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Highmark adds 10 doctors; total tops 150

| Wednesday, April 3, 2013, 12:01 a.m.

Highmark Inc. has hired 10 doctors in the last several days as the state's largest health insurer prepares for a decision by state regulators on its plan to buy a hospital network at the core of a health care system it is building.

Highmark, which plans to compete against UPMC to provide medical services in Western Pennsylvania, said on Tuesday that it acquired Triangle Urological Group, adding to its growing cadre of doctors who are essential to the system's financial success.

With the hirings, Highmark employs more than 150 physicians, spokesman Aaron Billger said.

Highmark is waiting for state regulators to sign off on its acquisition of West Penn Allegheny Health System, the five-hospital network that is essential to the insurer's bid to go head-to-head with UPMC, the biggest hospital network in the region.

Dr. Ralph Miller Jr., a senior physician with urology group, said he was optimistic that Highmark's more than $1 billion deal for West Penn Allegheny would go through.

“Of course we're concerned about what we read and what's going on with the acquisition,” Miller said. “But I think we have to have faith that issues like this will be resolved in a positive way for the community.”

In addition to Triangle's seven physicians, the health insurer on Monday said it hired UPMC colorectal surgeon Dr. Sherif Rizk; on Friday, Highmark said it acquired a two-neurosurgeon practice in Butler.

Highmark's head count is a drop in the bucket compared with UPMC's more than 3,300 doctors. But without specialists to refer patients into the system, Highmark is unlikely to succeed in turning around financially troubled West Penn Allegheny, experts have said.

“We thought we could best achieve what we want to achieve by partnering with Highmark,” Miller said.

Triangle is based in the North Side and has six offices in Western Pennsylvania, he said. It has treated 27,500 patients in the last three years.

Miller said the group considered remaining independent or joining UPMC, but decided on Highmark because the insurer is pushing new payment models that reimburse doctors for keeping patients healthy, rather than simply paying them every time they treat a patient.

Eliminating the traditional fee-for-service model is viewed as a way to reduce the nation's runaway health costs.

“In general, when changes are coming along, you want to have a voice about how things are structured for the benefit of patients,” Miller said.

The health insurer started acquiring independent physician practices and hiring specialists away from UPMC in early 2012 as it began what it's calling an integrated delivery network. Since announcing plans to acquire West Penn Allegheny in June 2011, it completed the purchase of Jefferson Regional Medical Center and is nearing the close of a deal to buy St. Vincent Health System in Erie.

It broke ground on a $100 million outpatient medical center in Pine and has established a group purchasing company to reduce the cost of buying medical supplies for its hospitals.

“Our (integrated delivery network) objective is centered around creating a vibrant network of independent community hospitals; an aligned network of physicians, both primary care and specialists; broader choice in health care services; and more convenient access to innovative ambulatory services,” Billger said.

The West Penn Allegheny acquisition is the final piece in the puzzle. Highmark has asked that the state Insurance Department issue a decision by the end of this month, when a deal for Highmark to buy West Penn Allegheny's bond debt expires.

Insurance Commissioner Michael Consedine has said he's aware of the timing, but won't be rushed into making a decision.

A deadline in the bond deal “doesn't dictate our time line,” Consedine told the Tribune-Review last month. “We've never committed to April 30.”

Alex Nixon is a staff writer for Trib Total Media. He can be reached at 412-320-7928 or anixon@tribweb.com.

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