A rebound in the capital markets drove up Highmark Health’s net income by more than 250% during the first quarter, the nonprofit health system reported Wednesday.

The Pittsburgh-based company accumulated $227 million in net income in the quarter after losing $150 million a year before, when its investments declined $200 million. Highmark Health revenue increased 4.6% to $6.7 billion on gains in health insurance enrollment and higher volumes at its Allegheny Health Network providers.

Highmark’s health insurance operation, which covers almost 7 million people in Delaware, New York, Pennsylvania and West Virginia, generated $130 million in operating income on $5.6 billion in revenue. Health insurance exchange, Medicare Advantage and large-group membership collectively increased 2.5% while small-group enrollment declined slightly, Highmark Health Plan Chief Financial Officer Daryl Veach said during a news conference Wednesday.

“That market, it has struggled in a way other markets didn’t,” Veach said. “The local insurance companies and all the hospitals have lost money, mostly because of the inadequate small group rates. But they are better for ‘23 and we’re hoping to get back to minimal profitability for us, and we think the hospitals will hopefully get to the same place.”

Allegheny Health Network narrowed its net loss 65.6% to $36.2 million, driven by higher patient volumes, value-based reimbursement incentives and settlements with third-party payer settlements, Highmark reported. Revenue for the 14-hospital system grew 16.7% to $1.1 billion. Inpatient volume increased 10%, outpatient registrations and physician visits grew 7%, emergency department rose 11% and childbirths increased 4%. The provider operation’s supply expenses inflated nearly 18% to $265.4 million due to higher utilization and inflation, and labor costs also rose, according to the company.