One is a gleaming glass structure where patients can check out iPads or iPods and order meals directly from a cafeteria that features a brick stove, and where patients enjoy the meal as they watch a program on a 46-inch widescreen television in their private room.
The other has been a big part of Monroeville's fabric for decades and has undertaken a $20 million renovation in the past year, including a complete upgrade of three patient floors, which also now feature all private rooms.
Those aesthetics, of course, are not the primary purpose and mission of UPMC East and Forbes Regional hospitals, but they are undoubtedly the byproduct of the head-to-head competition between the spanking new UPMC East and the long-established Forbes Regional.
More than six months after UPMC East's opening, top administrators at both facilities say they are happy with how things are going in their respective hospitals. "I think what we're developing there is a peaceful co-existence. We have two different platforms," said anesthesiologist Mark Taylor, who is president of the Forbes medical staff.
Even more important than having a shiny new facility, from UPMC East's perspective, is what their hospital represents -- a gateway into the vast UPMC health system. About 90 percent of the hospital's medical staff also works at the health system's major urban centers, said UPMC East president Mark Sevco. "We're almost an extension of UPMC Shadyside."
Forbes, meanwhile, sees itself as the one-stop shop for care for Monroeville and surrounding eastern communities. Unlike UPMC East, the hospital can deliver babies, perform open heart surgeries and neurosurgeries.
"How do you compete with the glass front right off of [the Parkway East]? That's difficult to replicate," said Reese Jackson, president and CEO at Forbes. "But how can they replicate a hospital that's been here since the mid-'70s? What we don't have, they don't have."
Forbes has seen growth in services such as open heart procedures, robotics, neurosurgery and trauma. Its overall surgical volume is unchanged from a year ago, he added, "and it's going to increase with the further development of these services." The hospital opened a new breast care center in August.
Mr. Jackson acknowledged that Forbes has taken a hit in patient volume numbers since UPMC East opened, most notably in the emergency room. He said the hospital has lost 20-25 daily emergency room walk-ins, but still sees about 115 ER patients daily at Forbes.
The federal Centers for Medicare and Medicaid Services (CMS) just released a report showing Forbes patients waiting 46 minutes on average to see a health professional in the emergency room, compared with a national media wait time of 33 minutes. But West Penn Allegheny spokesman Dan Laurent said the 2011 addition of a new wing in the Forbes emergency department, which added eight more beds and four more triage rooms, has dropped that wait time "from arrival to reaching an ED room" to about 10 minutes.
(Because it is so new, UPMC East was not included in the CMS report, although Mr. Sevco said emergency room patient wait time before seeing a physician is "12 minutes or less.")
The presence of two healthy hospitals has been nothing but beneficial for eastern suburb residents, says Monroeville Mayor Gregory Erosenko.
"We're having physician offices move in, and once the [Highmark-West Penn Allegheny Health System] merger takes place, I think there will be even more. I hope that whole corridor is going to be medical businesses."
Health benefits expert Tom Tomczyk of Buck Consultants, Downtown, said the build-up is no surprise. "I think both UPMC and Highmark see this as a key spot. What you have are two businesses trying to achieve market share. It just so happens that the business is health care and the market is people's lives and people's needs."
Both facilities may survive and even thrive, he said, but eventually the Pittsburgh region will have to come to terms with the fact that it has too many hospital beds. Whether it's in Monroeville or a facility in the city, eventually "some other facility will have to close" or be converted to some other use, he said.
Meanwhile, both UPMC and Highmark-backed Forbes show every sign of going all-in at their Monroeville sites.
Mr. Sevco said UPMC East, where patient rooms feature state-of-the-art technology for tracking and monitoring care, has seen increases in patient volume every month since the hospital opened and it is now at 85 percent capacity. When patients do require higher level care, he said, they are 10 minutes by air to UPMC Shadyside or a 15-minute drive. He described the process as "seamless."
He also noted the hospital's economic benefit: UPMC East opened with 400 employees in July, now has 650 and "we're still hiring. I think it's been a tremendous asset, not only to Monroeville but to surrounding communities."
Highmark, whose formal affiliation with Forbes parent West Penn Allegheny Health System is still under state insurance department review, has made it clear it wants to establish footholds in suburban communities. Its $20 million investment in Forbes underscores that. If all goes according to plan, Forbes will have renovated operating rooms and state certification as a Level II trauma center in a matter of months.
"Nationally, there are a lot of eyes on us," said Mark Rubino, an obstetrician-gynecologist and the chief medical officer at Forbes.
All agree that the competition has forced both sides to pick up their game.
The question for health care consultants such as Mr. Tomczyk is whether it can be sustained. "Right now both of them are moving forward with their initial plans," he said, "but something is going to have to change."