Majority backs forced health pact between UPMC, Highmark

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Should Highmark and UPMC fail to strike a new deal, Pittsburgh-area employers won’t be dumping Highmark’s insurance plans — but they won’t be offering Highmark exclusively either, according to a small survey from the Pittsburgh Business Group on Health.

The survey, conducted in February, asked member companies, "If UPMC and Highmark are not legally required to contract with each other, will you change carriers?" Nearly 40 companies responded to the survey. 

Of those, 53 percent said they would offer another health carrier in addition to Highmark plans; 19 percent said there would be "no change in carriers;" and 28 percent said they would "replace Highmark with another national plan that contracts with UPMC."

"This is independent third-party validation," said UPMC spokesman Paul Wood. "And it's exactly what we've been forecasting all along, that business would choose to” offer plans from other carriers, or multiple carriers.

The results suggest that some businesses could start changing their health insurance offerings soon -- if not by the summer enrollment period, then by the end of 2014, when the current deal between Highmark and UPMC is set to expire. 

If that deal expires, or isn't renewed shortly afterward, those with Highmark insurance would find that most UPMC hospitals and specialist are out-of-network for 2015. It's a pressing issue because Highmark has more customers than any area insurer, and UPMC has more hospitals and doctors than any health system in the region. 

While most businesses surveyed said they would change up their insurance offerings, most would rather not.

Nearly two-thirds — 62 percent — believe UPMC and Highmark should be "legally required" to contract with each other. Of the remainder, it's unclear how many don't want any contract, and how many wish for a deal but don't think it should be politically forced upon the two companies. 

"The survey reflects the current marketplace and underscores the continuing and overwhelming public sentiment that Highmark and UPMC should be collaborating to meet the community’s health care needs," said Highmark spokesman Aaron Billger. "The community expects us to work together."

The Pittsburgh Business Group on Health — which provides group health purchasing and advocacy services to its dozens of member companies — asked its members what role the organization should play in the dispute.

More than a third (34 percent) said the organization should encourage Highmark and UPMC to work together, and an additional 29 percent of respondents said it should "reinforce the position that the employers pay the bills for [insurance] and need to be considered in the dispute."

Seven percent of survey respondents said the business group should remain neutral, and 2 percent (just one respondent) said PBGH should "support Highmark" in the dispute. None of the respondents advocated supporting UPMC.

Bill Toland: btoland@post-gazette.com or 412-263-2625.


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