY2018: February 27, p.m., U.S. Steel Tower, Conf. Room
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