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Employers push Highmark, UPMC for details of transition plan

| Tuesday, June 10, 2014, 12:01 a.m.
Justin Merriman
The fueding companies are being pressed to release a report on which UPMC facilities and services will be available to Highmark members when a contract between the two expires at the end of the year.

A group representing many of Pittsburgh's largest employers wants Highmark Inc. and UPMC to quickly release a detailed report on which UPMC facilities and services will be available to Highmark members when a contract between the two feuding companies expires at the end of the year.

Pittsburgh Business Group on Health, which represents Western Pennsylvania employers who provide health coverage to about 250,000 people, said a state-mandated deadline of July 31 for a transition plan is “too late” for companies that need to make decisions now about health insurance for their employees.

“There needs to be a greater sense of urgency on the part of Highmark and UPMC to resolve outstanding issue and publish complete transitional plans so employers can make good, sensible decisions about their company's health plans,” said Jessica Brooks, executive director of the group.

The group is asking for greater involvement in and transparency from state officials who are sitting down with UPMC and Highmark officials to discuss what will happen to Highmark members with UPMC doctors.

When a reimbursement contract that gives Highmark members in-network access to UPMC's doctors and hospitals expires at the end of this year, Highmark members will have to pay costly out-of-network rates at UPMC.

UPMC has refused to renew the contract because Highmark has begun a rival hospital system, the Allegheny Health Network.

Gov. Tom Corbett last week called for UPMC and Highmark officials to begin discussions on a transition plan. The first meeting of Corbett's “Patients First” team took place at the end of last week, but no details of the meeting were released.

“While we think it was vitally important for Gov. Corbett to encourage discussion between Highmark and UPMC, and applaud his directive, we have heard similar requests over the last two years from local, regional and state officials that has not yet led to a clear resolution, or furthermore, clarity regarding a viable transition effort for employees,” Brooks said.

Highmark, which has been advocating for a new contract with UPMC, “appreciates the support of the business community,” spokesman Leilyn Perri said. “Highmark will continue to work towards an agreement that benefits our customers and the entire community.”

UPMC spokesman Paul Wood said the hospital system looks forward to working with the Corbett administration “on their collective goal of the best possible, patient-focused transition plan as the contracts expire at the end of this year.”

The Pittsburgh Business Group on Health has more than 70 members, including University of Pittsburgh, Giant Eagle, Dick's Sporting Goods, the city of Pittsburgh and Alcoa.

In a March survey of its members, the group found that nearly two-thirds of respondents said they thought UPMC should be legally required to contract with Highmark. But barring a resolution, 28 percent of the group's members said they would replace their Highmark health plans with a carrier that will have full access to UPMC next year. And 53 percent said they would offer their employees a choice of Highmark and a plan from Aetna Inc., Cigna Corp., United Healthcare or UPMC Health Plan.

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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