UPMC Health Plan has made its first big splash in Central Pennsylvania.
The Western Pennsylvania powerhouse is just starting to offer plans to businesses and working-age adults in parts of this region.
This week, Tower Health in Berks County said Independence Blue Cross had ended their contractual relationship because of Tower’s partnership with UPMC Health Plan.
“In addition to rate reductions, IBC included a non-compete provision in the service areas of the Tower Health/UPMC Health Plan products,” a Tower release said.
Tower said IBC “has chosen to restrict access to the low cost, quality providers in our markets,” and that Tower “is, and will continue to be, a participating provider in Tower Health/UPMC Health Plan, Aetna, Cigna, Capital Blue Cross, Highmark, United HealthCare, and other health plans.”
A written statement from IBC Facilitated Health Networks president Dr. Anthony V. Coletta called its rejected proposal fair and reasonable “based on our careful consideration of various factors, including the potential long-term impacts to Independence customers.”
“While we are very disappointed with this outcome, our biggest concern right now is addressing the immediate needs of our members,” he wrote on Oct. 1. “We are committed to providing coverage for our members at in-network levels at the five hospitals, entities and physicians they employ, during at least the next 30 days.”
UPMC Health Plan is the insurance arm of UPMC, which became owner of two Lancaster County hospitals on Sept. 1 and has also recently entered several other counties in the region.
Formerly known as Reading Health System, Tower Health assumed its new name on Oct. 1 after finalizing the purchase of five hospitals formerly owned by Community Health Systems Inc.
Its partnership with UPMC Health Plan is a provider-payer joint venture that started in January 2017.
Date: Oct 03, 2017