PITTSBURGH – Protecting access to good health care for residents is a top concern for regional lawmakers as the leaders and members of the General Assembly today urged Highmark and UPMC to get back to the bargaining table.
House Majority Leader Mike Turzai (R-Allegheny County), House Democratic Leader Frank Dermody (D-Allegheny County), Senate Democratic Leader Jay Costa (D-Allegheny County), and members from the three legislative caucuses met today in the Allegheny County Courthouse to discuss the dispute between the two health care agencies.
The members announced they sent a formal letter to the two entities to sit down with legislators to discuss the status of negotiations. Hearings will be held by the House Insurance Committee and the Senate Banking and Insurance Committee to determine what, if any, legislative or regulatory remedy is available.
“These are two huge community assets in western Pennsylvania, and we can’t sit on the sidelines as constituents are seriously worried about their ability to see a doctor,” Turzai said. “They need to work out these important issues without cutting off access to the quality health care.”
“Highmark and UPMC are two of our region’s largest employers and they are crucial parts of the health framework for thousands of Pennsylvanians,” Dermody said. “This public dispute is causing great concern to retirees, workers with families, and employers all over. We cannot shut the door on people’s access to doctors or hospitals. This fight needs to end.”
“We want to make certain the public’s interest is being served by these two major players in delivering health care to Western Pennsylvania. The public clearly won’t be served if health care access is limited, restricted, or disrupted in any way. That must be avoided,” said Costa. “No matter where people seek care — Hillman Cancer Center, West Penn Burn Center, Magee-Women’s Hospital or any of the other institutions that are so heavily relied upon – the public needs to be assured that the high level of care they have received in the past will not be impacted.”
UPMC is the region’s largest hospital and doctor network. Highmark controls 65 percent of the region’s health insurance market in western Pennsylvania, extending from the Pittsburgh region up north to the Erie area.
UPMC and Highmark are in the last year of a 10-year provider agreement, which allows Highmark members to see UPMC doctors and use UPMC hospitals; the contract ends June 30, 2012. Negotiations for a new contract broke off when Highmark began considering acquiring the financially troubled West Penn Allegheny Health System, a major UPMC competitor (West Penn Allegheny is the Pittsburgh region’s second largest hospital network).
Highmark has since reached a preliminary agreement to buy West Penn Allegheny, which prompted UPMC to end talks and open its network to other commercial insurance carriers.
If Highmark and UPMC do not reach an agreement, 2,700 UPMC doctors and affiliated hospitals will become out-of-network providers to approximately 3 million Highmark subscribers. Out-of-network fees are generally much higher than in-network doctors and hospitals, increasing out-of-pocket expenses for consumers.
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