UPMC and Highmark, both in Pittsburgh, inked a deal ensuring Highmark policyholders in-network access to UPMC’s community and specialty hospitals.
Here are four things to know about the agreement.
- The Jan. 4 deal includes 10-plus UPMC Pittsburgh-area specialty hospitals and community hospitals statewide where UPMC is the only provider.
- The agreement between the rival health systems has been in the works since August, the Pittsburgh Post-Gazette reports. UPMC and Highmark signed consent decrees in 2014 providing in-network access for the companies’ customers. However, those agreements expire at the end of June 2019.
- The new agreement assures Highmark policyholders in-network status for UPMC’s joint venture cancer programs through 2021 or 2024, depending on the hospital. Community hospitals under the agreement will see in-network access extended to Highmark members until 2024 or 2025. A separate deal ensures Highmark policyholders will have access to Children’s Hospital of Pittsburgh of UPMC providers at in-network rates until 2022.
- Some Highmark members could still face out-of-network prices at several other Pennsylvania hospitals in 2019. These locations include Erie-based UPMC Hamot, Greenville-based UPMC Horizon, Hillman Cancer Center in Pittsburgh and just about every other UPMC community hospital in Allegheny County, the Pittsburgh Post-Gazette reports.
Date: Jan 05, 2018