Governor creates a team to address UPMC, Highmark dispute
June 2, 2014 11:48 PM
The Fifth Avenue Place headquarters of Highmark in view with the U.S. Steel Tower offices of UPMC, in Downtown Pittsburgh.
By Steve Twedt / Pittsburgh Post-Gazette
Saying "the fear-mongering needs to stop," Gov. Tom Corbett announced Monday that he has created a "Patients First" leadership team to address the ongoing contract dispute between Pittsburgh health care giants Highmark and UPMC.
Mr. Corbett said he has directed state insurance commissioner Michael Consedine and Department of Health Secretary Michael Wolf to meet with senior managers on both sides beginning this week "to make sure that Pennsylvanians in the western part of the commonwealth have clarity about their health care come Jan. 1, 2015, and in the years to come."
The governor said he also asked Attorney General Kathleen Kane "to join us in these discussions," adding that "I also expect to meet personally in the near future with the boards of both companies to communicate our goals."
UPMC has steadfastly said it will not renew or extend its in-network contract with Highmark beyond 2014 now that the insurer has established its own integrated delivery network, the Allegheny Health Network, to compete with UPMC's health care services.
While Highmark officials have said all along they are willing to talk about a new contract, their UPMC counterparts maintain that the discussion should be about planning a smooth transition out of the contract that covers about 1 million people in the region.
The governor's announcement does not say the leadership team will push for a contract and, in fact, Mr. Corbett said, "I am not asking, nor do I expect, the companies to abandon their business objectives. I do expect both companies to dedicate their energies toward putting their patients first."
Rep. Dan Frankel, D-Squirrel Hill, who has proposed legislation requiring providers such as UPMC to accept "any willing insurer," said he welcomed the governor's involvement in the issue but said the statement from Mr. Corbett's office was "not as tough a statement as I would have liked."
UPMC, he said, is "a purely public charity and that is something that this group needs to keep front and center."
Meanwhile, Senate Pro Tempore Joseph Scarnati, R-Jefferson, who has opposed using legislative action to intervene in the dispute, praised the governor's announcement. Speaking on behalf of the senator, chief of staff Drew Crompton said, "The conversation should focus on the transition [to the contract's end] and education for consumers, and it seems that is the perspective of the governor's office.
"We applaud the action and we hope that it helps subscribers into what we call this new frontier of a world in which these two entities will be competing against each other."
Two years ago, the governor brokered an agreement that extended the existing contract through December 2014. Also, in August, he directed the state insurance and health departments to create an interagency task force that would monitor Highmark and UPMC advertising and other communications to ensure they were not creating confusion for consumers.
Both sides said they have since stopped running attack ads -- UPMC since February and Highmark in recent weeks.
The formation of the governor's new leadership team comes as Highmark is facing a July 31 deadline to file a post-contract transition plan unless an agreement is reached this month.
Despite the deadline already in place, "The time has come for leaders from both sides to get together around a table and figure out a reasonable plan," the governor's statement reads.
"No patient in the midst of treatment should be told he or she needs to find a new doctor, nor should anyone need to travel outside the area because their local community hospital is no longer an option."
In response to the governor's announcement, UPMC spokesman Paul Wood said Monday, "UPMC has been in active discussions with the governor and his team about a robust, patient-focused transition when the contracts expire at the end of this year.
"Importantly, with the other national insurers in the marketplace providing affordable in-network access to UPMC, the vast majority of consumers switching plans will not need to worry about changing their doctors or hospitals."
Mr. Wood gave no indication that UPMC was open to renewing or extending the Highmark contract, but he did offer this:
"For those people who are seriously ill and in the course of treatment, and they elect to stay with Highmark instead of switching, we're going to take whatever time it takes to give them the care they need" as in-network patients, Mr. Wood said. "Only after they are properly served, do they need to worry about the transition."
Meanwhile, newly appointed Highmark President and CEO David Holmberg said, "We welcome and appreciate the governor's willingness to engage in any effort to put patients first amidst the contract issue with UPMC. Patients are, and have always been, our top priority at Highmark Health. Because our members are so important to us, we are prepared to do whatever is necessary to protect them.
"We support the opportunity to sit down with this new group and UPMC for the benefit of Western Pennsylvania members and all health care consumers in the region."
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