Many patients celebrate UPMC-Highmark agreement, but some remain skeptical |

Many patients celebrate UPMC-Highmark agreement, but some remain skeptical

Dillon Carr
Louis B. Ruediger | Tribune-Review
Jack Swanger of New Kensington has had multiple sclerosis for nearly 30 years, and the same UPMC doc for 25 years. Swanger and his wife, Kathy, love their UPMC doctor, who they have built a rapport with all these years.
Erin Ninehouser (left), spokeswoman for the Pennsylvania Health Access Network advocacy group, and Vicki Arnett (center), whose husband is a cancer patient from Western Pennsylvania, and Allegheny County Controller Chelsa Wagner (second from right) were among several speakers during a May 14, 2019 rally in Harrisburg calling for urgent legislative intervention in the looming UPMC-Highmark divorce. Arnett’s husband is traveling to Atlanta for cancer treatments because as of July 1 his Highmark insurance will be considered out-of-network at most UPMC facilities, including the Hillman Cancer Center.
The UPMC and Highmark buildings in Downtown Pittsburgh.

Thousands of patients across Western Pennsylvania breathed a unified sigh of relief after hearing news of a deal being struck between UPMC and Highmark.

Kathy and Jack Swanger watched Pennsylvania Attorney General Josh Shapiro’s news conference live on television from their home in New Kensington.

“In some ways, it’s like hitting the lottery,” Kathy Swanger said. Her husband, Jack, has multiple sclerosis and has seen UPMC’s Dr. Rock Heyman for roughly 25 years.

Some celebrated with a touch of skepticism.

Vicki Arnett of Monroeville said she broke into tears when she heard the news that UPMC and Highmark struck a truce to preserve patient access for another 10 years.

“I’m partly elated — it’s wonderful,” she said. “But, I have a lot of emotions. We’re conflicted.”

Shapiro said Monday that health giants UPMC and Highmark entered into an agreement that will provide Highmark customers with in-network access to UPMC facilities until 2029. The deal applies to nearly all patients in the region.

Kathy Swanger said she was not surprised entirely by the news but that she had started making calls last week to make arrangements for a new primary care provider.

“I’m so grateful … we’re not giving up these two doctors,” she said. “Because it’s like a lifeline you have when you make relationships with your doctor.”

The announcement comes six days before the expiration of a 2014 state-brokered consent decree signed by UPMC and Highmark.

Arnett and her husband, Maurice, have made up to six trips to Atlanta since he was diagnosed with an aggressive form of cancer in October. The couple decided to get treatment at Cancer Treatments of America because of the looming deadline that meant UPMC doctors and specialty centers would go out-of-network for most Highmark-insured patients starting July 1.

“We wanted to go with Hillman Cancer Center all along,” Vicki Arnett said. “But, because we have Highmark (insurance), unless he was miraculously cured, to interrupt his care didn’t make sense.”

Although she is happy the health giants are now agreeing to work together, she still has several lingering questions.

“What about the time we lost with this whole fight?” she said. “Can UPMC and Highmark guarantee, after 10 years, that they can work together still? How are they going to work together after being such bitter enemies?”

For others, the news was easier to digest.

“I’m happy. Why they didn’t decide to do this earlier, I don’t know,” said Nancy Spohn, of Renfrew in Butler County. “We’ve all been dealing with the anxiety and anguish. Especially cancer patients, we’re fighting for our lives.”

Spohn, 67, was just finishing up an appointment for blood work at Magee-Womens Hospital when she heard the news from someone in the office. She was diagnosed with ovarian cancer more than three years ago.

Since then, she switched several doctors to be in-network with her husband’s Highmark PPO Blue plan, which the couple has had for 50 years, she said.

Spohn now will keep those and not switch again. But she was going to wait until the last minute to change her oncologist.

“I was going to make the decision to change (oncologists) if they didn’t come to an agreement,” Spohn said. “I’m not going to switch my care again.”

Tim and Sherri Garrow heard the news from a family member and saw the notifications on their phones.

“We’re overjoyed,” said Tim Garrow of Avon, Ind. “We would feel better if it was a permanent solution … but we’ll take 10 years.”

Sherri Garrow was diagnosed with multiple sclerosis in 1994, when the couple still lived in the South Hills.

She began to be treated by Dr. Heyman after seeing three others and over the years has grown to love and trust him. The couple decided to keep visiting Heyman after moving to Indiana in 2013. The trip, there and back, takes 12 hours.

They made that trip in May and thought it would be their last.

“It was bittersweet,” Sherri Garrow said. “I hated to say goodbye.”

Dillon Carr is a Tribune-Review staff writer. You can contact Dillon at 412-871-2325, [email protected] or via Twitter .

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