Pennsylvania Attorney General Josh Shapiro announced yesterday that UPMC and Highmark have agreed to a long-term contract which will allow Highmark members continued in-network access to all UPMC physicians and facilities in western Pennsylvania. This news has been well received by the Pittsburgh community, which has benefited from a transformation of the insurance market over the past decade, but feared some would lose access to the excellent clinical care provided by UPMC physicians and hospitals.
 
Over the past two decades, UPMC Health Plan, with the support of all of you, has helped to transform western Pennsylvania into a highly competitive, pro-consumer insurance market with some of the lowest costs in the nation. The ability to offer high-value networks of providers with robust products to facilitate improved quality and cost outcomes is our signature.
 
The coming decade will require a further effort to improve quality and affordability in health care. We believe competition is essential to that formula.  UPMC's unique ability to align outstanding clinical services with outstanding coverage and superior member services is well positioned to meet the needs of the employers and individuals in our market who are looking for maximum value.   

Please note that the UPMC-Highmark announcement will not have any impact on the network status of the excellent UPMC and independent community hospitals and physicians participating in UPMC Health Plan’s network today; this includes products with access to 95% of all hospitals and physicians in Western Pennsylvania including the AHN physicians and select AHN facilities.  UPMC Health Plan will continue to offer a variety of networks and products, which support physicians and hospitals to deliver exceptional value and service to their patients and to our members. 

We appreciate your ongoing commitment to assist your clients in choosing the UPMC Health Plan products that offer the most value and best meet their needs for high quality coverage and care.   
 
Please see the UPMC Press Release below:
 

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.