Highmark shake-up: The insurer and UPMC still must come to terms

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Highmark rocked the region’s health care firmament Wednesday by abruptly canning its CEO. But today the same questions bedevil hospital patients and insurance customers: How do we keep access to quality medicine and how do we afford it?

It’s too early to say if the exit of William Winkenwerder, on the job for less than two years, and the promotion of David Holmberg, a Highmark executive who was working in Texas, will make a difference in the insurance giant’s coming split with UPMC. As everybody knows, most Highmark insurance customers will lose access to most UPMC physicians and facilities beginning Jan. 1, unless they pay much-higher out-of-network rates.

In announcing its CEO replacement, Highmark Health board chairman J. Robert Baum reiterated, “We want access to UPMC. We’re not going to give up on that.” To which UPMC fired back: There will be no new contract.

But maybe somewhere between the “contract” Highmark wants and the “transition plan” it must file with the state in July on how to handle patients through the UPMC separation, significant accommodations can be made to ensure fair access to the hospitals built by the people of this region.

All things are possible through negotiations. The question is whether Highmark and UPMC, now both in the health care and health insurance businesses, care enough to do what’s right for the patients who rely on them.

Mr. Holmberg comes highly touted to the CEO’s chair as someone who is customer-focused. If his UPMC counterpart will meet him halfway, they could come to terms that are right for Pittsburgh.

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