July 7, 2013
Currently, UPMC and Highmark have an agreement through December 31, 2014. This means that any Highmark member (except those with Community Blue) will be able to use all UPMC facilities and doctors at in-network rates through the end of 2014.
In June, UPMC announced that, because of Highmark’s recent acquisition of the Allegheny General/West Penn health system, they would not be extending this contract. This means that Highmark customers would not be able to see UPMC doctors or go to UPMC hospitals at in-network rates, beginning January 1st, 2015. The exceptions are Children’s Hospital of Pittsburgh of UPMC, Western Psychiatric Institute and Clinic, UPMC Northwest in Seneca, UPMC Bedford Memorial, and some specialty services, such as certain oncology services. Those hospitals have separate contracts with UPMC that extend beyond the end of 2014.
In general, we are telling our clients not to base any 2013 decisions on the potential split. While it is looking more and more certain, 2014 will be a big year of change in the health insurance marketplace with the implementation of Health Care Reform and the bidding wars between Highmark and UPMC for the best doctors and practices in the region. Once the dust settles in 2014, we will be better able to understand and advise clients on the personal impact of this dispute and make sure they are properly insured for their needs at the end of 2014.
By: Liz Kennon