Lifesaving measure: Forcing Highmark and UPMC back to the table
Share with others:
On Thursday UPMC CEO Jeffrey Romoff reiterated that the region's largest hospital network will not renew its contract with the region's largest health insurer, Highmark.
That puts millions of Highmark customers only nine months away from the expiration of the agreement that gives them in-network access to UPMC hospitals and personnel. This change will force a seismic disruption in the stability of health care in the Pittsburgh region, ending patients' long histories with valued doctors and making treatment at respected hospitals too expensive.
Yet Mr. Romoff's advice is to drop your Highmark plan and go with another carrier that has in-network access to his system.
Memo to Mr. Romoff: It's not that simple and it's not your system.
•
We're not alone in thinking this. Employers are concerned about the viability of the Highmark plans they've purchased to cover health care for their employees. Individuals, in a hostile health care/health insurance atmosphere, are consumed by uncertainty over switching providers for their families, particularly if they have pre-existing medical conditions.
Pittsburgh business leaders, elected officials and the public also agree on something else. This $8 billion global health enterprise -- with 20 academic, community and specialty hospitals; 400 outpatient sites; and facilities in Ireland, Italy and the United Kingdom -- was not built by the smarts and ingenuity of UPMC alone. It also comes courtesy of a tax exemption conferred by the state's public charities law, a preferred status that leverages not only dollars but, to a greater extent, good will that has delivered taxpayer funding and tremendous philanthropy, large and small, toward the construction and operation of UPMC facilities in Western Pennsylvania.
That community good will is being shredded by UPMC's corporate decision to refuse to negotiate a new agreement with Highmark, ostensibly because the insurer has thrown in its lot with UPMC's struggling competitor, the West Penn Allegheny Health System. While UPMC says it can no longer deal with Highmark because the insurer wants to partner with a competitor, we believe something more primal is at work: UPMC realizes that Highmark's preservation of WPAHS blocks UPMC's drive to become a near-monopoly in the region.
First Published September 25, 2011 12:00 am
