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UPMC, Highmark Strike 10-year Deal that will allow patients to keep their doctors

By Annabelle Hanflig
Pittsburgh Current Intern
info@pittsburghcurrent.com

UPMC and Highmark announced today a 10-year partnership to allow Highmark users to keep their UPMC doctors, hospitals and plans of care for the foreseeable future. 

After years of debate between the two healthcare giants, state Attorney General Josh Shapiro declared the inception of a “historic” agreement to extend the services of UPMC hospitals to those with Highmark insurance plans in Western Pennsylvania. The deal comes six days before a court-approved expiration of a consent decree that would’ve taken 11 UPMC hospitals off of Highmark insurance plans.  

At the urging of UPMC, Shapiro, UPMC President/CEO Jeffery Romoff and Highmark President/CEO David Holmberg entered into an “honest and tough and productive dialogue” to protect the healthcare of Western Pennsylvanias, “regardless of what the court might ultimately say.” 

The attorney general said this dialogue occurred before Commonwealth Court Judge Robert Simpson, who ruled on June 14 that the consent decree was to expire at the end of the month. 

The contract will go into effect July 1, one day after the end of the consent decree, avoiding any disruption in care for Highmark users. Had the deal not gone through, thousands of patients in Pittsburgh and Erie would’ve had to start their plans of care from scratch. 

Shapiro commended UPMC and Highmark for coming to the “historic” agreement without government intervention, as well as the doctors, nurses, hospital employees, activists and labor leaders who “refused to give up the fight.” 

“Because of their voices, the people of Western Pennsylvania now have access—access to a fair healthcare system secured for the next decade.”

The outcome of the months-long dispute between UPMC, Highmark, and the attorney general was up in the air until today. The consent decree was passed from court to court before ultimately being allowed to expire. In February, Shapiro filed a lawsuit against UPMC questioning the legal integrity of its charity status and alleging a violation of the Consumer Protection law. 

UPMC rebuffed the claims in court, and will not have to face them again. Shapiro is dropping the lawsuit in conjunction with the agreement. 

Elected officials expressed satisfaction with the overall results of the agreement, but made clear their desire to see permanent solutions to the issues raised throughout the dispute. 

“While we recognize and respect the fact that both Highmark and UPMC have been vital employers and participants in our region’s economic growth, their leadership should understand that if they continue to operate like for-profit businesses, our property tax laws will treat them as such,” said state Sen. Wayne D. Fontana. 

Allegheny County Controller Chelsa Wagner echoed these concerns, questioning the legitimacy of the contract and urging citizens to continue to question UPMC’s charitable status. 

“That such an agreement needs to be signed by a ‘purely public charity’ only serves to underline the absurdity of what UPMC has subjected us to over these years in its quest for market dominance,” she said.  

State Senator Lindsey M. Williams also highlighted the “uncertainty and upheaval” that plagued UPMC patients and their plans of care during these contentious negotiations. 

Shapiro went so far as to say that the agreement “eliminated angst from the marketplace and from the heart of Pennsylvania families,” as well as “[reinjected] real choice back into the marketplace.”

However, recent protests suggest otherwise. UPMC employees, elected officials and citizens from all over the region flooded the driveway of UPMC Montefiore late last month to demand that UPMC “respect workers’ rights, to cancel its employees’ debt, to accept every patient who needs care, and to return to its charitable mission,” according to the protesters’ Facebook event page. 

Many claim that UPMC has engaged in union-busting tactics against its employees, some of which are “barely scratching the surface of surviving.” 

This unprecedented deal between UPMC and Highmark may alleviate some of these concerns but still leaves UPMC with more than just a scratch on its record. 

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