UPMC refuses to contract with Highmark because Highmark will place UPMC in the highest tier, thereby forcing patients to use Highmark’s own hospitals. Since UPMC entered the health insurance business, all non-UPMC hospitals are out of network. Whether you call it a tier or a network, the end result is that both of these organizations want to dominate health care in the city of Pittsburgh.
In Section A of the Sunday issue of the Post-Gazette, UPMC ran a nearly full-page ad explaining the reason it refuses to contract with Highmark. In Section D of the same paper, a physical therapist in Erie County, Pa., describes that UPMC recently designated his privately owned physical therapy company as a “Level 2” provider to UPMC health insurance subscribers. His patients will pay higher co-pays and deductibles if they choose his facility over a UPMC-owned physical therapy provider (“Network’s Steps Irk Private Physical Therapists,” Dec. 15 Business).
Both of these organizations need to remember why they were granted nonprofit status. They need to get back to caring for the sick and fighting diseases, and stop spending our premium dollars fighting each other.