Independence Blue Cross’ parent company posted strong financial results for 2021, in part because members of its Medicaid and Medicare plans remained reluctant to get medical care during the pandemic.

The region’s largest health insurer said Tuesday that revenue climbed 13% last year, to nearly $25 billion, and that its 2021 net income soared 31%, to $816 million, compared to 2020. Independence’s profit margin climbed for the second year in a row, reaching 3.3%.

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Gregory E. Deavens, Independence Health Group’s president and chief executive, attributed the strong profits to revenue growth, $248 million in pretax profits from investments, and good expense discipline, in addition to some of IBC’s members staying away from doctors’ offices, which has been hard on hospitals and health systems.

“Our robust growth and diversification strategy helped us remain financially strong during another year filled with uncertainty,” Deavens said.

Independence’s majority-owned Medicaid subsidiary, AmeriHealth Caritas, continued to account for about two-thirds of the company’s revenue — $17 billion last year.

Independence owns 61.3% of AmeriHealth Caritas; Blue Cross Blue Shield of Michigan owns the remainder.

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AmeriHealth Caritas has Medicaid plans in eight states and Washington. It expanded last year to North Carolina, which added $658 million in revenue in the last six months of 2021, Independence’s chief financial officer Juan Lopez said. This year the subsidiary will launch in Ohio.

The Medicaid business also benefited from the rules that Congress passed in response to the national public health emergency, which are scheduled to expire Saturday. They meant that states have not been reevaluating Medicaid enrollees on a regular basis to see if they still qualified for government insurance for low-income individuals.

It’s too soon to say what impact the expiration will have on Independence. States are taking different approaches to deciding whether individuals are still eligible for Medicaid, Deavens said.

Some of the individuals who lose Medicaid could end up in Affordable Care Act plans that Independence offers through Pennie, Pennsylvania’s health insurance marketplace, Lopez said.

Independence had 7.7 million individuals enrolled in its insurance plans and other businesses at the end of 2021. That included 2.7 million in AmeriHealth Caritas’ Medicaid plans.

The total was down from 8.2 million at the end of 2020. Lopez attributed the net decline to the loss of a large pharmacy benefit administration contract in the Medicaid unit.

“It was a very small slice of the business and had a minimal impact on our results,” he said.