About UPMC

UPMC Fast Facts (PDF)

UPMC Insurance Services Division Fast Facts

Western Pennsylvania is the proving ground for a new model of health insurance — a model in which the insurer serves as the front door to a wealth of renowned clinical services and delivers on the promise of using data to achieve better quality and lower costs. UPMC’s Insurance Services Division is leading the way with innovative health plans for virtually all segments of society.

Over the past 10 years, Insurance Services has grown from about 300,000 members to 1.4 million. The division provides health plans to employers and their employees and dependents, as well as to Medicare beneficiaries, Medicaid members, and members of Children’s Health Insurance Program (CHIP).

UPMC Insurance Services also offers workplace productivity and health programs in workers' compensation, disability management, and leave management, and some of the most comprehensive health improvement and health promotion programs anywhere in the United States. The Insurance Services Division also is the largest behavioral health insurance provider  in Pennsylvania, and operates two software development companies focused on helping health care providers and employers provide efficient health care and employee benefits.

Commercial Insurance Products — Founded in 1998 on the premise that providers armed with complete data and evidence-based guidelines could produce the best clinical outcomes, UPMC Health Plan has become one of the most innovative insurance plans in the nation, offering traditional HMOs, PPOs and EPOs, as well as new consumer-directed health plans like Health Savings Accounts and Health Reimbursement Arrangements. The insurer works with the region’s employers and providers to develop better ways to deliver health care. These efforts have paid off. UPMC Health Plan has designed programs and tools to help consumers manage their health on a day-to-day basis and has created programs for patients with chronic diseases like congestive heart failure, asthma, and diabetes. UPMC Health Plan was ranked in 2009 as the best in customer service in the region by J.D. Power and Associates. In its annual survey of health plans, U.S. News & World Report ranked UPMC Health Plan in the top 10 percent of all commercial plans across America.

Worker Productivity and Health — UPMC was recently recognized by the National Business Group on Health as one of America’s healthiest places to work, thanks to the MyHealth Program, an award-winning health and wellness program. Work Partners also offers employers integrated productivity management programs, helping employers manage workers’ compensation, disability, and medical leave programs.

Employer Data Integration — Through eBenefits, UPMC Insurance Services offers the most sophisticated tools for integrating health plan and worker productivity data, which assists employers in managing recordkeeping and improving productivity/efficiency. The bottom line is significant savings to employers.

Medicare Advantage Plans —  UPMC Insurance Services provides coverage to Medicare beneficiaries through its UPMC for Life program, which offers benefits beyond those of traditional Medicare at affordable rates. The UPMC for Life plan was ranked in the top 20 Medicare Advantage plans in the nation for 2008 by U.S. News & World Report.

Medical Assistance and CHIP Programs — UPMC for You offers physical health care benefits to Medicaid recipients in western Pennsylvania. Recognized as a model program, UPMC for You was ranked in the top 15 of all Medicaid programs in the United States in 2008. UPMC for Kids offers affordable plans to children in western Pennsylvania, no matter what their family’s income level. UPMC for Kids is one of the fastest growing CHIP programs in Pennsylvania.

Behavioral Health — Community Care Behavioral Health, a subsidiary of UPMC Insurance Services, is the largest insurance provider of behavioral health services for Medicaid recipients in Pennsylvania, and it was awarded the Moffic Award for Ethical Practice in Public Sector Managed Behavioral Healthcare in October 2003. In 2007, Community Care was awarded “full” accreditation by the National Committee for Quality Assurance (NCQA) for its commercial and Medicare product lines.

Askesis Development Group — This subsidiary of Insurance Services specializes in developing and deploying software for behavioral health practice management offices for provider services and managed care organizations. The software makes scheduling appointments, tracking patient activity, and billing more efficient while improving quality and cost effectiveness.

Partners Program for Physicians — The UPMC Health Plan Partners Program is designed to strengthen the doctor-patient relationship by encouraging coordinated care and guiding patients to make more informed health care choices. This model places the patient and physician at the center of care, with support from the family, the community, and UPMC Health Plan to more effectively meet the needs of patients.