9/19/2013
Virtually All Businesses Offering Plans Other than Just Highmark to Assure Full, Affordable In-Network Access to UPMC
PITTSBURGH, Sept. 19, 2013 – Less than a year ago, five of the seven hospital members of the Allegheny Health Network were in court trying to invalidate their affiliation agreement with Highmark and escape ensnarement in Highmark’s newly formed provider network. In that lawsuit, they argued that Highmark’s obsessive pursuit of an extended contract with UPMC was about to destroy them. Having lost that case and been ordered to consummate their ill-advised deal with Highmark, they now call for legislation forcing every other hospital in western Pennsylvania to be a part of Highmark's network.
UPMC will not make that mistake. Instead, UPMC will make its world-class hospitals and doctors available through multiple insurance companies other than Highmark. In fact, when its commercial contracts with Highmark expire at the end of 2014, virtually the entire population of western Pennsylvania will be assured of the choice of full, affordable in-network access to UPMC’s hospitals and doctors through government programs, the Health Exchanges, and national insurers such as Aetna/HealthAmerica, Cigna and United Healthcare, as well as the UPMC Health Plan. All will have multiple options seeking to offer the highest quality care with the lowest possible insurance premiums.
Highmark continues to pursue a contract with UPMC despite the fact that the Pennsylvania Insurance Department approved the Highmark acquisition of West Penn Allegheny based on a plan submitted by Highmark that explicitly assumed the expiration of the UPMC-Highmark contract after 2014. Blatantly ignoring this two year process and the Insurance Department Approval Order focused on “saving” West Penn Allegheny, Highmark has begun the process of downsizing it while focusing on UPMC.
The idea of a contract between a dominant insurer — Highmark, which now owns and must invest billions of dollars in an attempt to save West Penn Allegheny and other hospitals — and a dominant provider — UPMC, which owns nationally recognized, world-class hospitals and has a vibrant insurance company — is to combine into one contractually bound “organization” the delivery of all health care in western Pennsylvania. Such a contract would instantly extinguish insurance competition and provider competition, and restore the double-digit premium increases which have plagued this community, kept wages down, and stalled job growth.
Businesses in the region — both large and small, municipalities such as the City of Pittsburgh, and the not-for-profit organizations — understand this and are offering insurance alternatives other than just Highmark to their employees. The community has eagerly moved on to more choice and high-quality care at the least possible cost.
Any sort of “any willing” legislative proposal is anything but willing — it’s coercion. It is unprecedented in the nation, contrary to the trend to offer varied, select and narrow networks to minimize expenses and coordinate care, and would impose yet another layer of State government intervention and price control in the health care marketplace. Requiring everybody to contract with everybody is the exact opposite of the choice that every employer and every consumer wants in order to make health care affordable in our region.
UPMC will not make that mistake. Instead, UPMC will make its world-class hospitals and doctors available through multiple insurance companies other than Highmark. In fact, when its commercial contracts with Highmark expire at the end of 2014, virtually the entire population of western Pennsylvania will be assured of the choice of full, affordable in-network access to UPMC’s hospitals and doctors through government programs, the Health Exchanges, and national insurers such as Aetna/HealthAmerica, Cigna and United Healthcare, as well as the UPMC Health Plan. All will have multiple options seeking to offer the highest quality care with the lowest possible insurance premiums.
Highmark continues to pursue a contract with UPMC despite the fact that the Pennsylvania Insurance Department approved the Highmark acquisition of West Penn Allegheny based on a plan submitted by Highmark that explicitly assumed the expiration of the UPMC-Highmark contract after 2014. Blatantly ignoring this two year process and the Insurance Department Approval Order focused on “saving” West Penn Allegheny, Highmark has begun the process of downsizing it while focusing on UPMC.
The idea of a contract between a dominant insurer — Highmark, which now owns and must invest billions of dollars in an attempt to save West Penn Allegheny and other hospitals — and a dominant provider — UPMC, which owns nationally recognized, world-class hospitals and has a vibrant insurance company — is to combine into one contractually bound “organization” the delivery of all health care in western Pennsylvania. Such a contract would instantly extinguish insurance competition and provider competition, and restore the double-digit premium increases which have plagued this community, kept wages down, and stalled job growth.
Businesses in the region — both large and small, municipalities such as the City of Pittsburgh, and the not-for-profit organizations — understand this and are offering insurance alternatives other than just Highmark to their employees. The community has eagerly moved on to more choice and high-quality care at the least possible cost.
Any sort of “any willing” legislative proposal is anything but willing — it’s coercion. It is unprecedented in the nation, contrary to the trend to offer varied, select and narrow networks to minimize expenses and coordinate care, and would impose yet another layer of State government intervention and price control in the health care marketplace. Requiring everybody to contract with everybody is the exact opposite of the choice that every employer and every consumer wants in order to make health care affordable in our region.
