Not only are individuals concerned and frustrated about the end of relations between Highmark and UPMC, but so are some of the region’s major employers.
Last week, the Pittsburgh Business Group on Health, a coalition of employers that seeks to improve the cost and delivery of health care, released the results of a survey of its members on the split that is coming Jan. 1. That’s when UPMC, the region’s largest health care provider, will begin denying in-network access to customers of Highmark, the region’s largest health insurer.
The local health care landscape changed when Highmark acquired its own hospital group, the former West Penn Allegheny Health System, to compete with UPMC, thereby saving the region from being at the mercy of what eventually could become a hospital monopoly. Although UPMC’s response — to allow its contract with Highmark to expire — may have been understandable, it is not good for Western Pennsylvania patients, employers, insurance customers and others who need more time to adjust to the new health care reality.
According to the PBGH survey, almost two-thirds of the respondents, 62 percent, said UPMC and Highmark should be “legally required” to have a contract with each other. State House and Senate members have offered legislation that would accomplish that, but the proposal faces stiff opposition by Republican leaders who control the Senate.
Although most of the employers who participated in the survey want the law to require a UPMC-Highmark contract, a greater majority of the respondents are preparing for the separation. Fifty-three percent said they would offer their workers a choice between Highmark insurance and a plan that will provide in-network access to UPMC, such as UPMC Health Plan, United Healthcare, Cigna or Aetna. Another 28 percent said they would “replace Highmark with another national plan that contracts with UPMC.”
That’s 81 percent of the employers saying they will either switch health insurance from Highmark or add a Highmark alternative — either way, not the kind of news Highmark wants to hear. Welcome to the brave new world of health-insurance and hospital-network competition.
PBGH represents some of the region’s most prominent employers — Alcoa, Bayer, Consol Energy, FirstEnergy, GNC, Giant Eagle, Heinz, PPG and Westinghouse, to name a few — and since its survey was confidential and 37 of the 70 members who received it responded, it’s impossible to know where individual corporations stand on the UPMC-Highmark contract issue.
Even so, such employers account for many of the jobs and much of the health care and health insurance spending in the region. In that way, they wield considerable clout.
If they don’t like the coming separation of UPMC and Highmark, they should make their views known to both parties. If they want more time to adjust to the region’s evolving health care industry, they should speak out. If they believe, as 62 percent of the survey respondents do, that UPMC and Highmark should be “legally required” to contract with each other, they should pressure the leaders of the General Assembly and demand passage of the legislation that will accomplish that.
If employers believe, as many of their employees do, that UPMC and Highmark must continue to do business with each other, now is the time to make that case. In little more than nine months from now it will be too late.