ShareThis Page

UPMC feud with Highmark highlighted in national article

Ben Schmitt
| Wednesday, Feb. 14, 2018, 11:12 a.m.
UPMC President and CEO Jeffrey Romoff
UPMC President and CEO Jeffrey Romoff
Highmark Health CEO David Holmberg
Justin Merriman | Tribune-Review
Highmark Health CEO David Holmberg

The war between local health giants UPMC and Highmark Health drew national attention in a story published this week by the Washington Post.

The bitter feud between UPMC and Highmark dates back years and reached a peak in 2014 when their longstanding commercial contract expired. The contract gave Highmark insurance customers in-network access to UPMC doctors and hospitals. A state-brokered consent decree sought to smooth the transition and shield patients from the fallout, but the rivals clashed over its interpretation.

The consent decree that has preserved access for some Highmark members to UPMC hospitals expires in 2019.

During the height of the dispute, Highmark formed its own hospital system, Allegheny Health Network.

Last year, the Pennsylvania Insurance Department gave Highmark Health greater flexibility to invest in AHN, loosening requirements the department imposed when it allowed Highmark to form the hospital system.

The Post article describes the feud as such: "They could be mirror images of each other, flipped upside down. UPMC started out in the hospital business, then created its own health insurance plan and built a $20 billion-a-year enterprise. Highmark, which reported $18.2 billion in revenue last year, announced in 2011 that it would branch from insurance into hospitals."

Highmark CEO David Holmberg told the Post he is not as focused on advancing research but rather on providing quality health care.

"I want to keep people healthy; I want to keep them out of the hospital. Think of it like a consumer market," Holmberg said. "You can do things differently because you're not worried about heads and beds. You're not trying to fill up the hospitals."

UPMC unveiled plans in November to invest $2 billion to build three specialty hospitals in Pittsburgh focused on cancer, organ transplants, and heart and vision care. At the time, UPMC president and CEO Jeffrey Romoff said the health giant desires to be "the Amazon of health care."

He reiterated that desire in the Post.

"There's nothing in health care, that we know of, that UPMC doesn't have an entry into that marketplace," he said.

On Tuesday, the University of Pittsburgh and UPMC announced a partnership in a $200 million venture to bolster immunotherapy research and potentially spur economic development throughout Western Pennsylvania. The UPMC Immune Transplant and Therapy Center will be at 5000 Baum Blvd., a century-old, 200,000-square-foot building constructed by Ford Motor Co. that once served the dual purpose of assembly plant and showroom. When it opens in 2020, the center will focus on three areas: transplantation, cancer, and aging and chronic diseases.

Ben Schmitt is a Tribune-Review staff writer. Reach him at 412-320-7991, or via Twitter at @Bencschmitt.

TribLIVE commenting policy

You are solely responsible for your comments and by using you agree to our Terms of Service.

We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.

While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.

We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers

We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.

We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.

We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.

We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.

click me