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HIGHMARK UPDATE FOR JUNE 28, 2019

Today's Highmark Update features the following topics:
  • Highmark and UPMC 10-year Contract Producer Webinar Recap
  • Highmark Inc. and VSP Global Announce Definitive Agreement for VSP to Purchase Visionworks of America, Inc. 
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HIGHMARK AND UPMC 10-YEAR CONTRACT PRODUCER WEBINAR RECAP
Thank you for attending the Producer Webinar on the Highmark and UPMC 10-year Contract. We hope you found the update beneficial and as more information and client materials develop, we will continually keep you updated.

For your convenience and in case you missed it, here are some key takeaways:
  1. Highmark and UPMC have agreed to a 10-year contract offering full in-network access to Highmark members in our traditional PPO and EPO Products, beginning July 1, 2019.  
  2. The 10-year contract signed includes both Children’s Hospital and Western Psychiatric Institute and Clinic.
  3. The signed agreement is focused on western Pennsylvania and does not impact other regions.
  4. Highmark will continue to have the ability to offer High-Performing Network Products that include certain UPMC hospitals.
  5. Highmark and UPMC have agreed to Emergency Room Rates for all products.
     
  6. Commercial Products
  • Broad Access Products
    • In WPA, all Highmark members in broad access products like PPO Blue and Blue Card will have full in-network access to all UPMC facilities and doctors.
  • ​High Performing Products/Community Blue/Flex
    • In WPA, members in high-performing network products such as Community Blue Flex or Connect Blue are already in a high-quality lower cost plan. Members in these products will not have access to all UPMC facilities or doctors.
    • Certain services (like exception hospitals and some community oncology services) will be in-network. Other facilities and services (like Hillman and Passavant) will still be out-of-network. However, members will have affordable out-of-network protections for emergency department services at all UPMC facilities.
  1. Medicare and Medicare Advantage Members
  • Freedom Blue / Security Blue
    • The announcement of a contract with UPMC means these members have continued in-network access to UPMC. 
  • MA Community Blue message in WPA
    • These members are in a high-quality, lower-cost Medicare Advantage plan that does not include UPMC as an in-network provider.
    • The contract announcement doesn’t affect plans like Community Blue.
    • Community Blue PPO can continue to enjoy UPMC out-of-network benefits as they have in the past.
  • Medigap Blue Plan
    • ​Since Medigap policies do not have any network requirements, this announcement has no impact on Medigap Blue.
For your convenience, please utilize the presentation from yesterday's session to assist in any further questions you may have or when in discussions with your clients. A comprehensive Q&A and client materials are forthcoming. 

If you have additional questions, please email ProducerIntake@highmark.com or contact your Highmark Client Manager. 
HIGHMARK INC. AND VSP GLOBAL ANNOUNCE DEFINITIVE AGREEMENT FOR VSP TO PURCHASE VISIONWORKS OF AMERICA, INC. 
On June 27, 2019, Highmark Inc. and VSP Global® announced they have entered into a definitive agreement that provides for VSP Global's acquisition of Visionworks of America, Inc. Highmark is the majority owner of Visionworks.

"In today's fast changing health care marketplace, this is a win-win transaction that will best serve the needs of Highmark customers and members, VSP Global and Visionworks clients, members and customers, and the communities that we each serve," said Karen Hanlon, Chief Operating Officer of Highmark Health, Highmark's parent company. 

The proposed transaction will provide Highmark additional capital to continue to invest in its core businesses and in Highmark Health's strategy of integrating health care delivery and insurance coverage in its new patient-centered, clinician-led, and value-based model that improves health care quality, access and affordability. 

For more details, view the Press Release here. 
Highmark Blue Shield is an independent licensee of the Blue Cross Blue Shield Association. Insurance or benefit administration may be provided by Highmark Blue Shield or one of its affiliated companies.
 

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