UPMC Health System in Pennsylvania: 220,116 Medicare Advantage members, 15.7% share, 3rd of 17.
UPMC Health System lost 2,219 members (−1.0%) from Nov 2025 to Oct 2026 and stepped −3.0% at the 2026 election period against the market's −0.9%. It sells in 64 of Pennsylvania’s 67 counties with visible members and leads 14; Highmark Health sits just ahead at 19.4%, Independence Health Group, Inc. just behind at 9.3%.
UPMC Health System's twelve months in Pennsylvania
Visible members each month, Nov 2025 to Oct 2026. The December-to-January step is the election period. The market line for the state is on the Pennsylvania page.
Where UPMC Health System's Pennsylvania members are
The carrier’s five largest counties by visible members, with its share of each county’s visible Medicare Advantage members. It sells in 64 counties and leads 14 of them.
| County | UPMC Health System members | Share of county | County visible members | County leader |
|---|---|---|---|---|
| Allegheny | 62,090 | 36.9% | 168,487 | UPMC Health System |
| Westmoreland | 20,693 | 32.6% | 63,450 | UPMC Health System |
| Cambria | 13,186 | 56.2% | 23,474 | UPMC Health System |
| Blair | 9,358 | 50.5% | 18,525 | UPMC Health System |
| Washington | 9,046 | 28.4% | 31,878 | Highmark Health |
UPMC Health System against the Pennsylvania market
The carrier’s figures beside the state’s, each weighted by members. A difference is a difference, not a grade: a higher maximum or a lower rating is a design and a result, read in context.
top three hold 58.6%
market 4.00, +0.32, 2nd of 10 rated
market 79%, −32 points
market $7,150, −$1,150
| # | Carrier | Members | Share | Twelve months | Election step | Counties led | Rating | $0 premium |
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna (CVS) | 328,628 | 23.5% | +1.9% | +1.1% | 14 of 67 | 3.88 | 72% |
| 2 | Highmark Health | 271,302 | 19.4% | −6.2% | −8.9% | 15 of 66 | 4.35 | 93% |
| 3 | UPMC Health System | 220,116 | 15.7% | −1.0% | −3.0% | 14 of 64 | 4.32 | 47% |
| 4 | Independence Health Group, Inc. | 130,194 | 9.3% | −7.4% | −8.5% | 5 of 63 | 3.91 | 83% |
| 5 | UnitedHealth | 115,916 | 8.3% | +1.4% | −2.1% | 1 of 65 | 3.76 | 86% |
| 6 | Risant Health, Inc. | 95,418 | 6.8% | +0.9% | −3.4% | 17 of 46 | 4.00 | 63% |
| 7 | Humana | 92,426 | 6.6% | +17.5% | +12.0% | 1 of 67 | 4.00 | 100% |
| 8 | CAPITAL BLUE CROSS | 48,437 | 3.5% | +48.3% | +40.8% | 0 of 21 | 4.00 | 82% |
| 9 | Health Care Service Corporation | 36,116 | 2.6% | −3.4% | −4.5% | 0 of 26 | 3.00 | 84% |
| 10 | Thomas Jefferson University | 28,035 | 2.0% | +72.0% | +43.9% | 0 of 19 | 3.00 | 100% |
What 2027 does to UPMC Health System's plans in Pennsylvania
The fate assigned to each of the carrier’s plans for 2027, joined to the members in it today.
8,644 members are in 1 plan that end and must choose again. 37,434 members move with 2 plans consolidated into another of the carrier’s plans. 163,315 members are in 10 plans that drop at least one county; which counties is not stated. In all, 95% of UPMC Health System’s Pennsylvania members are in a plan whose service area or status changes.
The read on UPMC Health System in Pennsylvania is in Carrier Command.
Risk and rebate against the market, the five-test read on coding versus selection, Stars levers and next year's cut points, the election-period forecast and the county-by-county standing, written as a monthly page.
UPMC Health System elsewhere, and the rest of Pennsylvania
How these numbers are made
- Members are visible members: CMS suppresses any plan-county cell of ten or fewer, so small counties undercount. Market share excludes employer group plans.
- Enrollment is Oct 2026; the twelve months run Nov 2025 to Oct 2026; the election step compares December 2025 with January 2026.
- UPMC Health System is the parent organization UPMC Health System; its 17 plans in Pennsylvania may sell under other brand names. The rating is the 2027 overall Star Rating of its contracts weighted by members in Pennsylvania; $0 premium and the in-network maximum are the 2027 filings weighted by members today.
- Plan fates are the ones assigned for contract year 2027.
- Every figure comes from public CMS data as Livmor reads it, and the page is rebuilt when a new month posts. Livmor Carrier Command, public CMS data.