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UPMC, Highmark reach new 10-year deal, just before consent decree expires

New UPMC-Highmark contract announced by Pennsylvania Attorney General Josh Shapiro and Gov. Tom Wolf in Pittsburgh

UPMC, Highmark reach new 10-year deal, just before consent decree expires

New UPMC-Highmark contract announced by Pennsylvania Attorney General Josh Shapiro and Gov. Tom Wolf in Pittsburgh

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UPMC, Highmark reach new 10-year deal, just before consent decree expires

New UPMC-Highmark contract announced by Pennsylvania Attorney General Josh Shapiro and Gov. Tom Wolf in Pittsburgh

Attorney General Josh Shapiro announced Monday that UPMC and Highmark have a new contract that gives Highmark insurance customers in-network access to UPMC doctors and hospitals for the coming decade.FULL VIDEO: Watch the announcement by Gov. Tom Wolf and Pa. Attorney General Josh Shapiro in the video player above.Shapiro, who earlier this month lost a court decision in his effort to extend the companies' relationship, called the agreement a good deal for patients and the public.UPMC had opposed renewing their agreement in 2012 after Highmark purchased what's now Allegheny Health Network and became what UPMC viewed as a competitor in providing health services and insurance coverage. That led to a five-year consent decree that expires Sunday. Watch Pittsburgh's Action News 4 reporter Bob Mayo's report on the UPMC-Highmark deal. Pittsburgh Mayor Bill Peduto and Allegheny County Executive Rich Fitzgerald react to the UPMC-Highmark deal: Watch the full interview below.___Joint statement from governor and attorney general:Attorney General Josh Shapiro and Governor Tom Wolf today announced UPMC and Highmark have agreed to enter into a 10-year contract that ends their longstanding dispute and ensures Highmark patients will have access to UPMC doctors and facilities. The contract will go into effect on July 1, the day after the expiration of the current consent decrees, ensuring that patients should not experience any disruption in their care. This is a global agreement as all UPMC hospitals are now an option for Highmark's insured patients. This is the longest deal that UPMC has ever made with any insurer."I'm proud to announce this historic settlement today that restores fairness and access to affordable care for the people of Western Pennsylvania and reinjects real choice into the healthcare marketplace," said Attorney General Josh Shapiro. "Without this agreement, millions of patients -- including seniors, cancer patients, and working mothers—would have had their health care abruptly upended. Thanks to the patients who told their stories about what they stood to lose, Western Pennsylvanians now have their access to a fair healthcare system secured for the next decade.""Pennsylvanians deserve access to quality, affordable healthcare, and this agreement between UPMC and Highmark preserves that access for the people of Western Pennsylvania for the next ten years," said Governor Tom Wolf. "I'm proud of the hard work of Attorney General Shapiro and his legal team to secure this victory for Western Pennsylvanians, and I'm glad my administration was able to support this work. I'm grateful to the many patients who stood up and advocated for their right to care."Attorney General Shapiro worked with UPMC and Highmark for two years to resolve the issue posed by the expiring consent decrees and to prevent further harm to the public. When negotiations failed to yield a result, Attorney General Shapiro filed a petition in February 2019 against UPMC to modify the consent decrees. Before Commonwealth Court ruled on June 14th that the state could not modify those agreements, Attorney General Shapiro had already entered into rigorous negotiations with the leadership of UPMC and Highmark to reach this agreement."As Attorney General, I swore an oath of office to protect the rights of all Pennsylvanians," said Attorney General Shapiro. "That means putting people before powerful institutions, and holding powerful institutions accountable to the people they serve. My Office will continue working tirelessly on behalf of all Pennsylvanians."The legal battle over the last several months has been complex, and my legal team has worked tirelessly. On behalf of a grateful Commonwealth, I want to thank them for their dedication, talent and countless hours of work. I would also like to thank the leadership of UPMC and Highmark, Governor Wolf and the many other elected officials who came together to help deliver this result for the people they serve."____Statement from Highmark Health President and CEO David Holmberg:Today's news about a contract between Highmark and UPMC fulfills the promise to our community that we at Highmark Health have strived to achieve for the last five years: Consumers and patients have two outstanding health systems, in addition to our many independent community hospitals, to choose from for their care.This announcement brings the certainty of health care access to thousands of people in our community. It marks a significant step forward for our region.On behalf of our employees, clinicians and all of those we serve, I'd like to thank Pennsylvania Attorney General Josh Shapiro for his leadership and advocacy in helping to broker this new day for health care in Western Pennsylvania.It's important to remember that five years ago Highmark took bold steps to preserve health care choice in this region by investing more than $2 billion in the exceptional care and services provided by AHN in the Pittsburgh and Erie regions, including a nationally recognized cardiac team that boasts the #1 heart transplant program in the state and a top 10 program in the country; a cancer institute that collaborates with the world renowned Johns Hopkins cancer center to offer leading-edge innovation and cancer treatment capabilities; and a women’s health program that is setting new standards for the treatment of women with post-partum depression, among many other examples.We created AHN in service to the community and to preserve 17,000 health care jobs, a number that has grown to more than 20,000 today. We plan to continue growing AHN to meet the needs of patients throughout the region.Together, Highmark and AHN are recognized as national leaders in the development and delivery of a community-focused, value-based care model that focuses on keeping patients healthy, and providing effective health care options in convenient, close-to-home settings. This is the future of health care in our country and Highmark and AHN have been at the forefront of the transformation.While the contract terms and conditions between Highmark and UPMC will be finalized throughout the next few weeks, beginning July 1 all Highmark members will have full in-network access to UPMC if their health plan includes UPMC in their health care provider network.____Statement from UPMC spokesman Paul Wood:UPMC today announced that with Attorney General Josh Shapiro's support and facilitation, it has reached an agreement with Highmark to enter into a long-term contract to provide Highmark members with the in-network access to the UPMC physicians and facilities they desire -- not only in greater Pittsburgh and Erie, but across western Pennsylvania. This agreement includes an extension of the UPMC Children's and UPMC Western Psychiatric agreements and provides for UPMC in-network access at the highest benefits levels.Over the past decade, the insurance market in western Pennsylvania has transformed into a highly competitive, multi-insurer, pro-consumer market with some of the lowest costs in the nation. In that same time, UPMC continued to invest in the world-class medicine and research that makes UPMC the indispensable provider of health care throughout Pennsylvania.Following the June 14 Commonwealth Court decision, UPMC held a productive, congenial meeting with Highmark to outline its offer to provide in-network access to the UPMC Hillman Cancer Center for Highmark members with a suspected or confirmed cancer or hematologic diagnosis. Highmark recognized -- as do all -- that the UPMC Hillman Cancer Center is as essential to the region's well-being as specialty hospitals UPMC Children’s and UPMC Western Psychiatric. Those discussions then quickly expanded to other areas, and an agreement in the best interests of the patients and communities we serve was reached.UPMC believes in the importance of informed consumer choice and has always sought to ensure that when UPMC is part of any insurance network, those members have full access to UPMC without contractual terms used to discourage or limit the use of UPMC's physicians and facilities. This important consumer issue was resolved in a collaborative fashion and UPMC’s network will now be available to Highmark members. UPMC appreciates that we were able to reach this agreement with Highmark on a long-term, in-network contract.UPMC is grateful for the Attorney General's leadership as the agreement announced today was built on a foundation of trust, compromise and collaboration. As always, UPMC remains committed to exceptionally serving the health care needs of the citizens of Pennsylvania.

Attorney General Josh Shapiro announced Monday that UPMC and Highmark have a new contract that gives Highmark insurance customers in-network access to UPMC doctors and hospitals for the coming decade.

FULL VIDEO: Watch the announcement by Gov. Tom Wolf and Pa. Attorney General Josh Shapiro in the video player above.

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Shapiro, who earlier this month lost a court decision in his effort to extend the companies' relationship, called the agreement a good deal for patients and the public.

UPMC had opposed renewing their agreement in 2012 after Highmark purchased what's now Allegheny Health Network and became what UPMC viewed as a competitor in providing health services and insurance coverage. That led to a five-year consent decree that expires Sunday.

Watch Pittsburgh's Action News 4 reporter Bob Mayo's report on the UPMC-Highmark deal.

Pittsburgh Mayor Bill Peduto and Allegheny County Executive Rich Fitzgerald react to the UPMC-Highmark deal: Watch the full interview below.


___

Joint statement from governor and attorney general:

Attorney General Josh Shapiro and Governor Tom Wolf today announced UPMC and Highmark have agreed to enter into a 10-year contract that ends their longstanding dispute and ensures Highmark patients will have access to UPMC doctors and facilities. The contract will go into effect on July 1, the day after the expiration of the current consent decrees, ensuring that patients should not experience any disruption in their care. This is a global agreement as all UPMC hospitals are now an option for Highmark's insured patients. This is the longest deal that UPMC has ever made with any insurer.

"I'm proud to announce this historic settlement today that restores fairness and access to affordable care for the people of Western Pennsylvania and reinjects real choice into the healthcare marketplace," said Attorney General Josh Shapiro. "Without this agreement, millions of patients -- including seniors, cancer patients, and working mothers—would have had their health care abruptly upended. Thanks to the patients who told their stories about what they stood to lose, Western Pennsylvanians now have their access to a fair healthcare system secured for the next decade."

"Pennsylvanians deserve access to quality, affordable healthcare, and this agreement between UPMC and Highmark preserves that access for the people of Western Pennsylvania for the next ten years," said Governor Tom Wolf. "I'm proud of the hard work of Attorney General Shapiro and his legal team to secure this victory for Western Pennsylvanians, and I'm glad my administration was able to support this work. I'm grateful to the many patients who stood up and advocated for their right to care."

Attorney General Shapiro worked with UPMC and Highmark for two years to resolve the issue posed by the expiring consent decrees and to prevent further harm to the public. When negotiations failed to yield a result, Attorney General Shapiro filed a petition in February 2019 against UPMC to modify the consent decrees. Before Commonwealth Court ruled on June 14th that the state could not modify those agreements, Attorney General Shapiro had already entered into rigorous negotiations with the leadership of UPMC and Highmark to reach this agreement.

"As Attorney General, I swore an oath of office to protect the rights of all Pennsylvanians," said Attorney General Shapiro. "That means putting people before powerful institutions, and holding powerful institutions accountable to the people they serve. My Office will continue working tirelessly on behalf of all Pennsylvanians.

"The legal battle over the last several months has been complex, and my legal team has worked tirelessly. On behalf of a grateful Commonwealth, I want to thank them for their dedication, talent and countless hours of work. I would also like to thank the leadership of UPMC and Highmark, Governor Wolf and the many other elected officials who came together to help deliver this result for the people they serve."

____

Statement from Highmark Health President and CEO David Holmberg:

Today's news about a contract between Highmark and UPMC fulfills the promise to our community that we at Highmark Health have strived to achieve for the last five years: Consumers and patients have two outstanding health systems, in addition to our many independent community hospitals, to choose from for their care.

This announcement brings the certainty of health care access to thousands of people in our community. It marks a significant step forward for our region.

On behalf of our employees, clinicians and all of those we serve, I'd like to thank Pennsylvania Attorney General Josh Shapiro for his leadership and advocacy in helping to broker this new day for health care in Western Pennsylvania.

It's important to remember that five years ago Highmark took bold steps to preserve health care choice in this region by investing more than $2 billion in the exceptional care and services provided by AHN in the Pittsburgh and Erie regions, including a nationally recognized cardiac team that boasts the #1 heart transplant program in the state and a top 10 program in the country; a cancer institute that collaborates with the world renowned Johns Hopkins cancer center to offer leading-edge innovation and cancer treatment capabilities; and a women’s health program that is setting new standards for the treatment of women with post-partum depression, among many other examples.

We created AHN in service to the community and to preserve 17,000 health care jobs, a number that has grown to more than 20,000 today. We plan to continue growing AHN to meet the needs of patients throughout the region.

Together, Highmark and AHN are recognized as national leaders in the development and delivery of a community-focused, value-based care model that focuses on keeping patients healthy, and providing effective health care options in convenient, close-to-home settings. This is the future of health care in our country and Highmark and AHN have been at the forefront of the transformation.

While the contract terms and conditions between Highmark and UPMC will be finalized throughout the next few weeks, beginning July 1 all Highmark members will have full in-network access to UPMC if their health plan includes UPMC in their health care provider network.

____

Statement from UPMC spokesman Paul Wood:

UPMC today announced that with Attorney General Josh Shapiro's support and facilitation, it has reached an agreement with Highmark to enter into a long-term contract to provide Highmark members with the in-network access to the UPMC physicians and facilities they desire -- not only in greater Pittsburgh and Erie, but across western Pennsylvania. This agreement includes an extension of the UPMC Children's and UPMC Western Psychiatric agreements and provides for UPMC in-network access at the highest benefits levels.

Over the past decade, the insurance market in western Pennsylvania has transformed into a highly competitive, multi-insurer, pro-consumer market with some of the lowest costs in the nation. In that same time, UPMC continued to invest in the world-class medicine and research that makes UPMC the indispensable provider of health care throughout Pennsylvania.

Following the June 14 Commonwealth Court decision, UPMC held a productive, congenial meeting with Highmark to outline its offer to provide in-network access to the UPMC Hillman Cancer Center for Highmark members with a suspected or confirmed cancer or hematologic diagnosis. Highmark recognized -- as do all -- that the UPMC Hillman Cancer Center is as essential to the region's well-being as specialty hospitals UPMC Children’s and UPMC Western Psychiatric. Those discussions then quickly expanded to other areas, and an agreement in the best interests of the patients and communities we serve was reached.

UPMC believes in the importance of informed consumer choice and has always sought to ensure that when UPMC is part of any insurance network, those members have full access to UPMC without contractual terms used to discourage or limit the use of UPMC's physicians and facilities. This important consumer issue was resolved in a collaborative fashion and UPMC’s network will now be available to Highmark members. UPMC appreciates that we were able to reach this agreement with Highmark on a long-term, in-network contract.

UPMC is grateful for the Attorney General's leadership as the agreement announced today was built on a foundation of trust, compromise and collaboration. As always, UPMC remains committed to exceptionally serving the health care needs of the citizens of Pennsylvania.