Deborah Rice-Johnson, CEO, Highmark Health

In an interview with Invest:, Deborah Rice-Johnson, CEO of Highmark Health, said that diversification, innovation, and community investment have positioned the organization to thrive despite ongoing industry challenges. “We’ve faced the same challenges as others in the industry, but we’ve also made real strides. The diversification of our organization has enabled us to weather industry pressures and prepare for a stronger future.”

What are some key changes that have impacted Highmark?

There’s been a lot happening across our industry — on both the payer and provider sides. We’re continuing to navigate financial pressures, many of which have intensified post-COVID, such as increased care delivery costs, rising labor and goods costs, and a shift in disease prevalence. From the payer perspective, there are real challenges, including what I believe is some pent-up demand from the pandemic. We’re seeing more severe cases, and that’s creating pressure on both providers and payers, which is quite different from what I’ve seen in my decades in this business.

Despite those challenges, we’re doing a lot around growth. Companies today need to scale the capabilities they invest in and deliver them effectively to the market. My role as CEO of our diversified businesses, as well as chief growth officer for the organization, places me right at the center of this work, and it’s truly exciting.

The current pressures in the industry are forcing all of us to innovate and grow in more deliberate ways. When I look at our health insurance business, for example, we’ve built a number of capabilities that are enabling our Living Health strategy. That strategy is designed to lower the cost of care, improve access, enhance affordability, and deliver quality. We’ve spent the last five years building those capabilities, and now we’re in a position to extend them to other organizations, whether they’re health plans or providers.

On the topic of growth, we’ve been active both organically and inorganically. Organically, we’ve expanded into Southeastern Pennsylvania, including the five counties surrounding Philadelphia. That’s a major market with about 4 million people — roughly a third of the state’s population — and it’s become one of our fastest-growing areas. We entered just a few years ago and are already seeing strong results.

On the inorganic side, we’ve been growing through our diversified businesses. We created a platform called Alloyed Works, which packages our diversified capabilities in a way that makes it easier to engage with other companies.

To name a couple of our top-performing diversified businesses: United Concordia, our dental company, has grown from being the 10th-largest in the country to the 7th. My team wants to be number one — it’ll take a big push, but the momentum is there. We also have our HM Insurance Group, which focuses on stop-loss coverage. It’s now a top-10 player and continues to grow.

We’ve faced the same challenges as others in the industry, but we’ve also made real strides. The diversification of our organization has enabled us to weather industry pressures and prepare for a stronger future.

How are you recruiting, retaining, and developing talent across healthcare and insurance sectors, while also strengthening Pittsburgh’s workforce and ensuring long-term competitiveness?

Talent is such an important topic. Like many, we struggled during the pandemic. And while I’m admittedly tired of talking about it, the pandemic forced us to re-evaluate and become more effective and efficient in our work. However, it also brought new challenges to retaining talent.

At Highmark, we focus heavily on our mission and vision. They’re bold — we aim to create a remarkable health experience and to free people to be their best in health. That extends to our employees, too. If our team members are empowered and thriving, they’ll deliver exceptional experiences for our customers. That’s the only way we’ll realize our mission.

Creating a safe, inclusive space for employees to innovate and share ideas is key. I always recall a quote from Jack Welch — he recounted speaking to an assembly line worker nearing retirement who said, “All these years, you’ve had my hands, but you could have had my mind too.” That stuck with me. We want our people fully engaged, not just executing tasks but actively shaping the future of our organization.

How are you navigating national and regional healthcare trends?

Much of our ability to navigate these trends goes back to the strategic path we chose with our Living Health transformation, which began in 2019. Honestly, without that, I don’t think we’d be in the strong position we’re in today.

That strategy has helped us manage care more effectively, engage with clinicians and members, and address the fragmentation in the healthcare delivery system. Let’s be honest: insurance doesn’t always make healthcare easier. But our approach has enabled us to forge deeper provider connections — not just with Allegheny Health Network, which is part of our organization, but with other health systems as well.

We’re exploring value-based care models, partnering with what we call “anchor providers” in each market to implement those models effectively. We’re also prioritizing digital innovation. Our digital front door has significantly improved how we engage members. We’re rolling out ambient listening technology in AHN, allowing clinicians to better connect with patients during visits. We’re also applying evidence-based medicine in our models to ensure that patients receive the right care and treatments at the right time. That helps reduce waste and avoid unnecessary costs.

So while we are facing the same headwinds as the rest of the industry, I believe our strategies have helped us mitigate those challenges better than most and positioned us well for the future. 

How are you identifying opportunities for innovation, efficiency, and patient-centered care during these uncertain times?

When Allegheny Health Network became part of Highmark and we transitioned into a payer-provider model, everything changed. We’ve learned so much. I remember hearing something so simple from a clinician and thinking, “Why didn’t I consider that before?” But as a payer-only executive, I simply didn’t have that perspective.

Now, we’re very intentional about integrating everything we offer into a cohesive model that we can scale beyond Western Pennsylvania. We bring our clinicians and payers together to review data and find better ways to serve members. It’s not about increasing utilization management like a typical insurer — it’s about collaboration and solving problems at the root.

What’s especially powerful is that when we’re in meetings, you can’t tell who’s the provider and who’s the payer — and that’s exactly how it should be.

Our diversified businesses also play a huge role. During COVID, our insurance arm supported providers financially when patients weren’t seeking care. Today, those same diversified businesses—our dental company, our tech company Engine, and others — are performing well, giving us financial stability during a time of industry-wide pressure.

Back in the 1990s, we were a $2.3 billion company. Today, thanks to that diversification, we’ve grown to a $29 billion organization impacting more than 26 million lives across the country. That’s allowed us to weather the storm and continue innovating with purpose.

How does Highmark give back to the communities it serves?

It’s something we’re truly passionate about at Highmark. In 2024, we invested nearly $55 million in our communities through corporate giving, foundations, and other support for local organizations and agencies. Many of those organizations are supporting the very people we serve, so it’s deeply aligned with our mission.

AHN provides over $200 million annually in uncompensated care. That’s part of our responsibility as a not-for-profit, but also something we take to heart.

One of our most exciting programs is Bright Blue Futures, which helps guide our charitable giving and community engagement. Through that and our Highmark Foundation, we’ve forged strong collaborations with community organizations, and we actively encourage our employees to volunteer.

Personally, I serve on several nonprofit boards, which gives me insight into the community’s needs and helps bring those learnings back to Highmark.

One initiative that’s particularly close to my heart is our Caring Place — a center for grieving children. I recently toured the facility with a prospective client, and it’s always a powerful experience. I have a personal connection: when my daughter was 13, she lost her father. That grief and isolation she experienced were incredibly hard. At the Caring Place, children meet weekly in groups by age, where they can talk, express emotions, and most importantly, feel understood. It’s funded by Highmark and our foundation, and we’re expanding it across our footprint.

We’re also deeply invested in addressing social determinants of health. It’s all about helping the broader community — not just our customers and patients, but everyone.

What are your top priorities moving forward?

We’re deeply invested in our customers, patients, and communities. But we’re also committed to creating scalable tools and experiences that can serve others beyond our immediate footprint. Alloyed Works is our platform for launching those solutions, and it’s helping us build relationships with others across the country who are facing the same challenges. We’re always looking for ways to be helpful, and we’re excited about where we’re headed.