Insurance mess

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At first I found the UPMC ads amusing, now I am just annoyed. As a former employee of both UPMC and West Penn Allegheny Health System, I know what is true. UPMC insurance has never allowed its members to be treated at Allegheny General Hospital. They had to be transferred to a UPMC facility. This is the very thing UPMC is accusing Highmark of doing in the future.

However, if a facility has a contract with an insurance company, the insurance company cannot deny a member from seeking care from that facility. Patients still have control of their health care. So if UPMC signs a contract with Highmark, Highmark could not deny a patient's care at a UPMC facility. That would only happen if UPMC does not sign a contract. So if UPMC loses patients it's UPMC's fault for not signing a contract. UPMC is a much larger health system, so why is it paranoid? Why is CEO Jeff Romoff's knickers in a twist?

I know many great doctors in both systems and they are disgusted by this mess. They just want to practice medicine and better the lives of their patients. UPMC, sign the contracts and allow patients to receive the care they need from the doctors they want. Their lives may depend on it.




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