Highmark, UPMC competing for private physicians

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UPMC has acquired Infectious Disease Associates, an independent practice of four physicians in Bloomfield that has been associated with the rival West Penn Allegheny Health System for years.

The shift comes two weeks after the departure of three family practice physicians from the private practice Pittsburgh Medical Associates in Banksville who have joined Highmark Inc.'s new health care network.

The moves, say experts, show that while UPMC and Highmark may have temporarily resolved their contract dispute, their race to buy up local physician practices continues unabated, albeit largely out of public view.

"UPMC and Highmark are at war. It's no more complicated than that," said health consultant Jan Jennings, president and CEO of American Healthcare Solutions, Downtown. "One of the most important moving parts in how both organizations conduct themselves is the physicians who are loyal to them, so they are in a buying frenzy on both sides."

Highmark spokesman Aaron Billger said Monday that the insurer has recruited about 100 physicians in the past year to its still-under-construction regional network, including a dozen or so from UPMC. One of Highmark's biggest coups came in January, when it recruited Premier Medical Associates in Monroeville, the area's largest multispecialty private practice group.

But UPMC, which added 333 physicians in the past year, has done its share of scooping up doctors from the West Penn Allegheny Health System, which is awaiting final state regulatory approval to affiliate with Highmark.

In some cases, recruiting physicians from a competing health system may mean the physicians cannot practice locally for a period of time due to contractual obligations.

The departure of Infectious Disease Associates prompted WPAHS chief medical officer Tony Farah and Department of Medicine chair Susan Manzi to pen a letter to colleagues calling the group "a valuable resource to the West Penn Allegheny Health System for many years." A copy of the letter was obtained by the Pittsburgh Post-Gazette on Monday.

"We sincerely regret that these respected physicians have chosen to practice elsewhere despite lengthy negotiations, extremely competitive offers from Highmark, and our best possible efforts to keep them within our system," the letter read.

The letter also said they were already recruiting other infectious disease physicians, and that "there will continue to be sufficient infectious disease consultative coverage" within the WPAHS system.

While local physician groups, particularly independent practices, may enjoy the bidding war for their services, it comes at a time when it is getting harder to remain independent, said John Krah, executive director of the Allegheny County Medical Society.

"The challenges of remaining independent are so significant," he said Monday, citing ongoing uncertainty about Medicare reimbursements, the push to adopt and maintain electronic health record systems and provisions of the new health care reform law that encourage alignments.

"The expenses are going up and payments are going down," he said.

That is why aligning with either UPMC or Highmark could prove very appealing, said Mr. Jennings.

"It lifts the business of having to pay their own rent, paying their own medical malpractice, taking care of their own payroll. When you're employed, you're liberated. You get a paycheck every two weeks, no matter what, and you work predictable hours," he said.

"UPMC is buying more physician practices than it has in probably 10 years, but Highmark is in the market as well. So probably the endangered species in the Pittsburgh market is the private practice physician," Mr. Jennings said.

He said both UPMC and Highmark "are both very attractive" networks, and that he would have trouble deciding between them.

Doctors "are very privately sitting at a table and deciding on what's in their own best interest," he said, adding, that "the No. 1 driver is the economics."

businessnews - health

Steve Twedt: stwedt@post-gazette.com or 412-263-1963.


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